Effects of Red and Infrared Laser Therapy in Patients with Tinnitus: A Double-Blind, Clinical, Randomized Controlled Study Combining Light with Ultrasound, Drugs and Vacuum Therapy.

BACKGROUND: tinnitus is a symptom with no specific cause known to date, and there are no associated pharmacogenomics of hearing disorders and no FDA-approved drugs for tinnitus treatment. The effectiveness of drug treatments is not reproducible on idiopathic patients and inexistent in refractory patients. Personalized treatments for these patients are a great clinical need. Our study investigated the outcome of potential alternative and complementary treatment modalities for idiopathic and refractory tinnitus patients. METHODS: we were the first to evaluate the tinnitus handicap inventory (THI) score changes over the course of treatment up to 15 days after complete cessation of treatment for novel transmeatal low-level laser therapy (LLLT) modalities using light alone, as well as LLLT combined with vacuum therapy (VT), ultrasound (US), Ginkgo biloba (GB) and flunarizine dihydrochloride (FD), while also comparing all treatment outcomes with laser puncture (LP), FD alone and GB alone. RESULTS: a positive treatment outcome (superior to a placebo effect) was achieved by using either LP or transmeatal LLLT, whereas short-term antagonistic effects of VT, US, GB and FD when combined with LLLT. For transmeatal LLLT, an improvement in the treatment outcome was observed by increasing the irradiation time from 6 min to 15 min (with 100-mW of applied laser power at 660 nm). Finally, a lasting therapeutic effect higher than the placebo was observed at 15 days after treatment upon combining LLLT with VT, GB or by using FD alone, by using the transmeatal LLLT alone or by using LP. CONCLUSIONS: LP and Transmeatal LLLT can be promising alternative treatments for idiopathic and refractory tinnitus patients. Future studies should investigate the long-term effects of LLLT in tinnitus patients, as well as the dosimetry and wavelength of transmeatal LLLT.

Can photobiomodulation restore anosmia and ageusia induced by COVID-19? A pilot clinical study.

Along with other COVID-19 clinical manifestations, management of both olfactory and gustatory dysfunction have drawn a considerable attention. Photobiomodulation (PBM) has emerged to be a possible effective therapy in restoring taste and smell functionality, but the evidence is scarce. Hence, the present pilot study is aimed to evaluate the effectiveness of intranasal and intraoral PBM administrations in management of anosmia and ageusia respectively. Twenty Caucasian subjects who diagnosed with anosmia and ageusia were recruited. Visual analogue scale was utilised to evaluate patients' self-reported for both olfactory and gustatory functionality. The laser-PBM parameters and treatment protocols for anosmia and ageusia were as follows respectively: 660 nm, 100 mW, two points intranasally, 60 J/session, 12 sessions; dual wavelengths (660 nm and 808 nm), 100 mW, three points intraorally, 216 J/session, 12 sessions. Our results showed a significant functionality improvement of both olfactory and gustatory functionality. Extensive studies with large data and long-term follow-up period are warranted.

Photodynamic therapy of adenoid hypertrophy in acute rhinosinusitis.

A first step for microorganisms to reach the respiratory system and cause infectious disease is colonization in the nasopharynx. Humans inhale a bacterial load of up to 106 per cubic meter of air per day [1], including transient microorganisms between the upper and lower airways. This can lead to lung infections, amounting to billions of dollars in annual direct treatment costs in the United States, depending on the etiologic agent [2,3]. Curcumin has been described as a photosensitizer (PS) that, activated at 450 nm, is efficient against planktonic bacteria [4] and biofilms [5]. At the same time, effects on microbial interactions are commonly detected in the upper respiratory tract and should be considered for the treatment of adenoids [6]. We, therefore, propose in this study to optimize photodynamic therapy (PDT) conditions in vitro by simulating bacterial coinfection conditions in nasal cavities evaluated by the response surface method, where we can evaluate interactions of treatment variables. From this, the clinical case of the treatment of rhinosinusitis was carried out using PDT with nasal lighting. The absence of symptoms that characterize the disease was monitored and evaluated by the Kepler Meyer method. The study points out considerations that can be evaluated for the treatment to be a possibility of clinical indication in the control of rhinosinusitis.

Photobiomodulation therapy for treatment olfactory and taste dysfunction COVID-19-related: A case report.

It is postulated that the inflammatory process resulting from SARS-CoV-2 infection is the main cause of smell and taste dysfunctions in patients. In view of this, photobiomodulation, due to its anti-inflammatory and antioxidant effects, may be a promising therapeutic modality to treat these disorders. In the present case report, we observed clinical improvement in the symptoms of anosmia and ageusia related to COVID-19 after treatment with photobiomodulation. Due to the inflammatory nature of COVID-19 and the anti-inflammatory effects, photobiomodulation antioxidants already proven in the literature make it a promising therapeutic modality, especially sequela COVID-related, including olfactory (anosmia) and taste (ageusia) dysfunction. In the present case report, the patient's olfactory and gustatory functions were re-established after 10 treatment sessions with photobiomodulation.

Evaluation of the Whitening Effectiveness of Violet Illumination Alone or Combined with Hydrogen Peroxide Gel.

