Use of ozone therapy in Implant Dentistry: a systematic review.

PURPOSE: Ozone is a potent antioxidant agent which presents an important antimicrobial action and many other biological effects. Although ozone therapy has been widely described and summarized in several other Dentistry areas recently, the studies concerning Dental Implantology have not been systematically compiled and evaluated. Thus, the present study aimed to evaluate the effectiveness of ozone therapy in dental implant procedures. METHODS: MEDLINE (via PUBMED), Cochrane Central Register of Controlled Trials (CENTRAL), and OpenGrey databases were searched (up to, and including, January 23, 2023) for studies in the English language. In addition, the reference lists of the articles were manually examined. Only interventional studies (controlled clinical trials, randomized or not) were considered eligible for inclusion. The risk of bias in each included study was assessed using the Cochrane tool for assessing risk of bias in randomized trials - version 2. RESULTS: 71 potentially eligible records were retrieved but only 5 articles were evaluated and considered eligible for inclusion. Among the studies, 2 addressed clinical situations related to implant insertion, and 3 involved pathological conditions affecting implants in function. Furthermore, only one randomized clinical trial was categorized as low risk of bias. CONCLUSION: The adjuvant use of ozone therapy may positively affect some outcomes in Implant Dentistry, both in treating pathological conditions and conducting rehabilitation (implant installation, secondary implant stability). However, as most studies have a high risk of bias and high heterogeneity, a definitive conclusion cannot be drawn.

Osteoradionecrosis treatment in head and neck cancer patients: An overview of systematic reviews.

AIMS: Evaluate the existing evidence of osteoradionecrosis (ORN) treatment in adults with head and neck cancer, the methodological quality and the evidence grade within systematic reviews (SRs). METHODS: An extensive systematic literature search of SRs that addressed ORN in head and neck cancer patients was conducted with screening of eligible studies, data extraction, methodological (AMSTAR 2) and evidence quality assessment (GRADE) of the SRs by independent and calibrated authors. RESULTS: A total of six SRs were enrolled. Based primarily on studies from the 1990s, there is critically low- or moderate-quality evidence that hyperbaric oxygen therapy (HBO) improves ORN healing. From 2005 onward, evidence has been discovered in relation to treatment with pentoxifylline and tocopherol (PENTO). The SRs indicate that the management of ORN with PENTO appears to be promising. The greatest rates of healing are seen in mild and moderate stages of ORN. However, the quality of evidence regarding PENTO, surgery and other treatments remains critically low. CONCLUSION: There is no standardized protocol to treat ORN. PENTO appears to be the most promising conservative treatment; however, the current level of evidence regarding PENTO is still critically low. More robust clinical studies are needed to establish the best treatment for ORN.

Photobiomodulation Therapy for Multiple Painful Fixed Drug Eruptions: The First Case Report.

Introduction: Fixed drug eruption (FDE), a very specific adverse drug reaction and one of the most common types of drug eruption, generally resolves spontaneously within 7-10 days upon withdrawal of the causative agent; however, extensive and severe cases may also require systemic drug therapy. The present study aimed to report a case in which a broad spectrum of severe, painful lesions of FDE was managed with photobiomodulation therapy (PBMT). Case Report: A 31-year-old Caucasian woman presented with many extremely painful mucocutaneous lesions of FDE which had arisen 8 days before, following a long period of hospitalization. The lesions were not responsive to either corticosteroids or analgesics within 5 days, and then seven daily sessions of PBMT were proposed. Pain alleviation was achieved on the 1st day of PBMT, and the lesions showed an advanced course of healing on the 3rd day. Within 7 days of PBMT, the lesions were almost completely repaired. In a 3-month follow-up period, no relapse of any FDE lesion was reported. Conclusion: PBMT may be a promising strategy for the management of painful lesions of FDE refractory to conventional medication therapy. However, further studies are needed to confirm this hypothesis.

Effect of botulinum toxin A on pain, bite force, and satisfaction of patients with bruxism: A randomized single-blind clinical trial comparing two protocols.

