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1.
J Contemp Dent Pract ; 21(1): 2-10, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32381793

RESUMO

AIM: The photobiomodulation (PBM) effect of 660 nm diode laser in reducing pain, edema, trismus and promote healing subsequently to the transalveolar extraction of mandibular third molars in female patients taking contraceptive pills were evaluated. MATERIALS AND METHODS: Fifty female patients participated in our study. The 660 nm diode laser was applied immediately on randomly selected patients of the study group (n = 25) over the surgical site for 1 minute with continuous laser beam application. For the control group (n = 25), the same extraction procedure was performed without the application of 660 nm diode laser. Pain intensity, swelling, trismus, and healing was evaluated before extraction and during recall visits 24 hours, 48 hours, and 7 days postoperatively. RESULTS: The values of pain, swelling, and trismus were significantly inferior in the study group compared to the control group (p < 0.05) at T2 and T3; while the values of the healing index were significantly superior in the study group compared to the control group (p < 0.001) at T1, T2, and T3. CONCLUSION: Using 660 nm diode laser reduced the postsurgical discomforts (pain, edema, and trismus) and promote healing associated following transalveolar extraction of the lower third molar. CLINICAL SIGNIFICANCE: To develop a framework based on the results regarding the PBM effect of 660 nm diode laser following transalveolar extraction of lower third molar in a female patient taking oral contraceptive pills, which may help to improve the treatment services provided to the community.


Assuntos
Terapia com Luz de Baixa Intensidade , Dente Impactado , Anticoncepcionais , Feminino , Humanos , Lasers Semicondutores , Dor Pós-Operatória
2.
Medicine (Baltimore) ; 99(16): e19583, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311925

RESUMO

INTRODUCTION: Hypertension (systemic arterial hypertension [SAH]) is a systemic condition that affects about 30% of the world population, according to data from the World Health Organization (WHO). Drugs used to control this disease have the potential to induce xerostomia, an oral condition in which the decrease of the salivary flow is observed and whose presence leads to the increase of the index of caries, periodontal disease, loss of the teeth, dysgeusia, difficulty of mastication, dysphagia, bad breath and oral burning and impairment of prothesis installed in the buccal cavity, including retention of removable and total dentures. METHODS: This is a randomized, placebo-controlled, blind clinical protocol that aims to analyze the impact of phobiomodulation (PBM) on salivary glands of patients with antihypertensive drug induced xerostomia. Patients will be divided into 2 groups: G1: older adults with xerostomia induced by antihypertensive drugs and treatment with PBM (n = 30); G2: placebo PBM (n = 30). The irradiation will be made using a diode laser emitting at 808 nm with 100 mW and 40 seconds of exposure per site at the salivary glands. Twenty sites will be irradiated weekly for 4 weeks. Non-stimulated and stimulated salivary flow will be analyzed before and after the treatment. RESULTS: This protocol will determine the effectiveness of photodynamic therapy regarding the reduction of xerostomia in older adults using antihypertensive drugs. CONCLUSION: This protocol will determine the effectiveness of photodynamic therapy regarding the reduction of xerostomia in older adults using antihypertensive drugs. TRIAL REGISTRATION: Clinicaltrials.gov - NCT03632096.


Assuntos
Anti-Hipertensivos/efeitos adversos , Lasers Semicondutores/uso terapêutico , Terapia com Luz de Baixa Intensidade , Salivação/efeitos da radiação , Xerostomia/metabolismo , Xerostomia/radioterapia , Método Duplo-Cego , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Saliva/metabolismo , Xerostomia/induzido quimicamente
3.
Medicine (Baltimore) ; 99(17): e19904, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332670

RESUMO

Hypotonia, particularly of the masticatory and oropharyngeal muscles, is 1 of the main characteristics of Down Syndrome (DS), resulting in impaired speech, chewing and swallowing. Moreover, the complete or partial obstruction of the airways during sleep may occur due to hypotonia of the tongue, leading to snoring and sleep disorders, such as obstructive apnea and sleep bruxism. OBJECTIVE:: Analyze salivary levels of dopamine and cortisol and muscle activity before and after treatment with low-level laser therapy administered to acupoints in children with DS. METHODS:: A randomized, controlled, clinical trial will be conducted. Individuals 4 to 17 years of age with a diagnosis of DS and possible sleep bruxism will be screened at the Integrated Health Clinic of Nove de Julho University. We will evaluate orofacial dysfunction (Nordic Orofacial Test - Screening questionnaire), Masseter muscle activity during sleep will be assessed by BiteStrip and the masticatory muscles will be evaluated by electromyography (BTS TMJOINT) head posture as well as salivary cortisol and dopamine. After the evaluations, the participants will be randomized into 2 groups: Grupo 1 - treatment with low-level laser therapy at a wavelength of 808 nm; Group 2 - sham treatment (simulated laser therapy). Treatment will be conducted twice per week for a total of 12 sessions. The data will be tabulated and treated using GraphPad Prism version 7.0. The Kolmogorov-Smirnov test will be used to determine the normality of the data. Variables that fit the Gaussian curve will be expressed as mean and standard deviation. The ANOVA 2-way will be used for comparisons between the groups, with the significance level set to 5% (P < .05).ClinicalTrials registration number: NCT04211870.


