Systemic vascular photobiomodulation accelerates the recovery of motor activity in rats following spinal cord injury.

OBJECTIVES: Spinal cord injury (SCI) causes the discontinuity of the spinal canal, leading to functional and sensorial losses in areas below the injury, which are often irreversible. Photobiomodulation (PBM) can enhance the neuromuscular repair process, especially in cases of peripheral nerve injuries. However, there is little knowledge regarding the effects of this therapeutic modality on recovery following a SCI, especially the noninvasive systemic form denominated vascular PBM (VPBM). To analyze the effects of VPBM in the immediate, acute and intermediate phases following a compression-induced SCI on morphological aspects of neuromuscular tissue repair, functional recovery and the protein expression of brain-derived neurotrophic factor (BDNF). METHODS: Wistar rats were divided into five groups: control, SCI, SCI + VPBM-Im (immediate administration of VPBM), SCI + VPBM-2h (VPBM administered 2 h after injury) and SCI + VPBM-14d (VPBM administered 14 days after injury). VPBM was administered in the region of the caudal vein/artery with low-level laser (AsGaAl, 780 nm, 80 J/cm², 40 mW for 80 s, totaling an energy of 3.2 J over a single point) for 14 consecutive days. During the analysis periods (1, 3, 7, 14, 21, 28 and 35 days after injury), functioning was evaluated using the Basso-Beattie-Bresnahan (BBB) index. At the end of each experimental period, blood samples were collected for the determination of the concentration of circulating BDNF using ELISA. Muscle tissue and nerve tissue samples were also extracted for morphological and histological analyses using H&E staining. RESULTS: SCI + VPBM-Im and SCI + VPBM-2 h led to the recovery of motor function beginning on the 7th day after injury (p < 0.05), an increase in the cross-sectional area (CSA) of the muscle fibers in the second week (p < 0.05) and an increase in muscle fiber diameter beginning on Day 14 (p < 0.05). Early irradiation had a greater effect on the reduction in the size of the cavity, with stabilization of the cavity found on Day 7 (p < 0.05). Considering the circulating BDNF levels, no changes was found during the experimental periods. CONCLUSION: The present results showed that VPBM was capable of modulating morphological and functional recovery following SCI, especially when administered early. The positive effects on functional recovery were demonstrated by the BBB index; the reestablishment of the structure of the muscle and nerve tissue was demonstrated by the preservation of CSA and diameter of muscle fiber and reduction in the area of the injury (cavity size) respectively. Thus, noninvasive VPBM may be an important component of treatment for spinal cord injuries.

Photobiomodulation is effective in oral lichen planus: A randomized, controlled, double-blind study.

OBJECTIVES: To compare the efficacy of photobiomodulation to that of topical clobetasol 0.05% in patients with symptomatic oral lichen planus (OLP). SUBJECTS: Thirty-four patients with symptomatic OLP were randomly allocated into two groups: (a) the Control group (n = 17), application of topical clobetasol propionate 0.05% three times a day for 30 consecutive days with laser placebo applied twice a week to mask the treatment, and (b) the photobiomodulation group (n = 17), laser application twice a week, totalling 8 sessions, and gel placebo for 30 consecutive days to mask the treatment. Evaluations were performed once a week during treatment and 30, 60 and 90 days after treatment. The following parameters were evaluated: pain, clinical scores, clinical resolution and recurrence rate. RESULTS: Photobiomodulation and propionate clobetasol 0.05% were able to significantly decrease pain in oral lichen planus patients and improve clinical scores during treatment and follow-up. Both the Control and photobiomodulation groups presented similar clinical resolution and recurrence rates. Most importantly, no difference was observed between treatments during treatment and follow-up. CONCLUSIONS: These findings indicate that photobiomodulation twice a week is as effective as corticoid therapy in treating oral lichen planus. Moreover, photobiomodulation is a safe and non-invasive therapy with the remarkable advantage of no adverse effects.

Effects of Photobiomodulation with Low-level Laser Therapy on Muscle Repair Following a Peripheral Nerve Injury in Wistar Rats.