Purpose: The current study aims to evaluate bite force, perception of orofacial pain, and treatment satisfaction of patients with bruxism using two protocols of botulinum toxin A (BTX-A) injections. Material and Methods: Two groups of patients seeking bruxism treatment and presenting bilateral orofacial pain of muscle origin were randomly created according to BTX-A injection sites: masseter muscle only, bilaterally (3 points in each muscle, 10 U per point), and masseter and temporal muscles (3 points in each masseter muscle and 2 points in each temporal muscle, 10 U per point). The patients were evaluated preoperatively and longitudinally at 15, 90, 120, and 180 days by the use of visual analog scales for pain and treatment satisfaction and a gnathodynamometer for bite force recording. Results: The final sample included 10 participants in each group. Both groups presented mitigation of pain at 15, 90, 120, and 180 days in comparison with baseline; however, reduction in the posterior bite force was noted only at 15, 90, and 120 days. Quite high treatment satisfaction was reported from both groups at 15, 90, 120, and 180 days. No differences were observed between the groups in all evaluations and study periods. Conclusion: In general, considering pain relief, reduction in bite force, and treatment satisfaction, both protocols of BTX-A seem to be somewhat equally effective in the short-term management (up to 120 days) of bruxism.

Associated factors and treatment options for sleep bruxism in children: an umbrella review.

Data on clinical management options for sleep bruxism in the primary dentition are inconclusive. This umbrella review aimed to synthesize the available evidence from systematic reviews (SRs) on the associated factors and treatment approaches for clinical management of sleep bruxism in children. A search was conducted in the MEDLINE/PubMed, Web of Science, Embase, and OpenGrey databases up to March 2022. SRs published on sleep bruxism in children containing data on associated factors or treatment outcomes were included. The AMSTAR-2 tool was used to assess the methodological quality of SRs. The search identified 444 articles, of which six were included. Sleep conditions, respiratory changes, personality traits, and psychosocial factors were the associated factors commonly identified. Treatments included psychological and pharmacological therapies, occlusal devices, physical therapy, and surgical therapy. All SRs included presented a high risk of bias. Overlapping of the included studies was considered very high. The best evidence available to date for the management of sleep bruxism in children is based on associated factors, with sleep duration and conditions, respiratory changes, as well as personality traits and psychosocial factors being the most important factors commonly reported by studies. However, there is currently insufficient evidence to make recommendations for specific treatment options.

Associated factors and treatment options for sleep bruxism in children: an umbrella review

Abstract Data on clinical management options for sleep bruxism in the primary dentition are inconclusive. This umbrella review aimed to synthesize the available evidence from systematic reviews (SRs) on the associated factors and treatment approaches for clinical management of sleep bruxism in children. A search was conducted in the MEDLINE/PubMed, Web of Science, Embase, and OpenGrey databases up to March 2022. SRs published on sleep bruxism in children containing data on associated factors or treatment outcomes were included. The AMSTAR-2 tool was used to assess the methodological quality of SRs. The search identified 444 articles, of which six were included. Sleep conditions, respiratory changes, personality traits, and psychosocial factors were the associated factors commonly identified. Treatments included psychological and pharmacological therapies, occlusal devices, physical therapy, and surgical therapy. All SRs included presented a high risk of bias. Overlapping of the included studies was considered very high. The best evidence available to date for the management of sleep bruxism in children is based on associated factors, with sleep duration and conditions, respiratory changes, as well as personality traits and psychosocial factors being the most important factors commonly reported by studies. However, there is currently insufficient evidence to make recommendations for specific treatment options.

Effectiveness of Violet LED alone or in association with bleaching gel during dental photobleaching: A Systematic Review.

AIMS: To conduct a systematic review to determine the efficacy of violet led in promoting dental bleaching by itself or accelerating dental bleaching when associated with peroxides. METHODS: Clinical and in vitro studies were identified by a search on November 27th 2020 in the PubMed and Scopus databases. Inclusion criteria were: 1) studies related to bleaching; 2) studies related to violet LED Light (405-410nm); and 3) studies that analyzed efficacy. The authors assessed the studies for risk of bias independently. Authors extracted outcomes including color change evaluation and pain assessment independently. RESULTS: During the search process, 895 articles were found in the previously cited databases. After the first screening consisting of title and abstract evaluations, 18 articles were selected. Finally, 13 articles met the eligibility criteria and were included in this review, being 5 clinical trial/case series and 8 in vitro studies. In vitro studies showed a high risk of bias and interventional studies showed a low risk of bias. CONCLUSION: The violet Led seems to have the potential to bleach teeth without peroxides, with a clinical perceptible color alteration. However, the effect is small in comparison to bleaching using peroxides. When Violet Led is used in association with peroxides, it seems to potentialize the bleaching result. However, due to the high heterogeneity between studies, a small number of clinical studies, and the high risk of bias of the in vitro included studies, the results are not definitive, and further well-designed studies are needed to reach safe evidence.

aPDT for oral decontamination of hospitalized patients with COVID 19.

