Photobiomodulation for Blood Pressure and Heart Rate Reduction in Mastectomized Women on Hormone Blockers: A Randomized Controlled Trial.

Objective: To assess the impact of intravascular laser irradiation of blood (ILIB) on the primitive carotid artery (PCA) hemodynamic variables, specifically blood pressure (BP) and heart rate (HR), in mastectomized patients undergoing hormone blocker treatments. Materials and methods: This study is a controlled, experimental, and randomized clinical trial. Patients were allocated into two groups: the experimental group (G1)-patients who received ILIB therapy using a 660 nm laser targeted at the PCA, and the control group (G2)-patients who did not receive ILIB therapy. Clinical research was conducted weekly, with measurements of systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR. The Mann-Whitney U test for independent samples was used, with a significance level of α = 0.05. Results: Systemic photobiomodulation on the PCA did not demonstrate a statistically significant difference in relation to SBP and DBP. However, for HR, the p-value was <0.05, indicating a significant difference between G1 and G2. The initial mean p > decreased from 142.3 to 116.4 mmHg in G1, and from 130.4 to 119.8 mmHg in G2. The DBP varied from 78.8 to 72.8 mmHg in G1, and from 79.1 to 74.2 mmHg in G2. A statistically significant difference was observed in HR, decreasing from 81.3 to 62.06 bpm in G1, and changing minimally from 74.1 to 75.1 bpm in G2. A considerable reduction was present in the timing of application. Conclusions: ILIB therapy applied to the PCA induces a reduction in BP and, more notably, HR in mastectomized women using the tamoxifen or aromatase inhibitors.

aPDT associated with sequestrectomy in the treatment of osteonecrosis in cancer patients with metastasis: Case report.

INTRODUCTION AND IMPORTANCE: Bisphosphonates are drugs that have demonstrated effectiveness in the prevention and treatment of bone metastases from malignant neoplasms and other diseases of bone metabolism and although they represent a risk factor for osteonecrosis. PRESENTATION OF CASE: The present case depicts a patient with prostate neoplasia and metastases, referred to the dental department because he presented severe periodontal infection in the previous incisors of the mandible and was under treatment by intravenous zoledronic acid. A panoramic x-ray showed a marked bone loss with a periodontal infection that indicated the tooth exodontia of the affected teeth. However, 2 months after the removal of the dental elements, bone sequestration was detected a CT scan confirmed that. Surgery was then performed to remove mandibular bone sequestration and photodynamic therapy (aPDT) treatment for decontamination of the affected area. DISCUSSION: There was a tissue reconstitution of the site in 3 weeks and total eradication of bone necrosis with aPDT treatment associated with bone sequestration. CONCLUSION: aPDT has proven to be an effective complementary treatment for the process of tissue decontamination and photostimulation in cases of BRONJ.

Photobiomodulation (PBMT) and antimicrobial photodynamic therapy (aPDT) in oral manifestations of patients infected by Sars-CoV-2: systematic review and meta-analysis.

Background: In 2019, a viral and respiratory pathology called COVID-19 emerged in Wuhan, China, and spread to other continents. Its main symptoms include fever, cough, dyspnea, myalgia, anorexia and respiratory distress in the most severe cases, which can lead to death. Furthermore, manifestations in the oral cavity such as ageusia and dysgeusia, as well as lesions in other regions of the oral cavity, can be observed. Main body: This systematic review and meta-analysis aimed to critically assess the clinical evidence on the use of photobiomodulation (PBMT) and antimicrobial photodynamic therapy (aPDT) for the treatment of oral lesions in patients infected with Sars-Cov-2. The literature extracted from electronic databases such as PubMed, Medline, CINAHL, and Google Scholar was screened for eligibility, and relevant articles were included. The review is limited to manuscripts published in English, Spanish and Portuguese language between December 2019 and October 2021. A total of 5 articles with 11 cases retracting PBMT and aPDT as therapeutic strategies for the regression of oral lesions and painful symptoms. The results show favoring the associated use of PBMT with aPDT (P = 0.004), and the isolated use of PBMT with the result of significant "P = 0.005" and good confidence interval (7.18, 39.20) in ulcerative lesions, herpetic, aphthous, erythematous, petechiae and necrotic areas. Conclusions: PBMT and aPDT could be effective in the treatment of oral lesions of patients infected with Sars-Cov-2 in a short period of time; however, more long-term randomized clinical trials studies are needed to define the therapeutic strategy.

Photobiomodulation therapy for oral mucositis management in head and neck cancer patients undergoing radiotherapy: case reports

Introduction: Photobiomodulation therapy (PBM) has been recommended for the prevention of oral mucositis (OM). Objective: to evaluate the use of PBM to prevent and control the severity of oral mucositis lesions and painful sensitivity in patients undergoing radiotherapy for head and neck cancer (HNC) treatment. Case reports: Eight patients with HNC attended for radiotherapy treatment, either associated with chemotherapy, or not were followed up. Clinical evaluation was performed, including meticulous anamnesis. The patients were followed up throughout the entire period of radiotherapy treatment. For the protocol of prophylaxis of OM, low level laser equipment was used, with a wavelength in the range of 660nm, in a contact mode, 30 mW of continuous emission 4J/cm² three times per week and for the therapeutic protocol wavelength in the range of 660nm, in a contact mode, 30 mW of continuous emission 8 J/cm², in the respective areas compromised by oral mucositis, 3 times per week till the complete remission of the lesions. All the patients were clinically followed up from the beginning of the antineoplastic therapy up to the conclusion of the medical treatment or total remission of the oral lesion, involving post radiotherapy control. A visual analog scale (VAS) was used to measure pain every week. Results: A progressive development of the lesions was observed from the 1st to the 5th week. Remission of OM was observed from the 7th week up to the conclusion of treatment. There is a continuous increase in the pain process, attaining the maximum level in the 6th week, with decline occurring up to the 7th week. Conclusion: Photobiomodulation therapy was able to control the severity of OM lesions and painful sensitivity in patients undergoing radiotherapy for head and neck cancer treatment, avoiding the interruption of the cancer therapy.