Assuntos
Protocolos Clínicos , Síndrome de Down/terapia , Terapia com Luz de Baixa Intensidade/normas , Bruxismo do Sono/terapia , Pontos de Acupuntura , Adolescente , Criança , Pré-Escolar , Crianças com Deficiência , Feminino , Humanos , Terapia com Luz de Baixa Intensidade/métodos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Inquéritos e Questionários
4.
Indian J Dent Res ; 31(1): 42-47, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32246680

RESUMO

Aim: Temporomandibular disorders (TMDs) comprise a number of signs and symptoms affecting the masticatory muscles, temporomandibular joint (TMJ), or both. Because of the multifactorial etiology of such problems, the treatment usually involves more than one modality. Objectives: Therefore, the aim of this study was to compare the effectiveness of transcutaneous electric nerve stimulation (TENS) and low-level laser therapy for the treatment of patients with TMD. Materials and Methods: The clinical trial was performed with 60 patients diagnosed with TMD of multiple causes. All the patients received both methods of treatment in 6 consecutive weeks. A paired t-test was applied to verify the significance of the results. Results: A significant improvement in the range of motion and pain relief for both the therapies was observed. Conclusions: Comparatively after analyzing the two methods, the values obtained after LLLT were significantly higher than those obtained after TENS therapy (P < 0.01).


Assuntos
Terapia com Luz de Baixa Intensidade , Transtornos da Articulação Temporomandibular , Estimulação Elétrica Nervosa Transcutânea , Humanos , Músculos da Mastigação , Articulação Temporomandibular , Resultado do Tratamento
5.
Int. j. morphol ; 38(2): 252-258, abr. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1056431

RESUMO

The aim of this study was to evaluate the effects of mandibular advancement appliance and low level laser therapy (LLLT) with different doses on cellular hypertrophic changes in the mandibular condyle of rats. Forty-eight 8-week-old male Wistar albino rats weighing between 260 and 280 g were randomly divided into four experimental and control groups. Group I was the control group; group II was the mandibular advancement appliance group; group III was the 8 J/cm2 (0.25 W, 20 s) laser irradiation with mandibular advancement appliance group; and group IV was the 10 J/cm2 (0.25 W, 25 s) laser irradiation with mandibular advancement appliance group. Mandibular condyle cartilage and subchondral bone changes with different LLLT dose and mandibular advancement appliance were evaluated by histomorphometrical analysis. Subchondral bone fraction results showed that there were no significant differences between groups (p<0.05). The statistically significant differences found between control group and experimental groups in anterior and posterior cartilage layers thickness (p<0.05) and (p<0.01). Posterior and anterior condylar cartilage layers of rats react differentially to LLLT and mandibular advancement application. Maximum changes in condylar cartilage layers were found in 8 J/cm2 laser irradiation with mandibular appliance group.


El objetivo de este estudio fue evaluar los efectos del aparato de avance mandibular y la terapia con láser de bajo nivel (TLBN) con diferentes dosis sobre los cambios hipertróficos celulares, en el cóndilo mandibular de ratas. Cuarenta y ocho ratas albinas macho Wistar de 8 semanas de edad con un peso de 260 y 280 g se dividieron aleatoriamente en cuatro grupos experimentales y control. El grupo I control; grupo II, dispositivos de avance mandibular; grupo III de irradiación con láser de 8 J / cm2 (0.25 W, 20 s) con el grupo dispositivos de avance mandibular; y grupo IV con irradiación láser de 10 J / cm2 (0,25 W, 25 s) con el grupo de dispositivos de avance mandibular. El cartílago del cóndilo mandibular y los cambios en el hueso subcondral con diferentes dosis de TLBN y dispositivo de avance mandibular, se evaluaron mediante análisis histomorfométrico. Los resultados de la fracción ósea subcondral indicaron que no hubo diferencias significativas entre los grupos (p <0,05). Las diferencias estadísticamente significativas encontradas entre el grupo control y los grupos experimentales, en el grosor del cartílago anterior y posterior (p<0,05) y (p<0,01). Las capas de cartílago condilar posterior y anterior de las ratas reaccionan de manera diferencial a la aplicación de TLBN y avance mandibular. Se encontraron cambios significativos en las capas de cartílago condilar con irradiación láser de 8 J /cm2 con el grupo de dispositivos mandibulares.


Assuntos
Animais , Masculino , Ratos , Osso e Ossos/efeitos da radiação , Cartilagem Articular/efeitos da radiação , Avanço Mandibular/métodos , Terapia com Luz de Baixa Intensidade/métodos , Osso e Ossos/cirurgia , Cartilagem Articular/cirurgia , Ratos Wistar
7.
Braz Dent J ; 31(1): 57-62, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32159707

RESUMO

The objective of this study was to investigate the effects of low-level laser therapy (LLLT) and cigarette smoke on alveolar socket osteoclastogenesis signaling after tooth extraction, in rats. Sixty male Wistar rats were randomly assigned to four groups with 15 animals each: Control Group (with right maxillary molar extraction - ME), Experimental I (with ME and LLLT), Experimental II (with ME and cigarette smoke) and Experimental III group (with ME, LLLT and cigarette smoke). Euthanasia was performed at 3, 7 and 14 days postoperative. qRT-PCR was used to evaluate expression of Tnfrsf11a (RANK), Tnfsf11 (Rankl) and Tnfrsf11b (OPG). Data were submitted to statistical analysis using two-way ANOVA followed by Bonferroni test (α=0.05). There was an upregulation of RANK, RANKL and OPG genes over all the time of healing in Exp I group compared to control group. Exp II group showed a decreased expression of all genes over time, whereas Exp III genes expression were higher than Exp II values but lower than Control and Exp I values over time. The results of this study concluded that the LLLT had a positive effect, whereas cigarette smoke had a negative effect on RANK, RANKL and OPG gene expression in bone remodeling process.