Peripheral nerve injury (PNI) can lead to sensory and/or motor impairment. As a treatment photobiomodulation (PBM) has demonstrated positive effects in terms of the maintenance of muscle activation and trophism. Wistar rats were divided into five groups: control, injury, injury + PBMn (irradiation over injured nerve), injury + PBMm (irradiation over affected muscle) and injury + PBMnm (irradiation over nerve and muscle). The left sciatic nerve was submitted to a crushing injury. Treatment was administered with low-level laser (780 nm, 0.04 cm2 , 1 W cm-2 , 3.2 J) over the injured nerve and/or the tibialis anterior muscle. The effects of PBM were favorable on muscle morphology and gene expression of calcineurin, myogenin and acetylcholine receptors. PBM led to an acceleration on muscle repair process, and effects were more evident in 2 weeks after PNI. Thus, PBM is indicated for the area over both the injured nerve and the affected muscle.

Occlusal adjustment associated with periodontal therapy--a systematic review.

OBJECTIVES: Occlusal adjustment as part of periodontal therapy has been controversial for years, mostly because the literature does not provide enough evidence regarding the influence of trauma from occlusion (TfO) on periodontitis. The need for occlusal adjustment in periodontal therapy is considered uncertain and requires investigation. The aim of this systematic review was to identify and analyse those studies that investigated the effects of occlusal adjustment, associated with periodontal therapy, on periodontal parameters. DATA: A protocol was developed that included all aspects of a systematic review: search strategy, selection criteria, selection methods, data collection and data extraction. SOURCES: A literature search was conducted using MEDLINE via PubMed, the Cochrane Central Register of Controlled Trials, and EMBASE. STUDY SELECTION: Three reviewers screened the titles and abstracts of articles according to the established criteria. Every article that indicated a possible match, or could not be excluded based on the information given in the title or abstract, was considered and evaluated. On final selection, four articles were included. CONCLUSIONS: Although the selected studies suggest an association between occlusal adjustment and an improvement in periodontal parameters, their methodological issues (explored in this review) suggest the need for new trials of a higher quality. There is insufficient evidence at present to presume that occlusal adjustment is necessary to reduce the progression of periodontal disease. CLINICAL SIGNIFICANCE: Although it is still not possible to determine the role of occlusal adjustment in periodontal treatment, adverse effects have not been related to occlusal adjustment. This means that the decision made by clinicians whether or not to use occlusal adjustment in conjunction with periodontal therapy hinges upon clinical evaluation, patient comfort, and tooth function.

Médias de tempo despendidas a execução de atividades clínicas por alunos de graduação da disciplina de clínica integrada da Faculdade de Odontologia da Universidade de São Paulo / Average time expended for the acomplishment of several clinical activities, by graduation students of ntegrated clinics in dentistry school of University of São Paulo

Este estudo avalia a média de tempo despendida na execução de diversas atividades clínicas em pacientes, pelos alunos do Curso de Graduação na Disciplina de Clínica Integrada da FOUSP, com o intuito de contribuir para a avaliação do nível de aprendizado e para o aperfeiçoamento do processo educacional em Odontologia. Através da utilização, pelos alunos, de relógios digitais, (cronômetros), fez-se a mensuração de tempo das atividades propostas. Os dados coletados foram submetidos a análise estatística (média, desvio padrão e análise de variância -Teste "t" ). Foi elaborado também um diagrama de desvio-padrão que possibilita a aferição dos graus de complexidade nas diversas atividades e promove a avaliação do binômio ensino/aprendizado. Pode-se concluir através dos resultados que: I) A média de tempo despendida na execução de exames clínicos, moldagens de estudo, e procedimentos básicos em periodontia, enquadram-se em padrões aceitáveis embora possam apresentar diferentes graus de' complexidade. 2) Exodontias de elementos posteriores demandam em média de tempo superior à sua execução em comparação a elementos anteriores, sendo que ambas as atividades, parecem envolver o mesmo grau de complexidade. 3) Nas três etapas do tratamento endodôntico (abertura, preparo químico mecânico e obturação de condutos) a média de tempo utilizada em elementos unirradiculares é inferior a elementos birradiculares. O grau de complexidade dos elementos uni e birradiculares é similar.