Emerging variants of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) may have an impact on the virus's transmissibility and pathogenicity and an increased risk of reinfection. Antimicrobial photodynamic therapy (aPDT) is a promising technique to decontaminate the oral cavity to minimize and inactivate microorganisms' load. This article reports through a case series, a proposal for efficient oral decontamination for hospitalized patients with COVID 19 using aPDT. Samples of oral tissues were obtained after aPDT and analyzed using two methods of RT-qPCR to elucidate qualitative and quantitative viral profiles of SARS-CoV-2 RNA in the oral cavity. There was a reduction of viral load in the oral cavity immediately or one hour after the use of aPDT. This method could be a good option to decontaminate the oral cavity to minimize and inactivate microorganism load.

Muscle Function Recovery Following Botulinum Toxin Type A Facial Injections: A Case Managed With Photobiomodulation Therapy.

Introduction: Aesthetic applications of botulinum toxin type A (BoNT-A) may lead to some complications, including unwanted muscle paralysis. Moreover, BoNT-A effects may last several months, and there is no medical intervention so far to accelerate muscle function recovery. Case Report: A female patient with a movement disorder of the mimic muscles resulting from BoNT-A injections received daily sessions of photobiomodulation therapy (PBMT). A fast improvement in both facial asymmetry and muscle function was noted within a few weeks. After nine weeks, almost complete recovery was achieved. Conclusion: According to the current case, PMBT seems to be an effective intervention to accelerate muscle function recovery following BoNT-A use.

Botulinum Toxin A in the Management of a Gummy Smile: A Clinical Controlled Preliminary Study.

BACKGROUND: Botulinum toxin type A (BTX-A) is recent technique for the treatment of gummy smile. OBJECTIVES: The aim of this randomized controlled preliminary clinical trial was to evaluate the effects of BTX-A on excessive gingiva display (EGD) reduction, muscle activity, and patient satisfaction at 2, 8, 12, 16, 21, and 25 weeks. METHODS: Group 1 (G1) received 4 points of BTX-A application (2 U/point) for relaxation of the levator labii superioris alaeque nasi and levator labii superioris muscles; Group 2 (G2) received 2 points of BTX-A (2 U/point) for relaxation of only the levator labii superioris alaeque nasi muscle. RESULTS: A high dropout of patients from follow-up sessions occurred. Therefore, because of this data limitation, the results were considered a preliminary outcome. At 2 weeks, there was a significant difference between baseline regarding the reduction of EGD in G1 and G2, reduction in muscle activity in G1, and increased satisfaction in G1 and G2. At 2 weeks, there was no difference between the 2 groups. Statistically significant EGD reduction was maintained until 16 weeks in G2 and 25 weeks in G1. After 14 days there was a gradual recovery of muscle activity in both groups until recovery of baseline values by 25 weeks. Patients' satisfaction with treatment lasted 21 weeks in G1 and 16 weeks in G2. CONCLUSIONS: Increasing the number of BTX-A injection points resulted in a prolonged effect regarding EGD reduction and patient satisfaction but did not increase the intensity of the outcome. However, due to the high dropout of patients, this is a preliminary conclusion and further studies are necessary to confirm these results.

Influence of 35% hydrogen peroxide gel renewal on color change during in-office dental photobleaching with violet LED: A split-mouth randomized controlled clinical trial.

BACKGROUND: To clinically evaluate the effect of 35% hydrogen peroxide gel renewal in association with violet LED (405-410nm) through a split-mouth randomized controlled clinical trial. METHODS: The treatment consisted in 3 bleaching sessions of 15 min each, with an interval of 7 days between them, using 35% hydrogen peroxide combined to violet LED irradiation. Selected patients had two experimental segments for the split-mouth design: No change of the bleaching gel during each session (NBGR) and 3 changes of the bleaching gel every 5 min for each session (BGR). During the 3 bleaching sessions, the selected quadrant received the same treatment. Patients had their upper canines and central incisors teeth color measured with a subjective (color scale - VITA Classical) and an objective (spectrophotometer - VITA Easyshade) method and their teeth sensitivity measured using a Visual Analog Scale (VAS) before, immediately after each bleaching session, and 14 days and 2 months (60 days) after the end of the treatment. RESULTS: The protocol adopted in the present study reached satisfactory results regarding color change. No statistical difference between groups was observed immediately after the end of the treatment and in the follow-up analysis for both subjective and objective color evaluation. No difference in tooth sensitivity between segments was observed. CONCLUSION: There is no need for bleaching gel renewal when following the clinical protocol of 3 sessions of 15 min in a bleaching protocol of 35% hydrogen peroxide combined with violet LED.