Assuntos
Fumar Cigarros , Terapia com Luz de Baixa Intensidade , Animais , Masculino , Ratos , Ratos Wistar , Extração Dentária , Cicatrização
8.
Medicine (Baltimore) ; 99(10): e19005, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150048

RESUMO

Photobiomodulation therapy (PBMT) with low-power laser is used for pain relief in several clinical conditions, including temporomandibular disorders (TMD). As musculoskeletal pain often produces changes in motor behavior, it is common for patients with TMD to present limited mandibular movements. To the date, there is no consensus about the optimal dosimetric parameters of PMBT for TMD. This randomized, controlled, double-blind clinical trial aims to evaluate pain relief and mandibular mobility in patients with TMD following treatments with 2 laser wavelengths, red (660 nm) and infrared (808 nm) individually and in combination as compared to a placebo treatment. One-hundred participants presenting myalgia and arthralgia, with disk displacement or not, will be selected based on the Research Diagnostic Criteria for Temporomandibular Disorders. All participants will be instructed about the etiology, prognosis, and self-care techniques for pain control on TMD, and followed up for 2 weeks. After this period, those who still present pain score over 4 in a visual analog scale (VAS) will be included in the study. Participants will be randomly assigned to 4 treatment groups: G1 = placebo (SHAM); G2 = PBMT with red laser (660 nm, 0.034 cm, 88 J/cm, 100 mW, 3 J/point); G3 = PBMT with infrared laser (808 nm, 0.034 cm, 88 J/cm, 100 mW, 3 J/point); and G4 = PBMT with red and infrared laser alternated between sessions. The treatment consists of 8 sessions, 2 times a week. The effect of the proposed therapies will be measured by: pain reduction in VAS; pressure pain threshold on TMJ, masseter and temporal muscles; and the amplitude of mandibular movements (opening, protrusion, and right and left lateral movements). The data will be collected at the following times: initial (T1), after the 1st treatment session (T2), at the end of treatment (T3), and 30 days after the last PBMT session (T4). For statistical analysis will be used 2-way repeated measures analysis of variance test, complemented by a post hoc Tukey test (P < .05).


Assuntos
Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos da Articulação Temporomandibular/radioterapia , Método Duplo-Cego , Humanos , Terapia com Luz de Baixa Intensidade , Medição da Dor , Educação de Pacientes como Assunto , Projetos de Pesquisa
9.
Medicine (Baltimore) ; 99(13): e19430, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32221067

RESUMO

INTRODUCTION: Loss of a dental element can generate several repercussions in the stomatognathic system. According to the latest survey by the Ministry of Health, in 2010, Brazilian adults had, on average, 7 missing teeth. This loss may lead to movement of the adjacent teeth and the antagonist, which would make prosthetic rehabilitation harder to do. Anchoring systems, such as mini-implants, have been increasingly used as a treatment option because they act with heavy but controlled forces and without side effects. Recent studies have shown that photobiomodulation (PBM) can accelerate orthodontic movement in molar intrusion. The objective of this study will be to evaluate the effect of PBM on the acceleration of the orthodontic movement of molar verticalization and its effect on pain and inflammation of the periodontal tissues. PATIENT CONCERNS:: the concerns assessments will be done over the study using anamnesis interviews and specific questionnaire. DIAGNOSIS: verticalization will be evaluated by clinical and radiographic analysis. INTERVENTIONS: Thirty four healthy patients aged 30 to 60 years, who need to recover the prosthetic space for oral rehabilitation after loss of the posterior inferior dental elements and inclination of the adjacent element, will be randomly divided into 2 groups: G1 (control group) - verticalization by mini-implant + PBM simulation (placebo); G2 (experimental group) - verticalization by mini-implant + PBM. The movements will occur with the aid of mini-implants and elastomeric chains ligatures. The PBM will occur with diode laser application, 808 nm, 100 mW, receiving 1J per point, 10 seconds, 10 points (5 per buccal and 5 per lingual) and radiant exposure of 25 J/cm. The orthodontic forces of verticalization (corresponding to any exchange of elastomeric ligation) will be applied every 30 days and the PBM will be applied immediately, 3 and 7 days of each month, for a period of 3 months. The crevicular gingival fluid (CGF) will be collected on the 1st, 3rd, and 7th days after the first activation, and then on the 3rd day of the following 2 months. OUTCOMES: Interleukins IL1ß, IL-6, IL-8, IL-10, and TNF-α will be analyzed by ELISA. Panoramic radiography will be performed at baseline and 90 afterwards to ascertain the amount (in degrees) of verticalization. To evaluate the pain, the Visual Analog Scale (VAS) will be used in all the consultations, and to evaluate the quality of life, the Oral Health Impact Profile (OHIP-14) questionnaire will be applied. Analgesics will be given and the quantity of drugs will be counted. If the data are normal, they will be submitted to Student t test. The data will be presented as means ± SD and the value of p will be defined as <0.05. DISCUSSION: This protocol will determine the effectiveness of photobiomoduation regarding the orthodontic movement of molar verticalization. ETHICS AND DISSEMINATION: This protocol received approval from the Human Research Ethics Committee of Universidade Nove de Julho (certificate number: 3 533 219). The data will be published in a peer-reviewed periodical.


