Effect of low-level laser stimulation of acupuncture points in pediatric dentistry: a systematic review.

The biomodulatory potential of low-level laser therapy (LLLT) has prompted investigations of different outcomes in health. One line of research is the stimulation of acupuncture points for the relief of different signs and symptoms related to the stomatognathic system. In dentistry, some studies in pediatric dentistry have demonstrated the benefit of LLLT therapies in the management of dental anxiety in children. This systematic review aimed to analyze previous clinical studies on the application of LLLT at acupoints among pediatric dental patients. This systematic review was conducted according to the Cochrane Collaboration guidelines and the population, intervention, comparison, and outcome strategy. A broad literature search up to June 17, 2022, was performed using four electronic databases (PubMed, Scopus, Embase, and Google Scholar). The risk of bias in randomized clinical trials was assessed using the RoB 2 tool. A total of four studies using LLLT for photobiomodulation were included (n = 4). The most common wavelengths used were in the infrared range (variation between 716 nm and 980 nm). There were little variations in the application time (14 s to 1 min) and exposure dose (1 to 5 joules). LLLT acted positively on different acupuncture points. LLLT provided various benefits and optimized dental practice by reducing the gag reflex during radiography and impression taking, preanesthetic pain, and symptoms of sleep bruxism in the pediatric dental population. Only one of the evaluated studies had a high risk of bias. The LLLT at acupuncture points is associated with positive results on sleep bruxism, preanesthetic pain, and gag reflex in pediatric dentistry. Future research studies should prioritize standardization of the study design and the methods of analysis.

VEGF and FGF-2 Released In Palatal Suture after Rapid Maxillary Expansion (RME).

Vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (FGF-2) have the ability to increase vascular proliferation and permeability. The aim of this study was to quantify the release of two diffusible angiogenic growth factors (VEGF and FGF-2) after rapid maxillary expansion (RME). Thirty animals were randomly assigned to two groups. Control group (5 rats - intact suture) and Experimental groups (25 rats with RME) which were evaluated in different periods of treatment. Five animals were euthanized in different periods of healing at 0, 1, 2, 3, 5 and 7 days after RME. RT-PCR was used to evaluate the gene expression of angiogenic growth factors released on different periods of study. Data were submitted to statistical analysis using ANOVA followed by Tukey test and significance was assumed at a=0.05. RT-PCR showed that mRNAs of VEGF and FGF-2 were expressed in intact palatal suture tissue. mRNAs of VEGF and FGF-2 was upregulated in early periods (24 h) after RME (p<0.001 and p<0.01, respectively). The molecular levels of VEGF never returned to its original baseline values, and FGF-2 expression decreased up to day 5 (p<0.001) and suddenly increased at day 7, returning to its original level. RME increased VEGF secretion, but decreased FGF-2 secretion when compared to intact tissue. The results showed that these angiogenic growth factors are released and regulated in the palatal suture tissue after RME and could make an important contribution to the knowledge of overall reparative response of the suture tissue during the bone remodeling process.

Oral rehabilitation in a patient with Jeune syndrome presenting with multiple teeth agenesis.

Jeune syndrome (JS) is a rare disease, with systemic manifestations, such as renal and hepatic insufficiency, retinal pigmentation, and respiratory insufficiency. Etiological factors have not been completely elucidated, but the molecular biology has contributed to the diagnosis and understanding of JS with DNA sequencing, showing the association among polymorphisms in different genes DYNC2H1 (MIM 603297) and TCTEX1D2 (MIM617353), which are the main genes associated with JS. There are a few reports on buccal findings in these patients; here, we present dental anomalies and clinical oral findings in a patient with JS, focusing on a multidisciplinary approach for rehabilitation. A 15-year-old boy with JS was referred to our dental clinic. Clinical and radiographic examination revealed the presence of dental agenesis, taurodontism, and geographic tongue with lobulations. The treatment plan consisted of preventive, restorative, surgical, and oral rehabilitation. We observed that the treatment improved the patient's quality of life owing to improved functions, maintenance of oral health, and above all, self-esteem. Clinical findings in this case may contribute to a better characterization of JS and other ciliopathies.

Orofacial findings and dental care management in a patient with Robinow Syndrome

Introduction: Robinow syndrome is a rare genetic disorder of skeletal development. It is characterized by short stature, facial dysmorphisms and orodental anomalies, underdeveloped genitalia, mesomelic brachymelia. Case Report: A 6 year old girl with Robinow Syndrome was referred in the Center for Formation of Human Resources Specialized in Dental Care to Special Needs Patients (Ribeirão Preto, São Paulo, Brazil) for evaluation. Medical history investigation and clinicalexamination were observed in short stature, facial dimorphism and hypoplastic genitalia. Orofacial findings showed retrognathism, a mid-line hemangioma approximately 1 cm wide with upturned borders, bifid tongue, ankyloglossia, general gingival hypertrophy, deep bite and mild tooth crowding. Cardiac abnormality and neuromotor developmental delay consisted of systemic manifestations present which demanded individualized dental care. The dental treatment consisted of preventive and restoratives procedures to adequate the oral health condition of the patient and orthodontic treatmentwas planned. The patient has been in follow-up for six years. Conclusion: Orofacial anomalies andother alterations found in the present case contributed to complement the orofacial findings described in the literature and to assist in diagnosis of the syndrome. In this case, amultiprofessional team and integral treatment were essential to rescue oral health and improvelife quality of the patient.