In-office bleaching protocols using violet LED: A split mouth case report.

A new LED wavelength, violet LED (VL) with a wavelength between 405 - 410 nm was recently introduced to be used for in-office dental bleaching. In comparison to the blue LED system (440 to 485 nm), the shorter wavelength has more energy carried in its photons and also corresponds to the absorption peak of the stained particles, which lead to whitening utilizing a physical process. Considering the need to suggest and develop new protocols with this new technology, this article reports 2 different dental bleaching protocols developed in a split-mouth model using VL. A 25-year-old male patient was submitted to in-office dental bleaching. On the teeth from the left side, the bleaching gel (35% H2O2) was renewed 3 times (every 8 mins), and on the right side, the gel was maintained without renewal during the bleaching session. The irradiation with Violet LED Light (405 nm ± 10 nm) was performed with the following protocol: 1 min of irradiation with 30 s light off until 8 min of total time. A total of 3 cycles were performed (total time of 24 min). Two bleaching sessions were performed with an interval of 7 days between sessions. Based on the results of this split-mouth case report, there was no visible difference in the final color outcome and sensitivity between both bleaching protocols tested.

Correlations between dental assistance/oral health and clinical intercurrences in an end-stage kidney disease patients: a historical cohort study.

BACKGROUND: The aim of this study was to correlate the self-report oral health, oral hygiene and dental assistance with clinic intercurrences with hospitalization in adults in End-Stage Kidney Disease patients. METHODS: Seventy-seven patients were interviewed during dialysis therapy concerning their self-report oral health, oral hygiene habits and available dental assistance. Clinical intercurrences were assessed in clinical records. Pearson correlations and linear regression tests were applied for statistical analysis. RESULTS: There was a strong negative correlation between the number of brushing times/day and patient hospitalization; there was a negative correlation between oral health and patient hospitalization, there was a positive correlation between the number of teeth in the mouth and oral diseases. CONCLUSIONS: The study shows an important correlation between oral health, oral hygiene habits, dental assistance and clinical intercurrences with hospitalization in dialysis patients. The results are weighty to establish protocols that can, directly improve, critical health outcomes of end-stage kidney disease patients under dialysis treatment.

Current evidence of tissue engineering for dentine regeneration in animal models: a systematic review.

Aim: The aim of this study is to verify the type of scaffold effect on tissue engineering for dentine regeneration in animal models. Materials & methods: Strategic searches were conducted through MEDLINE/PubMed, Web of Science and Scopus databases. The studies were included with the following eligibility criteria: studies evaluating dentine regeneration, and being an in vivo study. Results: From 1392 identified potentially relevant studies, 15 fulfilled the eligibility criteria. All studies described characteristics of neoformed dentine, being that the most reported reparative dentine formation. Most of included studies presented moderate risk of bias. Conclusion: Up to date scientific evidence shows a positive trend to dentine regeneration when considering tissue engineering in animal models, regardless the type of scaffolds used.

Effects of manufacturing methods on the survival rate of ceramic and indirect composite restorations: A systematic review and meta-analysis.

OBJECTIVES: To evaluate the survival rate of ceramic and indirect composite inlays, onlays, and overlays manufactured according to different methods (CAD/CAM, pressable, and stratified). MEDLINE, EMBASE, and Cochrane Library databases were searched for published articles. Risk of bias, data extraction, subgroup analysis, meta-analysis, and GRADE was performed. MATERIALS AND METHODS: Prospective, retrospective, or RCT studies, without restriction of language, from 1983 to 2019, with follow-up ≥5 years, reporting survival rates were screened independently by two reviewers in accordance with eligibility criteria. RESULTS: A total of 13 articles (12 for ceramic, one for indirect composite) met the inclusion criteria. No articles were included regarding crystalline ceramic. The estimated cumulative survival rate for CAD/CAM was 97% after 5 years and 89% after 10 years; for pressable was 95% after 5 years, and for stratified was 88% after 5 years and 93% after 10 years. CONCLUSIONS: Regardless of the manufacturing method, vitreous ceramic inlays, onlays, and overlays showed high survival, providing evidence that these restorations are a safe treatment. CLINICAL RELEVANCE: Vitreous ceramic inlays, onlays, and overlays showed high survival, regardless of the manufacturing method, providing evidence that these restorations are a safe treatment.

Scientific evidence for the management of dentin caries lesions in pediatric dentistry: A systematic review and network meta-analysis.