Assuntos
Interleucinas/biossíntese , Terapia com Luz de Baixa Intensidade/métodos , Dente Molar/efeitos da radiação , Técnicas de Movimentação Dentária/métodos , Adulto , Brasil , Método Duplo-Cego , Feminino , Líquido do Sulco Gengival , Humanos , Lasers Semicondutores , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Medição da Dor , Qualidade de Vida , Técnicas de Movimentação Dentária/efeitos adversos , Fator de Necrose Tumoral alfa/biossíntese
10.
Medicine (Baltimore) ; 99(12): e19541, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32195960

RESUMO

BACKGROUND: Knee osteoarthritis (KOA) is a common degenerative joint disorder that affects 250 million people globally. KOA can lead to disability and is often associated with cardiovascular disease, poor quality of life, and mortality. The most common treatment for KOA is non-steroidal anti-inflammatory drug administration. However, the analgesic effect is limited and often accompanied by multiple side effects. Hence, many KOA patients opt for complementary and alternative medicine. Acupuncture is one of the most popular complementary treatments with great analgesic effect and minimal side effect. Electroacupuncture (EA) and laser acupuncture (LA) have been known to reduce pain in KOA patients. However, to date, no study has assessed the benefits of combining these two therapies. METHODS: Fifty participants diagnosed with KOA, aged 50 years or older, and with consistent knee pain for more than 3 months were recruited and randomly assigned to the treatment group (EA plus LA) or control group (EA plus sham LA without laser output). All subjects in the treatment group will undergo a combined EA and LA treatment thrice a week for 4 weeks. The acupuncture will be performed on GB33, GB34, SP9, SP10, and ST36 sites. The treatment group will receive acupuncture with a transcutaneous electrical nerve stimulator at GB33, GB34, SP9, and SP10 sites and with LA at EX-LE5, ST35, and BL40 sites. The subjects in the control group will undergo the same treatment modality as the treatment group, except these subjects will not be exposed to laser output. Outcome measurements will include visual analog scale, Western Ontario McMaster Universities Osteoarthritis Index, Knee injury and osteoarthritis outcome, body composition analysis, knee range of motion, quadriceps muscle stiffness, one-leg standing with eyes open test, and the 30-s chair stand test before and after 4 weeks of intervention. OBJECTIVES: This protocol aims to investigate the combined effect of EA and LA in KOA patients.


Assuntos
Terapia por Acupuntura/métodos , Eletroacupuntura/métodos , Terapia a Laser/métodos , Osteoartrite do Joelho/terapia , Estimulação Elétrica Nervosa Transcutânea/instrumentação , Terapia por Acupuntura/tendências , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Humanos , Joelho/patologia , Terapia com Luz de Baixa Intensidade , Pessoa de Meia-Idade , Osteoartrite do Joelho/radioterapia , Avaliação de Resultados em Cuidados de Saúde , Dor , Manejo da Dor/métodos , Amplitude de Movimento Articular/fisiologia , Taiwan/epidemiologia , Escala Visual Analógica
11.
Medicine (Baltimore) ; 99(12): e19547, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32195961

RESUMO

Obstructive sleep apnea (OSA) increases morbidity and mortality and it is associated with an increased cardiovascular risk. The gold standard treatment for OSA is positive airway pressure therapy (CPAP). However, it is an expensive treatment and several patients do not adapt to CPAP. GOAL: The researchers will verify the effects of low-level laser therapy (LLLT) on OSA, when applied to the soft palate and on the tongue base. METHODS: The researchers will select individuals of both sexes aged 30 to 60 years old who are sedentary and that present a high risk of OSA by the Berlin questionnaire. The evaluations pre and post interventions will be polysomnography; anthropometric and body composition measurements (Bioimpedance); metabolic syndrome risk factors (International Diabetes Federation); physical capacity (VO2 peak at the cardiopulmonary exercise test, CPET); endothelial function (flow-mediated dilatation, FMD); autonomic control (heart rate variability and sympathovagal balance). Those diagnosed with moderate and severe OSA (apnea/hypopnea index, AHI ≥15 events/h) will be invited to participate in the study and they will be randomized into 2 groups: LLLT treatment or placebo (C). The LLLT group will receive applications at 8 points on the soft palate and on the base of the tongue for 8 seconds for each point. The applications of LLLT will occur twice a week, with a minimum interval of 2 days between the applications for 2 months, when using a Therapy Plus NS 13678 Laser. The C group will have similar applications, but with the device turned off. EXPECTED RESULTS: In the individuals with OSA, photobiomodulation through LLLT will decrease the AHI. Additionally, when LLLT is applied in the oral cavity, a highly vascularized region, this may cause improvements in the vascular function and in the autonomic and hemodynamic control. ETHICS AND DISSEMINATION: This protocol was approved by the Research Ethics Committee of the Nove de Julho University, São Paulo, Brazil, on the date of March 11, 2019 (CAAE: 06025618.2.0000.5511 - Acceptance Number: 3.191.077). This trial has been registered with the Brazilian Registry of Clinical Trials (REBEC TRIAL RBR-42v548). This study is not yet recruiting. Issue date: November 4, 2019.


Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Boca/efeitos da radiação , Apneia Obstrutiva do Sono/fisiopatologia , Apneia Obstrutiva do Sono/terapia , Adulto , Brasil/epidemiologia , Teste de Esforço/métodos , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Boca/irrigação sanguínea , Palato Mole/efeitos da radiação , Polissonografia/métodos , Fatores de Risco , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/mortalidade , Língua/efeitos da radiação
12.
Medicine (Baltimore) ; 99(6): e18860, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028396

RESUMO

RATIONALE: Coccyx fracture is an injury usually caused by trauma. In most cases, the fractures recover after conservative therapy. For refractory cases that exhibit coccydynia after more than 2 months of conservative treatment, coccygectomy is indicated. However, limited information about the efficacy of this procedure is available, and it is known to have a high complication rate. As such, other therapeutic approaches are needed. Here, we report our experience using another conservative treatment option, low-level laser therapy, to successfully reduce refractory coccydynia in a patient with coccyx fracture. PATIENT CONCERNS: A 23-year-old woman had refractory coccydynia and increased pain after a traffic accident-induced coccyx fracture. DIAGNOSES: Initially, the patient reported transient improvement after conservative treatment with non-steroidal anti-inflammatory drugs. However, the pain increased in severity (numerical rating scale score of 8) soon after she resumed work in her office, and progressed in the following 2 months. Surgical intervention was suggested owing to the prolonged coccydynia following the failure of conservative treatment and difficulties in performing daily life activities. However, she sought other conservative therapy options, because she was concerned about the risks associated with the coccygectomy surgery. INTERVENTIONS: The patient received low-level laser therapy once a week, for 24 weeks. OUTCOMES: After 11 weeks of treatment, the patient reported significant improvements in her symptoms; her pain was reduced to a numerical rating scale score of 2 and bone healing was noted on radiographs. The patient could eventually perform her daily activities satisfactorily, without coccydynia, after 24 weeks of treatment. LESSONS: Laser acupuncture produced analgesic effects in this patient with refractory coccydynia after traumatic coccyx fracture. This is the first case report to apply laser acupuncture for refractory coccydynia after traumatic coccyx fracture. Our findings imply that laser acupuncture may be a good conservative therapy option for coccyx fracture.


Assuntos
Cóccix/lesões , Dor Lombar/terapia , Fraturas da Coluna Vertebral/complicações , Terapia por Acupuntura , Feminino , Humanos , Dor Lombar/etiologia , Terapia com Luz de Baixa Intensidade , Medição da Dor , Resultado do Tratamento , Adulto Jovem
13.
Medicine (Baltimore) ; 99(8): e19191, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080103

RESUMO

INTRODUCTION: Chronic neck pain is a common musculoskeletal disorder that is associated with functional disability and decreased of quality of life. Electrophysical agents are commonly used to relieve pain, however the effects of combined use of these agents are little studied. The objective is to investigate the efficacy of photobiomodulation and electrical stimulation to relieve pain, both in isolation and combined. MATERIALS AND METHODS: This a 4-arm randomized placebo-controlled trial with patient and evaluator blinded. This study will be performed in Department of Physical Therapy at Federal University of São Carlos, São Carlos/SP, Brazil. One hundred and forty-four patients with chronic neck pain will be randomized into 4 groups: active photobiomodulation therapy with active electrical stimulation, active photobiomodulation therapy, active electrical stimulation, or placebo treatment. They will receive 10 sessions of treatment. PRIMARY OUTCOME: pain intensity (measured by pain numerical rating scale) posttreatment. SECONDARY OUTCOMES: pain during movement, neck disability, range of motion, pressure pain threshold, temporal summation, conditioned pain modulation, depressive symptoms, pain catastrophizing, quality of life, analgesic intake, and global perceived effect at posttreatment (10 sessions). Pain intensity and global perceived effect will also be measured after 6 weeks randomization. DISCUSSION: The findings of this study might clarify the importance of using the photobiomodulation therapy and transcutaneous electrical nerve stimulation for patients with chronic neck pain. TRIAL REGISTRATION: NCT04020861. https://clinicaltrials.gov/ct2/show/NCT04020861?term=NCT04020861&draw=2&rank=1.


Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Cervicalgia/terapia , Modalidades de Fisioterapia , Estimulação Elétrica Nervosa Transcutânea/métodos , Adolescente , Adulto , Idoso , Analgésicos/administração & dosagem , Dor Crônica , Terapia Combinada , Depressão/epidemiologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cervicalgia/epidemiologia , Medição da Dor , Qualidade de Vida , Amplitude de Movimento Articular , Adulto Jovem
14.
J Photochem Photobiol B ; 204: 111785, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31954267

RESUMO

Postoperative sensory disturbances of inferior alveolar nerve (IAN) are major challenges in dental procedures. We aimed to investigate the effect of photobiomodulation therapy (PBMT) with 810 nm and 980 nm diode lasers on behavioral and immunological factors in a rat IAN crush model. Seventy-two rats were randomly assigned to the four groups of 810 nm laser (crush injury+810 nm laser; 6 J/cm2, 15 sessions, every 48 h), 980 nm laser (crush injury+980 nm laser; same protocol), control (crush injury without irradiation), and sham surgery (no crush injury and no irradiation). The neurosensory response of IAN was evaluated by Von Frey behavioral test before (baseline) and post-surgery in a period of one month. Changes of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), nuclear factor-kappa B (NF-κB), TNF-α, and IL-1ß, were assessed on days 2 and 30 post injury. Data were analyzed for significant differences by repeated measures and one-way ANOVA (p < .05). One day after surgery, all rats subjected to nerve injury showed significant increase in the withdrawal threshold of von Frey test compared to the baseline (p = .02 for control and p = .03 for laser groups). The threshold gradually returned to the baseline scores in 810 nm, 980 nm, and control groups from days 11, 17, and 29, respectively. There was a significant lower withdrawal threshold in 810 nm and 980 nm laser groups compared to the control group in days 11 to 19 and 9 to 23, respectively. At both time points, the levels of NGF and BDNF were significantly higher in 810 nm laser group compared to the control group. There was a significant difference between laser and control groups regarding NF-κB expression (all p values<.001). TNF-α and IL-1ß were significantly lower in laser groups compared to the control group (all p values < .001). PBMT with 810 and 980 nm diode laser protocol used in this study, promoted the neurosensory recovery of IAN after crush injury in rats. In addition, application of 810 nm diode laser was associated with more improvement in immunological responses compared to that of 980 nm laser.