Objective: To evaluate the effectiveness of the whitening and washing steps of a treatment using violet illumination (VI) alone or combined with hydrogen peroxide gel. In addition, we evaluated the color change after cleaning the tooth with and without mineral oil. Methods: First, 16 bovine teeth were extracted and stored in 5% thymol solution. Next, the teeth were collected and cleaned. Then, the teeth were stained with instant coffee solution for 24 h. The teeth were divided in four groups: control, VI without 35% hydrogen peroxide gel (VI), VI with 35% hydrogen peroxide gel (VI + gel), and VI without 35% hydrogen peroxide gel and cleaned with mineral oil before washing (VI + oil). Results: The whitening treatment VI + gel was able to completely restore the teeth whiteness and make the teeth 31.2% less yellow than prior coffee staining. The VI + oil treatment led to about 3.7 times the whiteness and yellowness changes observed in the VI treatment and restored 51% of the whiteness lost by staining. Conclusions: The VI + gel treatment can be recommended against coffee stains and should be further investigated for other types of tooth stains. In addition, cleaning the tooth surface with mineral oil could be an alternative to increase the performance of whitening treatments.

Increased Oral Health-Related Quality of Life Postsynergistic Treatment with Ultrasound and Photobiomodulation Therapy in Patients with Temporomandibular Disorders.

Background and objective: The object of this study was to analyze the oral health-related quality of life (OHRQoL) of patients with temporomandibular disorders (TMDs) who were treated simultaneously with ultrasound (US) and photobiomodulation therapy (PBMT). Materials and methods: This study included 13 patients of both genders, with diagnosis of TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders. The patients were treated with equipment consisting of US and PBMT in the same system. The treatment was applied to the left and right sides of the face in the masseter muscle, anterior temporalis muscle, and temporomandibular joint, two sessions per week for a total of eight sessions. The OHRQoL was assessed by the Oral Health Impact Profile (OHIP-14) at three moments: pretreatment (T0), after the eight treatment sessions (T1), and 30 days after termination of treatment (T2). The Wilcoxon, Mann-Whitney U, Kruskall-Wallis, and Spearman's correlation coefficient tests were applied, with a significance threshold of 5%. Results: Psychological discomfort, physical pain, and psychological limitation were the domains where the highest scores were obtained at T0. The total OHIP-14 scores at T1 and T2 were significantly lower than at T0. No statistical differences were observed between T1 and T2. Conclusions: We conclude that synergistic treatment was effective in improving the OHRQoL of patients with TMDs, and that its beneficial effects persisted at 1 month after termination of treatment.

Violet LED with low concentration carbamide peroxide for dental bleaching: A case report.

The use of violet LED was recently introduced as a new alternative technique to perform tooth bleaching, associated or not with bleaching agents. This paper shows a tooth bleaching clinical case report performed in a 26-year-old woman, using a violet LED with 10% carbamide peroxide (CP). The tooth bleaching protocol was performed in 3 sessions. Fifteen irradiations using a violet light system (BMW, MMoptics, São Carlos, SP, Brazil) were done during 30 s (on) and 60 s (off) without bleaching gel, and more 5 irradiations associated to 10% CP. Upper and lower arches were irradiated separately. The total procedure time was 30 min. Subjective and objective color assessments were performed using Vitapan Classical shade guide and VITA Easyshade spectrophotometer, respectively. Dentin sensitivity was measured using a visual analogue scale. The use of violet LED associated to a low concentration carbamide peroxide successfully promoted tooth bleaching and no side effects i.e. dentin sensitivity during and post treatment was observed.

Fluorescence spectroscopy of teeth and bones of rats to assess demineralization: In vitro, in vivo and ex vivo studies.

This study investigated the effects of demineralization on teeth and bones evaluated by fluorescence spectroscopy and micro energy-dispersive X-ray fluorescence spectrometry (µ-EDXRF) in rats. For in vitro study, 20 teeth of Wistar rats were removed and decalcified to evaluate fluorescence. For in vivo study, 10 female Wistar rats aged 6months were randomized into 2 groups: Control Group (C): non-ovariectomized rats; Ovariectomy Group (OV): ovariectomized rats to induce osteoporosis. The fluorescence spectroscopy of the teeth was performed for long-term (until 180days). For ex vivo study, the tooth and femur bone of the Wistar rats were removed at 180days to perform fluorescence spectroscopy using excitation laser at 408 and 532nm and µ-EDXRF for calcium (Ca) and phosphorus (P) analysis. There were no intergroup differences in fluorescence spectra with laser at 408nm (p≥0.05), but there were changes in the fluorescence spectra using laser at 532nm which led to both the wavelength shift and changes in the band area (p<0.05). The concentrations of P and Ca for the dentine and cortical bone, respectively, were significantly reduced in OV (p<0.05). Demineralization leading to loss of tissue quality may be assessed by fluorescence spectroscopy using 532nm laser. These findings corroborate those obtained by µ-EDXRF.

Oral Decontamination of Orthodontic Patients Using Photodynamic Therapy Mediated by Blue-Light Irradiation and Curcumin Associated with Sodium Dodecyl Sulfate.