BACKGROUND: A systematic quantitative evaluation of the available evidence of the treatment for caries lesions in primary teeth that considers how different caries progressions lead to the need for distinct interventions might provide additional useful information for clinical evidence-based decision making. The aim of this systematic review and network meta-analysis was to verify the effect of the treatments on caries lesion arrestment (CLA) or the success rate (SR) of dentin caries lesion treatments in the primary teeth. METHODS: A search was conducted using the MEDLINE/PubMed, Web of Science and Scopus databases through December 2017. The primary search terms used in combination were primary teeth, caries lesion and restoration. The grey literature was also screened, as were the reference lists of eligible studies. A search of prospective studies with at least 12 months of follow up that compared different techniques was performed. The exclusion criteria were the absence of a comparison group; no evaluation of different restorative techniques; the evaluation of other outcomes unrelated to this review; and the recruitment of specific patient. The risk of bias was evaluated by the tools: the Cochrane Handbook for Systematic Reviews of Interventions and ROBINS-I. A network meta-analyses and meta-analyses were conducted considering CLA or SR as outcomes according to the surface involved and the depth of progression. RESULTS: Of the 1671 potentially eligible studies, 15 were included. For occlusal surfaces, only two studies presented data regarding the outer half of the dentin, with conventional restorative treatment (CRT) using composite resin showing superior results; five studies presented data regarding the depth of caries lesions, and CRT with compomer resulted in the best results. Seven studies considered occlusoproximal surfaces, and the Hall technique showed the best SR among the evaluated treatments. Finally, two annual applications of silver diamine fluoride showed the best nonrestorative approach to arrest caries lesions on occlusal and smooth surfaces. DISCUSSION/CONCLUSIONS: The treatments for dentin caries lesions in primary teeth depend on the depth of progression and the surface involved. However, few of the included studies provided evidence to strongly recommend the best treatment option. OTHER: Funding: FAPESP; Systematic review registration number-PROSPERO CRD42016037784.

Effect of bleaching agents on black tooth stains caused by chromogenic bacteria: 10 years follow-up case report / Efeito de agentes clareadores na pigmentação extrínseca causada por bactérias cromogênicas: 10 anos de acompanhamento de caso

ABSTRACT Some microorganisms are associated with the formation and deposition of pigmentation on dental surfaces, and its localization, intensity and recurrence persistence can introduce aesthetic disorders. Carbamide peroxide is a bleaching agent that also presents antimicrobial properties. This case report addresses a ten-year clinical follow-up, showing a possible influence of a bleaching procedure protocol on alterations of oral microbiota. Although a bleaching treatment does not have the purpose to alter the oral microbiota, a drastic reduction and recurrence of black tooth stains was observed in this case.

RESUMO Alguns microrganismos são associados com a formação e deposição de pigmentação sobre a superfície dental, sendo que a localização, intensidade e persistência de recorrência dessas pigmentações podem levar a problemas estéticos. O peróxido de carbamida é um agente clareador no qual também mostra propriedades antimicrobianas. Este relato de caso trata de um acompanhamento de dez anos mostrando uma possível influência de um clareamento dental em alterações na microbiota. Embora o clareamento dental não tenha a finalidade de alterar a microbiota bucal, neste relato foi observado a redução na quantidade e recorrência de manchas extrínsecas negras.

A self-report joint damage and musculoskeletal disorders data among dentists: a cross-sectional study.

BACKGROUND: Musculoskeletal disorders (MSD) are an occupational health problem that demands a high cost and may also reduce the quality of life and productivity of the dentists. The aim of this study was to evaluate the prevalence of MSD and its association with self-reported joint damage in dentists from São Paulo (Brazil). METHODS: This was a cross-sectional study performed from two self-administered questionnaires - the Nordic Musculoskeletal Questionnaire and the other containing demographic and occupational data - in 6072 dentists. Between April and May 2014, 5885 questionnaires were distributed via e-mail through São Paulo Regional Board of Dentistry (CRO-SP) and 187 in Congress and public offices. Multivariable logistic regression was used to assess the association between explanatory variables (sex, age, level of education, duration of practice in years, number of patients seen per day, previous receipt of information about ergonomics, physical activity, and the presence of joint damage) and MSD. RESULTS: Two hundred eighty-six valid questionnaires were returned. The prevalence of MSD was 63.6% (N.=182). Multivariable logistic regression showed that only the factor of self-reported joint damage has a significant association with MSD (OR 0.001; 95% CI: 0.000-0.007). Concerning the self-reported joint damage (60.1%), the carpal tunnel syndrome was the most frequent (13.2%). CONCLUSIONS: The prevalence of MSD in dentists from São Paulo is high, and carpal tunnel syndrome is the most common self-reported joint damage.