Assuntos
Lasers Semicondutores , Nervo Mandibular/efeitos da radiação , Animais , Comportamento Animal/efeitos da radiação , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Modelos Animais de Doenças , Regulação para Baixo/efeitos da radiação , Interleucina-1beta/metabolismo , Terapia com Luz de Baixa Intensidade , Masculino , Nervo Mandibular/imunologia , Nervo Mandibular/metabolismo , Traumatismos do Nervo Mandibular/imunologia , Traumatismos do Nervo Mandibular/metabolismo , Traumatismos do Nervo Mandibular/radioterapia , NF-kappa B/metabolismo , Fator de Crescimento Neural/metabolismo , Ratos , Ratos Wistar , Fator de Necrose Tumoral alfa/metabolismo , Regulação para Cima/efeitos da radiação
15.
J Oral Facial Pain Headache ; 34(1): 13­30, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31339967

RESUMO

AIMS: To evaluate the efficacy of low-level laser therapy (LLLT) for the therapeutic management of neuropathic orofacial pain. METHODS: This systematic review was conducted according to PRISMA guidelines. A comprehensive search of the literature was conducted in the PubMed/MEDLINE, Scopus, and Cochrane Library databases up to March 8, 2018, using terms such as low-level laser therapy, neuropathic pain, orofacial pain, neuralgia, neuropathy, and all the entities described in section 13 of the International Classification of Headache Disorders, third edition. The primary outcome was measurement of pain intensity. RESULTS: A total of 997 studies were obtained with the initial search; 13 (8 randomized controlled trials, 2 prospective studies, and 3 case series) met the inclusion criteria and were analyzed for data extraction. Three provided data for the treatment of trigeminal neuralgia, 1 for occipital neuralgia, and 10 for burning mouth syndrome. All studies showed a reduction in pain intensity (most of them significant). The different studies analyzed LLLT alone and compared to placebo, to another treatment, or to different LLLT application protocols. CONCLUSION: LLLT seems to be effective as a treatment option for different neuropathic orofacial pain entities such as trigeminal neuralgia, occipital neuralgia, and burning mouth syndrome as a single or combined treatment. However, more quality studies assessing all outcome measures of chronic pain are needed in the medium and long terms. Furthermore, due to the lack of standardization of the application technique, more well-designed studies are required to confirm the results of this systematic review.


Assuntos
Dor Crônica , Terapia com Luz de Baixa Intensidade , Neuralgia , Dor Facial , Humanos , Estudos Prospectivos
16.
Clin Oral Investig ; 24(1): 37-45, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31720851

RESUMO

OBJECTIVES: To evaluate therapeutic effects of laser therapy on patients with recurrent aphthous stomatitis assessing evidences from previously published systematic reviews. MATERIALS AND METHODS: An overview of systematic reviews was conducted based on PRISMA checklist. Search strategies were developed and adapted for six different electronic databases and a gray literature search was also performed. The methodology quality of the included systematic reviews was assessed by the Measurement Tool to Assess the Methodological Quality of Systematic Reviews 2 (AMSTAR 2). RESULTS: After a two-step selection, five systematic reviews were included. Methodology quality was considered as a high risk of bias in two systematic reviews, while in the other three were graded as moderate. The systematic reviews' conclusions demonstrated that all included systematics reviews showed positive effects of laser therapy for pain relief, and most of them demonstrated healing improvement. A meta-analysis was not feasible due to heterogeneity in treatments parameters. CONCLUSIONS: Evidence suggested that laser therapy is an effective tool to treat recurrent aphthous stomatitis; nevertheless, more randomized clinical trials should be conducted to compare different lasers parameters. CLINICAL RELEVANCE: The present overview evaluated recent evidence about laser therapy for recurrent aphthous stomatitis management in order to contribute for evidence-based dentistry and decision-making. This overview suggests that laser therapy is a safe and promising alternative to treat recurrent aphthous stomatitis, since it promotes wound healing and pain relief.