Introdução: A síndrome de Robinow é uma doença genética rara caracterizada por baixa estatura, dismorfismos faciais e anomalias orodentais, genitália subdesenvolvida e falhas no desenvolvimento esquelético. Relato de Caso: Uma paciente de 6 anos com Síndrome de Robinow foi encaminhada ao Centro de Formação de Recursos Humanos Especializado no Atendimento Odontológicode Pacientes com Necessidades Especiais (Ribeirão Preto, São Paulo, Brasil). Na investigação da história médica e ao exame clínico foram observados baixa estatura, dismorfismo facial e genitália hipoplásica. Os achados orofaciais mostraram retrognatismo, hemangioma de linha média de aproximadamente 1 cm de largura com bordas voltadas para cima, língua bífida, anquiloglossia, hipertrofia gengival geral, mordida profunda e apinhamento dentário leve. A anormalidade cardíaca e o atraso no desenvolvimento neuromotor demandaram cuidados individualizados. O tratamento odontológico consistiu em procedimentos preventivos e restauradores para adequar a condição de saúde bucal da paciente. Além disso, foi realizada avaliação ortodôntica e planejamento do tratamento. A paciente está em acompanhamento há seis anos. Conclusão: Anomalias orofaciais e outras alterações encontradas no presente caso contribuíram para complementar os achados orofaciais na literatura e auxiliar no diagnóstico da síndrome. Neste caso, um plano de tratamento integral e equipe multiprofissional foram essenciais para resgatar a saúde bucal e propiciar melhor qualidade de vida à paciente.

In vivo evaluation of inflammation and matrix metalloproteinase expression in dental pulp induced by luting agents in dogs

Objectives: To evaluate the inflammatory tissue response and matrix metalloproteinase (MMP)-2 and -9 expression in the pulp-dentin complex in response to RelyX TM Unicem (RU) and Ketac Cem TM Easymix (KC) cements. Methods : Class V cavities were prepared in 56 teeth from six dogs, and indirect pulp capping was performed using RU (n=20), KC (n=20), zinc oxide, and eugenol cement (control, n=16). At 7 and 70 days following indirect pulp capping, the animals were euthanized, and tissues were removed for histological evaluation. The distance from the cavity floor to the odontoblastic layer was measured, and the numbers of inflammatory cells, fibroblasts, and odontoblasts were counted in pulp tissue. MMP-2 and -9 expression levels were immunohistochemically assessed. Statistical analyses were performed for all experiments (significance level=5%). Results : The dentin remnant thickness between the cavity floor and the pulp chamber was similar for all materials, ranging from 469 to 739 µm (p>0.05). At 7 days, KC and RU induced a small inflammatory response in the pulp-dentin complex, similar to the control (p>0.05). At 70 days, RU induced a tissue response characterized by fewer odontoblasts and more mononuclear cells (p<0.05), whereas KC induced a response similar to the control (p>0.05). Lutingagents induced low levels of MMP-2 and MMP-9 expression, similar to the control (p>0.05). Conclusion : KC and RU luting agents are compatible materials for use in deep cavities close to dental pulp tissue, although RU led to a slightly diminished odontoblastic population with a higher percentage of mononuclear cells.

Objetivo : Avaliar a resposta tecidual inflamatória e a expressão de metaloproteinase de matriz (MMP) -2 e -9 no complexo polpa-dentina em resposta aos cimentos RelyX TM Unicem (RU) e Ketac Cem TM Easymix (KC). Métodos : Cavidades classe V foram preparadas em 56 dentes de seis cães, e capeamento pulpar indireto foi realizado com cimento de RU (n = 20), KC (n = 20), óxido de zinco e eugenol (controle, n = 16). Aos 7 e 70 dias após o capeamento pulpar indireto, os animais foram eutanasiados, e os tecidos foram removidos para avaliação histológica. A distância entre o assoalho da cavidade e a camada odontoblástica foi medida, e os números de células inflamatórias, fibroblastos e odontoblastos foram contados no tecido pulpar. Os níveis de expressão de MMP-2 e -9 foram avaliados por imuno-histoquímica. Análises estatísticas foram realizadas para todos os experimentos (nível de significância = 5%). Resultados : A espessura da dentina remanescente entre o assoalho da cavidade e a câmara pulpar foi semelhante para todos os materiais, variando de 469 a 739 µm (p> 0,05). Aos 7 dias, KC e RU induziram uma pequena resposta inflamatória no complexo polpa-dentina, semelhante ao controle (p> 0,05). Aos 70 dias, a RU induziu uma resposta tecidual caracterizada por menos odontoblastos e mais células mononucleares (p <0,05), enquanto o KC induziu uma resposta semelhante ao controle (p> 0,05). Os agentes cimentantes induziram baixos níveis de expressão de MMP-2 e MMP-9, semelhantes ao controle (p> 0,05). Conclusão : Os agentes cimentantes KC e RU são materiais compatíveis para uso em cavidades profundas próximas ao tecido da polpa dentária, embora a UR tenha levado a uma população odontoblástica levemente diminuída, com maior porcentagem de células mononucleares.