Evaluation of the effectiveness of diode laser on pain and edema in individuals with cleft lip and palate submitted to secondary bone graft.

OBJECTIVE : To clinically evaluate the effects of diode laser, Gallium-Aluminum-Arsenide laser (GaAlAs), on the pain and edema after secondary alveolar bone graft. DESIGN : Case-control, double-blind study. Setting : Institutional tertiary referral hospital. Participants : The sample was composed of 60 individuals with complete unilateral cleft lip and palate, of both genders, aged 9 to 15 years, submitted to secondary alveolar bone graft. MAIN OUTCOME MEASURES : The individuals were divided into an experimental group (patients irradiated with diode laser GaAlAs, energy density of 4 J/cm(2), power of 100 mW, and wavelength in the infrared spectrum, for 10 seconds per point on 10 points, adding up to a dose of 40 J/cm(2)) and a placebo group (simulated laser application for 60 seconds per point, also on 10 points). Applications were made on the receptor site immediately postoperatively and after 24 and 48 hours. The pain and edema were assessed preoperatively and at each application. RESULTS : The two groups presented increase in pain and edema in 24 and 48 hours. No statistically significant difference was found between groups. CONCLUSIONS : According to the present methodology, the use of low-level laser to control the pain and edema in the postoperative period of secondary alveolar bone graft was not effective.

Avaliação da cicatrização de defeitos ósseos criados cirurgicamente em calvárias de ratos e tratados com enxertos de origem bovina (Bio-Oss®) associados ao laser de baixa intensidade: estudo histológico e histométrico / Evaluation of healing of surgically created bone defects in rat calvaria treated with bovine grafts (Bio-Oss®) associated with low level laser: histological and histometric study

O propósito deste estudo foi avaliar, histologicamente, o efeito do laser de baixa intensidade na cicatrização óssea de defeitos de tamanho crítico (DTC- 5mm) criados cirurgicamente em calvárias de ratos, quando associado ou não ao osso bovino inorgânico (Bio-Oss®). 60 ratos machos (Rattusnorvegicus, albinus, Wistar) foram divididos em 6 grupos: C (controle), L (Laser de Baixa Intensidade - GaAlAs, 730nm, 100mW, 6J, 210J/cm2), AO (Osso Autógeno) OAL (Osso Autógeno + Laser de Baixa Intensidade), BO (Osso Bovino Inorgânico), BOL (Osso Bovino Inorgânico + Laser de Baixa Intensidade) . Os animais foram submetidos à eutanásia após 30 dias. A quantidade de osso neoformado e a área de partícula remanescente dos materiais implantados foram calculadas como porcentagem da área do defeito original. Os dados foram submetidos à análise estatística (Teste de Kruskal - Wallis, Teste de Dunn; p<0,05). Os grupos irradiados com laser de baixa intensidade, L (47,67% ± 8,66%), OAL (39,15% ± 16,72%) e BOL (48,57% ± 28,22%) apresentaram maior área de neoformação óssea que os grupos C (9,96% ± 4,50%), OA (30,98% ± 16,59%) e BO (11,36% ± 7,89%) que não foram irradiados. Além disso, foram significativamente melhores que o Grupo C. Dentro dos limites deste estudo, conclui-se que o laser acelerou o processo de neoformação óssea e de reabsorção das partículas dos materiais de enxertia, podendo ser considerado uma modalidade terapêutica interessante a ser associada com biomateriais em cirurgias ósseas reconstrutivas.