Assuntos
Terapia a Laser , Lasers de Gás , Terapia com Luz de Baixa Intensidade , Estomatite Aftosa , Humanos , Dor
17.
Fisioter. Mov. (Online) ; 33: e003318, 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1090390

RESUMO

Abstract Introduction: Photobiomodulation (PBM) assists in the processes of angiogenesis and cellular mitosis after skin lesion, contributing to tissue repair. Objective: to investigate the effects of photobiomodulation (during the proliferative phase) of 658 nm, 830 nm and 904 nm in the repair of skin lesions in an animal model. Method: 658 nm (G658), 830 nm (G830), 904 nm (G904) PBM, and control group (CG) integrated the research. We submitted the animals to an excisional wound and treatment at different wavelengths for 14 days. On the seventh and 14-1485004059th postoperative days, we calculated the area and percentage of lesion contraction. The animals were sacrificed on the 14-1485004056th postoperative day and cutaneous section of the injured region was collected for histomorphometric evaluation of the cellularity, neovascularization, thickness of the epidermis and volume density of collagen fibers colored with H&E and Picross Sirius respectively. For the statistical analysis, we applied the ANOVA test. Results: the G658 presented higher cellularity than GC (p = 0.03). The animals in the G658 group showed a significant increase in the neovascularization in relation to the CG (p = 0.01). Type III collagen significantly increased in G904 compared to G830 (p < 0.0001) and CG (p < 0.0001). The G658 had a significant increase in type III collagen fibers compared to G830 (p < 0.0001) and GC (p < 0.0001). We found no significant difference in the thickness of the epidermis, wound area, and in the percentage wound of contraction between the analyzed groups. Conclusion: PBM was effective to stimulate the tissue repair process, with better results for the 658 nm wavelength.


Resumo Introdução: A Fotobiomodulação (FBM) auxilia nos processos de angiogênese e mitose celular após lesão cutânea, contribuindo para reparo do tecido. Objetivo: investigar os efeitos da fotobiomodulação (durante a fase proliferativa) com comprimento de onda de 658 nm, 830 nm e 904 nm no reparo de lesões cutâneas em modelo animal. Método: FBM 658 nm (G658), 830 nm (G830), 904 nm (G904) e controle (GC) integraram a pesquisa. Os animais foram submetidos a uma ferida excisional e receberam tratamento em diferentes comprimentos de por 14 dias. No 7º e 14º dia pós-operatório, calculou-se a área e a porcentagem de contração da lesão. Os animais foram sacrificados no 14º dia pós-operatório e a secção cutânea da região lesada foi coletada para avaliação histomorfométrica da celularidade, neovascularização, espessura da epiderme e densidade volumétrica das fibras colágenas, corados com H&E e Picross Sirius respectivamente. Para a análise estatística, foi aplicado o teste ANOVA. Resultados: o G658 apresentou maior celularidade que GC (p = 0,03). Os animais do grupo G658 apresentaram aumento significativo da neovascularização em relação ao GC (p = 0,01). Houve aumento significativo do colágeno tipo III no G904 em relação ao G830 (p < 0,0001) e GC (p < 0,0001). O G658 teve um aumento significativo nas fibras colágenas tipo III em comparação ao G830 (p < 0,0001) e GC (p < 0,0001). Nenhuma diferença significativa foi encontrada na espessura da epiderme, área da ferida e na porcentagem de contração da ferida entre os grupos analisados. Conclusão: a PBM foi efetiva para estimular o processo de reparo tecidual, com melhores resultados para o comprimento de onda de 658 nm.


Resumen Introducción: La fotobiomodulación (FBM) auxilia en los procesos de angiogénesis y mitosa celular después de lesión cutánea, contribuyendo para la reparación. Objetivo: investigar los efectos de la fotobiomodulación (durante la fase proliferativa) con longitud de onda de 658 nm, 830 nm y 904 nm en la reparación de lesiones cutáneas en modelo animal. Método: grupos de FBM 658 nm (G658), 830 nm (G830), 904 nm (G904) y control (GC) integraron la investigación. Los animales fueron sometidos a una herida excisional y recibieron tratamiento 14 días. En el 7º y 14º día postoperatorio, se calculó el área y el porcentaje de contracción de la lesión. Los animales fueron sacrificados en el 14º día postoperatorio y la sección cutánea de la región lesada fue recolectada para evaluación histomorfométrica de la celularidad, neovascularización, espesor de la epidermis y densidad volumétrica de las fibras colágenas, colorados con H & E y Picross Sirius respectivamente. Para el análisis estadístico, se aplicó la prueba ANOVA. Resultados: G658 presentó mayor celularidad que GC (p = 0,03). G658 presentaron un aumento significativo de la neovascularización en relación al GC (p = 0,01). Se observó un aumento significativo del colágeno tipo III en el G904 con respecto al G830 (p < 0,0001) y GC (p < 0,0001). El G658 tuvo un aumento significativo en las fibras colágenas tipo III en comparación con el G830 (p < 0,0001) y GC (p < 0,0001). Ninguna diferencia significativa se encontró en el espesor de la epidermis, área de la herida entre los grupos. Conclusión: la PBM fue efectiva para estimular el proceso de reparación del tejido, con mejores resultados para grupo 658 nm.


Assuntos
Terapia com Luz de Baixa Intensidade , Cicatrização , Modelos Animais
18.
Oral Health Prev Dent ; 17(6): 547-556, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31825027