Introdução: A terapia com fotobiomodulação (FBM) tem sido recomendada para a prevenção da mucosite oral (MO). Objetivo: avaliar o uso de FBM para prevenir e controlar a gravidade das lesões da mucosite oral e a sensibilidade dolorosa em pacientes submetidos à radioterapia para tratamento de câncer de cabeça e pescoço (CCP). Relato dos casos: Oito pacientes com CCP atendidos para tratamento radioterápico, associado ou não à quimioterapia, foram acompanhados. Foi realizada avaliação clínica, incluindo anamnese meticulosa. Os pacientes foram acompanhados durante todo o período de tratamento radioterápico. Para o protocolo de profilaxia de MO, foi utilizado um equipamento laser de baixa potência, com comprimento de onda na faixa de 660nm, em modo de contato e 30 mW de emissão contínua com 4J/cm2. Para o protocolo terapêutico, e para comprimento de onda na faixa de 660nm, em modo de contato e 30 mW de emissão contínua com 8J/cm2 na área da lesão, até sua completa remissão. Todos os pacientes foram acompanhados clinicamente desde o início da terapia antineoplásica até a conclusão do tratamento médico ou remissão total da lesão oral, envolvendo o controle pós-radioterapia. Uma escala visual analógica (EVA) foi usada para medir a dor semanalmente. Resultados: Observou-se um desenvolvimento progressivo das lesões da 1ª à 5ª semana. A remissão da mucosite oral foi observada a partir da 7ª semana até o final do tratamento. Houve um aumento contínuo do processo doloroso, atingindo o nível máximo na 6ª semana, com declínio ocorrendo até a 7ª semana. Conclusão: A terapia de fotobiomodulação foi capaz de controlar a gravidade das lesões de MO e a sensibilidade dolorosa em pacientes submetidos à radioterapia para tratamento do câncer de cabeça e pescoço, evitando a interrupção da terapia oncológica.

Idiopathic exostosis: rarity on maxillary sinus

Introduction: Exostoses in the paranasal sinuses have been reported in a greater number in the dental radiological literature, despite the extensive citation in the otorhinolaryngology literature. Objective: This case report was a rare idiopathic expression that grew in the maxillary sinus. Case report: A 68-year-old black patient, BGS, followed up by the Odontology Service of Cancer Hospital for treating oral lesions (Mucositis) and other conditions resulting from radiation therapy and hormone therapy (Tamoxifen), presented malignant neoplasm at the right breast in 2015; an exostosis biopsy was not performed, since the patient is being treated and followed up by the hospital service. Panoramic radiography and clinical examination were performed. By analyzing the tests, it was possible to notice an image with double radiodensity, more radiopaque in the external portion and less radiopaque in the internal portion, with an aspect of trabecular bone, circumscribed, unilocular, in the region of pedunculated premolar, inside the left maxillary sinus. In order to have a better assessment and diagnostic hypothesis of the case, a CT scan was performed, a tool was applied to measure the density of the profile of the lesion, thus evidencing that the supposed injury invaginates to the interior of the maxillary sinus and had bone density similar to the alveolar crest bone. Conclusion: Simultaneously to other lesions, exostoses are benign lesions, present low aggression and rare symptomatology; exeresis is indicated only when it prevents functioning, or for aesthetics reasons, or when it is not possible to make prostheses. Many cases are incidentally diagnosed from routine radiographic review in medical or dental offices and should be followed up for analysis and verification of their growth.

Introdução: Exostoses nos seios paranasais têm sido muito mais relatados na literatura radiológica odontológica, apesar da extensa citação na literatura otorrinolaringológica. Objetivo: Neste relato de caso, encontramos uma exostose idiopática rara, que cresceu no seio maxilar. Relato de caso: Paciente negra de 68 anos, BGS, acompanhada pelo Serviço de Odontologia do Hospital do Câncer para tratamento de lesões orais (mucosite) e outras condições decorrentes da radioterapia e terapia hormonal (Tamoxifeno), apresentou neoplasia maligna da mama direita em 2015. Não foi realizada biopsia da exostose, pois a paciente está em tratamento e está sendo acompanhada pelo serviço do hospital. Realizaram-se radiografia panorâmica e exame clínico. Ao examinar os exames, foi possível notar uma imagem com dupla radiodensidade, mais radiopaca numa parte externa e menos radiopaca na parte interna, com aspecto de osso trabecular, circunscrito, unilocular, na região do ré-molar pediculado, no interior do seio maxilar esquerdo. Para melhor avaliação e hipótese diagnóstica, foi realizada uma tomografia computadorizada, aplicou-se uma ferramenta para mensuração da densidade do perfil da lesão, evidenciando-se que a suposta lesão invagina para o interior do seio maxilar e tinha densidade óssea semelhante ao osso da crista alveolar. Conclusão: Simultaneamente a outras lesões, as exostoses são lesões benignas, apresentam baixa agressividade e rara sintomatologia, sendo indicada exérese somente quando acomete a função, ou por motivos estéticos, ou quando não é possível a confecção de próteses. Muitos dos casos são diagnosticados de modo incidental e a partir de exames radiográficos de rotina em consultórios médicos ou odontológicos e devem ser acompanhados para análise e verificação de seu crescimento.