This study histologically evaluated the effect of low level laser on the bone healing of critical size defects (CSD- 5mm) surgically created in rat calvaria, associated or not with inorganic bovine bone (Bio-Oss®). Sixty male rats (Rattus norvegicus, albinus, Wistar) were divided in 6 groups: C (control), L (low level laser - GaAlAs, 730nm, 100mW, 6J, 210J/cm2), AO (autogenous bone) OAL (autogenous bone + low level laser), BO (inorganic bovine bone), BOL (inorganic bovine bone + low level laser). The animals were killed after 30 days. The quantity of newly formed bone and area of remaining particles of the implanted materials were calculated as percentages of the original defect area. Data were statistically analyzed (Kruskal Wallis test, Dunn test; p<0.05). The groups irradiated with low level laser, L (47.67% ± 8.66%), OAL (39.15% ± 16.72%) and BOL (48.57% ± 28.22%) presented greater area of new bone formation than the groups C (9.96% ± 4.50%), OA (30.98% ± 16.59%) and BO (11.36% ± 7.89%), which were not irradiated. Also, they were significantly better than group C. within the limits of this study, it was concluded that the laser accelerated the new bone formation and resorption of particles of graft materials, thus it may be considered an interesting therapeutic option for association with biomaterials in reconstructive bone surgeries.

Esthetic composition of smile in individuals with cleft lip, alveolus, and palate: visibility of the periodontium and the esthetics of smile.

Objective. To evaluate characteristics of smile related to visibility in individuals with cleft lip, alveolus, and palate. Design. Cross-sectional. Setting. HRAC/USP, Brazil. Patients. Individuals with repaired complete unilateral cleft lip and palate (n = 45), aged 15-30 years. Interventions. Frontal facial photographs were obtained in natural and forced smiles (n = 135). Six specialists in periodontics evaluated the photographs as to the smile line, thickness, and curve of the upper lip. Main Outcome Measures. The cleft area was compared with the contralateral region. Results were expressed as percentages and means. The findings were compared between groups of periodontists. Results. Statistically significant relationship was observed in the smile line between examiners and between natural and forced smiles, regardless of the association with the cleft side. The lip was thicker at rest and thinner in the forced smile, as also evaluated by the group not experienced with cleft care. The curve of the upper lip in natural and forced smiles was considered as close to straight by both groups, regardless of the cleft. Conclusion. The smile in individuals with clefts was regarded as average for both cleft and noncleft sides. The thickness was characterized as average to thin, being thinner in forced smile and when analyzed by the group not experienced with cleft care. In the average, the curve of the upper lip was considered as straight. The present study elucidates some characteristics related to the smile in individuals with repaired unilateral cleft lip, alveolus, and palate.

Amelogênese imperfeita em paciente nefropata: relato de uma reabilitação oral conservadora / Amelogenesis imperfecta in a patient with kidney disease: a report of a conservative oral rehabilitation

Amelogênese imperfeita é uma doença hereditária que afeta a formação do esmalte, tanto na dentição decídua como na permanente. Ela também pode ser associada com alterações morfológicas e bioquímicas em outra parte do corpo. O diagnóstico da amelogênese imperfeita envolve a exclusão de fatores ambientais e o estabelecimento de um provável padrão de herança genética, reconhecimento do fenótipo e correlação com a formação do esmalte. Numerosas modalidades de tratamento têm sido descritas para a reabilitação de pacientes com amelogênese imperfeita. No entanto, tem-se buscado reabilitar de maneira conservadora e com um enfoque na prevenção dos efeitos dessa patologia. Este trabalho tem por objetivo relatar um caso clínico de reabilitação estética e funcional por meio do uso de resinas compostas, em um paciente com amelogênese imperfeita e que apresentava hiperplasia gengival devido ao uso de imunossupressores. Pôde-se concluir que é possível melhorar a estética e restabelecer a função destes pacientes através de procedimentos e técnicas simples e de baixo custo.

Amelogenesis imperfecta is a hereditary disease that disrupts enamel formation, affecting both the deciduous and permanent teeth. It can also be associated with morphological and biochemical changes elsewhere in the body. The diagnosis of amelogenesis imperfecta involves the exclusion of environmental factors and the establishment of a likely pattern of inheritance, recognition of the phenotype and correlation with enamel formation. Numerous treatment modalities have been described for the rehabilitation of patients with amelogenesis imperfecta. However, rehabilitation is preferably conservative, focusing on preventing the effects of this pathology. The aim of this paper is to report a case of aesthetic and functional rehabilitation of a patient with amelogenesis imperfecta and immunosuppressant-induced gingival hyperplasia using composite resins. In conclusion, it is possible to improve the aesthetics and restore the function of these patients with simple and inexpensive procedures and techniques.