RESUMO

PURPOSE: Dentin hypersensitivity (DH) is a prevalent painful condition of the teeth, the management of which lies in the obliteration of patent dentinal tubules. The purpose of this study was to compare the efficacy of 5% potassium nitrate (PN), low-level laser therapy (LLLT), and combination of low-level laser therapy and 5% potassium nitrate (LLLT+PN) in patients with fluorotic and non-fluorotic hypersensitive teeth. MATERIALS AND METHODS: Ninety self reporting patients with DH completed the randomised, double-blind study. Patients were equally divided into fluorosis group (FG), with moderate to moderately severe fluorosis and the non-fluorosis group (NFG) and subdivided into 3 groups to receive PN, LLLT (810 nm, 1 W) alone and LLLT+PN. Each participant had at least one tooth eliciting a response of ≥ 3 on a visual analog scale (VAS) to evaporative, thermal and electric tactile stimulus (digital scratch-o-meter). The teeth were evaluated at baseline, 30 min post treatment, 1 week, 4 weeks and 12 weeks. The magnitude of pressure applied by the scratch-o-meter was also assessed for all three interventions. RESULTS: Statistically, LLLT+PN was more effective in alleviating DH at all time intervals compared to baseline. However, statistically significant results (p ˂ 0.05) were seen with LLLT+PN at 12 weeks in FG. Magnitude of pressure applied showed statistically significant differences with LLLT+PN at 30 min post treatment. CONCLUSION: LLLT+PN alleviated DH at all time intervals, with a greater effect in the fluorotic group. However, LLLT+PN was more efficacious in reducing DH at 12 weeks post treatment in the fluorotic group.


Assuntos
Dessensibilizantes Dentinários , Sensibilidade da Dentina , Fluorose Dentária , Terapia com Luz de Baixa Intensidade , Método Duplo-Cego , Humanos , Resultado do Tratamento
19.
Medicine (Baltimore) ; 98(48): e17756, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31770194

RESUMO

BACKGROUND: Surgically assisted rapid maxillary expansion (SARME) generates an uncomfortable postoperative period accompanied by pain, edema, and paresthesia. There are few studies on the effect of photobiomodulation (PBM) after SARME and it was not possible to find studies on the efficacy of light emitted by diode (LED) after this type of intervention. The main objective of the study will be to evaluate the efficacy of PBM with LED in the control of pain, facial edema, paresthesia, and bone repair after SARME. METHODS: A randomized, double-blind, placebo-controlled clinical trial involving 72 participants aged from 18 to 45 years, who search the Department of Buccomaxillofacial Surgery and Traumatology of Mandaqui Hospital Complex, will be conducted. Immediately after surgeries, the participant will be inserted into the placebo or LED group. In the LED group, the participants will receive PBM with an extraoral device (660 and 850 nm with 6 J per point) and an intraoral device (660 nm with 2 J per point) and in the control group the person in charge of the application will simulate the irradiation with the devices kept off. The applications will be in the immediate postoperative period, 1, 2, 7, 14, 30, 60, 90, and 120 days after the end of the surgeries, when the evaluations will also be performed. Facial measurements, extra and intraoral sensitivity, pain and bone repair will be evaluated. Secondarily, data regarding the occurrence of headache; otalgia; nausea; bruising; nasolacrimation; epistaxis; dysphagia; systemic and superficial temperature in the operated region; use of analgesics and anti-inflammatories; anxiety and impact of oral health on the participants' quality of life will be computed. DISCUSSION: Since PBM has shown positive effects on postoperative complications of other types of oral surgery and also has a positive effect on bone repair after maxillary disjunction, surgically assisted or not, it seems clear the need to evaluate its performance regarding pain, edema, and paresthesia after these surgeries. TRIAL REGISTRATION: This protocol was registered in Clinical Trials platform (https://clinicaltrials.gov/) with the number NCT03814525, first published and last updated on January 24, 2019.


Assuntos
Edema/terapia , Terapia com Luz de Baixa Intensidade/métodos , Doenças Maxilares/terapia , Dor Pós-Operatória/terapia , Técnica de Expansão Palatina/efeitos adversos , Parestesia/terapia , Complicações Pós-Operatórias/terapia , Adolescente , Adulto , Regeneração Óssea , Método Duplo-Cego , Edema/etiologia , Feminino , Humanos , Masculino , Maxila/cirurgia , Doenças Maxilares/etiologia , Pessoa de Meia-Idade , Parestesia/etiologia , Complicações Pós-Operatórias/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Adulto Jovem
20.
Medicine (Baltimore) ; 98(48): e17948, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770202

RESUMO

BACKGROUND: Laser systems are a common treatment choice for onychomycosis. They exert their effects on inhibiting the growth of the fungus by selective photothermolysis but efficacy is dependent on the specific type of apparatus used. To systematically review the available published literature on the curative effects and safety of laser treatment for onychomycosis. METHODS: Databases including PubMed, web of science, China National Knowledge Internet (CNKI), WanFang Database and VIP were searched systematically to identify relevant articles published up to July 2018. Potentially relevant articles were sourced, assessed against eligibility criteria by 2 researchers independently and data were extracted from included studies. A meta-analysis was performed using R software. RESULTS: Thirty-five articles involving 1723 patients and 4278 infected nails were included. Meta-analysis of data extracted from these studies revealed that: the overall mycological cure rate was 63.0% (95%CI 0.53-0.73); the mycological cure rate associated with the 1064-nm Nd: YAG laser was 63.0% (95%CI 0.51-0.74); and that of CO2 lasers was 74.0% (95%CI 0.37-0.98). The published data indicate that laser treatment is relatively safe, but can cause tolerable pain and occasionally lead to bleeding after treatment. CONCLUSION: Laser treatment of onychomycosis is effective and safe. The cumulative cure rate of laser treatment was significantly higher for CO2 lasers than other types of laser. Laser practitioners should be made aware of potential adverse effects such as pain and bleeding.


Assuntos
Lasers de Gás/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Onicomicose/radioterapia , Humanos , Unhas/efeitos da radiação , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
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