OBJECTIVE: The aim of this study was to investigate the effects of the antimicrobial photodynamic therapy (aPDT) using the association of curcumin with the surfactant sodium dodecyl sulfate (SDS) for oral decontamination in orthodontic patients. BACKGROUND DATA: The installation of the orthodontic appliances promotes an increase in the retentive area that is available for microbial aggregation and makes difficult the oral health promotion. However, aPDT is one possible approach that is used for the reduction of oral microbial load. MATERIALS AND METHODS: Twenty-four patients (n = 24) were randomly distributed into four groups: Light group: which was treated only with the blue light, no drug; PDT group, which was treated with curcumin and blue light; PDT + S group, which was treated with curcumin plus surfactant and irradiated with blue light; and Chlorhex group, which was treated with chlorhexidine. The photosensitizer agent was prepared by adding 0.1% of SDS to a curcumin solution of 1 g/L. Two distinct LED devices emitting blue light (450 ± 10 nm) were used as follows: extra-oral irradiation (200 mW, 80 mW/cm(2), 36 J and 14 J/cm(2)) and intra-oral irradiation (1200 mW, 472 mW/cm(2), 216 J and 85 J/cm(2)).The collection of nonstimulated saliva (n = 3; 3 mL/collection) was performed at the following steps: (1) immediately before swishing (curcumin, chlorhexidine, or water); (2) after swishing; and (3) after performing aPDT treatments. The colony-forming units (CFU) were counted visually, and the values were adjusted to CFU/mL. RESULTS: There was significant Log reduction for PDT (from 6.33 ± 0.92 to 5.78 ± 0.96, p < 0.05), PDT + S (from 5.44 ± 0.94 to 3.83 ± 0.71, p < 0.01), and Chlorhex (from 5.89 ± 0.97 to 2.55 ± 1.80, p < 0.01) groups. The survival rate was significantly reduced in both PDT + S and Chlorhex groups compared with all situations (p < 0.05). However, there was no significant difference between PDT + S and Chlorhex groups (p ≥ 0.05). CONCLUSIONS: These results indicate that when associated with the surfactant SDS, the aPDT can be used as an adjutant and a convenient agent to promote the oral decontamination in clinical practice.

Comparative clinical study of light analgesic effect on temporomandibular disorder (TMD) using red and infrared led therapy.

Low-level laser therapy (LLLT) has been widely applied in pain relief in several clinical situations, including temporomandibular disorders (TMD). However, the effects of LED therapy on TMD has not been investigated. This study aims to evaluate the effects of red and infrared LEDs on: (1) tissue temperature in ex vivo and (2) pain relief and mandibular range of motion in patients with TMD. Thirty patients between 18 and 40 years old were included and randomly assigned to three groups. The two experimental groups were: the red LED (630 ± 10 nm) group and the infrared LED (850 ± 10 nm) group. The irradiation parameters were 150 mW, 300 mW/cm(2), 18 J/cm(2), and 9 J/point. The positive control group received an infrared laser (780 nm) with 70 mW, 1.7 W/cm(2), 105 J/cm(2), and 4.2 J/point. LED and laser therapies were applied bilaterally to the face for 60 s/point. Five points were irradiated: three points around the temporomandibular joint (TMJ), one point for the temporalis, and one near the masseter. Eight sessions of phototherapy were performed, twice a week for 4 weeks. Pain induced by palpating the masseter muscle and mandibular range of motion (maximum oral aperture) were measured at baseline, immediately after treatment, 7 days after treatment, and 30 days after treatment. There was an increase in tissue temperature during both the red and the infrared LED irradiation in ex vivo. There was a significant reduction of pain and increase of the maximum oral aperture for all groups (p ≥ 0.05). There was no significant difference in pain scores and maximum oral aperture between groups at baseline or any periods after treatment (p ≥ 0.05). The current study showed that red and infrared LED therapy can be useful in improving outcomes related to pain relief and orofacial function for TMD patients. We conclude that LED devices constitute an attractive alternative for LLLT.

Apresentação de uma abordagem corretiva não-convencional da má oclusão de Classe II, divisão 2, em adulto / Presentation of non-conventional corrective approach of Class II, division 2, malocclusion in an adult

Este trabalho mostra uma alternativa de tratamento da má oclusão de Classe II, divisão 2, em paciente adulto, onde não existe mais crescimento formativo. Foi obtida uma oclusão satisfatória e funcional, sem extrações dentárias ou cirurgia ortognática. Conseguiu-se espaço interdentário entre os pré-molares inferiores e foram instalados implantes nestes espaços. Com essa conduta conseguiu-se uma reação de caninos ideal e manteve-se a relação Classe II de molar, obtendo-se assim estética dentária, oclusão funcional e estética facial.

Extração unilateral: apresentação de uma abordagem corretiva / Unilateral extraction: a corrective procedure

O presente trabalho objetiva abordar o desvio de linha média nos diversos tipos de más oclusões, apresentando um método de diagnóstico e o tratamento de dois casos clínicos de pacientes portadores de Classe II, divisão 1, subdivisão e simetria facial