Isolation and characterisation of Leishmania (Leishmania) infantum from cutaneous leishmaniasis patients in northeast Brazil.

BACKGROUND: In Brazil, Leishmania (Leishmania) infantum is a widely distributed protozoan parasite. The human leishmaniasis caused by this species is often associated with visceral form. Tegumentary leishmaniasis (TL) cases due to L. (L.) infantum in the country are considered rare but may be underestimated. Although probably uncommon, these cases represent a new challenge to the prevention and control of leishmaniasis. OBJECTIVES: Here, we describe two distinct cases of TL with atypical clinical presentations caused by L. (L.) infantum. METHODS AND FINDINGS: Parasites were isolated from cutaneous lesions of the two patients and typed as L. (L.) infantum after sequencing of the ribosomal DNA internal transcribed spacer. The dermotropic L. (L.) infantum isolates were compared in terms of growth culture patterns, metacyclogenesis and in vitro infectivity in macrophages. MAIN CONCLUSIONS: This study addresses the emergence of L. (L.) infantum as a causative agent of cutaneous disease in a visceral leishmaniasis hotspot located in northeast Brazil. The data presented provides novel information about the presence of dermotropic L. (L.) infantum in the country and demonstrates the infectivity potential of theses isolates.

Accuracy and reproducibility of real and virtual occlusal contact points in implant-supported fixed prostheses.

AIM: To evaluate the accuracy and reproducibility of real and virtual occlusal contact points in implant-supported, fixed complete dentures. MATERIALS AND METHODS: The study included 19 participants using mandibular interim complete-arch fixed prosthesis supported by 3 or 4 implants as opposed to conventional removable complete dentures. At installation, an examiner installed the prostheses and verified the occlusal contact points through 2 methods: recording the real contact points with carbon paper (RC) followed by occlusal photography and intraoral scanning (VC) to record the virtual contact points to obtain a screen print of the software. Then, the two images were randomized to determine the order to be inserted into Microsoft PowerPoint for blind and paired evaluation. The independent variables consisted of the distribution of occlusal contacts points (qualification through pre-defined scores based on the position of the contact points on the surfaces of the teeth) and the reproducibility of the methods by verifying the number of occlusal points. For this, a descriptive analysis was used to evaluate the distribution of occlusal contacts points and the Wilcoxon test for the reproducibility of the occlusal contact points between the methods (p<0.05). RESULTS: The methods had 100% and 73.6% real and virtual occlusal contact points, respectively, which is considered clinically excellent. There was no significant difference regarding the reproducibility of the methods by the number of occlusal contact points (RC: x̅13.32; VC: x̅13.68; p=0.715). CONCLUSION: The use of the tested intraoral scanner can be an easy and fast tool for studying and mapping the occlusion, and storing data for future treatment, with the conventional method being the preferred method for performing the occlusal adjustment.

Characterization of Leishmania (L.) amazonensis oligopeptidase B and its role in macrophage infection.

Leishmania spp. are parasitic protozoa that cause leishmaniasis, a disease endemic in 98 countries. Leishmania promastigotes are transmitted by the vector and differentiate into amastigotes within phagocytic cells of the vertebrate host. To survive in multiple and hostile environments, the parasite has several virulence factors. Oligopeptidase B (OPB) is a serine peptidase present in prokaryotes, some eukaryotes and some higher plants. It has been considered a virulence factor in trypanosomatids, but only a few studies, performed with Old World species, analysed its role in Leishmania virulence or infectivity.L. (L.) amazonensis is an important agent of cutaneous leishmaniasis in Brazil. The L. (L.) amazonensis OPB encoding gene has been sequenced and analysed in silico but has never been expressed. In this work, we produced recombinant L. (L.) amazonensis OPB and showed that its pH preferences, Km and inhibition patterns are similar to those reported for L. (L.) major and L. (L.) donovani OPBs. Since Leishmania is known to secrete OPB, we performed in vitro infection assays using the recombinant enzyme. Our results showed that active OPB increased in vitro infection by L. (L.) amazonensis when present before and throughout infection. Our findings suggest that OPB is relevant to L. (L.) amazonensis infection, and that potential drugs acting through OPB will probably be effective for Old and New World Leishmania species. OPB inhibitors may eventually be explored for leishmaniasis chemotherapy.

Photoprotective effect of solid lipid nanoparticles of rutin against UVB radiation damage on skin biopsies and tissue-engineered skin.

Solid lipid nanoparticles (SLNs) containing rutin were prepared to enhance their photochemopreventive effect on the skin. SLNs were produced by the hot melt microemulsion technique. Two 3D skin models: ex vivo skin explants and 3D tissue engineering skin were used to evaluate the photochemopreventive effect of topical formulations containing rutin SLNs, against ultraviolet B (UVB) radiation, inducing sunburn cells, caspase-3, cyclobutane pyrimidine dimers, lipid peroxidation, and metalloproteinase formation. The rutin SLNs presented average size of 74.22 ± 2.77 nm, polydispersion index of 0.16 ± 0.04, encapsulation efficiency of 98.90 ± 0.25%, and zeta potential of -53.0 ± 1.61 mV. The rutin SLNs were able to efficiently protect against UVB induced in the analysed parameters in both skin models. Furthermore, the rutin SLNs inhibited lipid peroxidation and metalloproteinase formation. These results support the use of rutin SLNs as skin photochemopreventive agents for topical application to the skin.

Short-Term Effect of Scalp Acupuncture on Pain, Sleep Disorders, and Quality of Life in Patients with Temporomandibular Disorders: A A Randomized Clinical Trial.

OBJETIVE: To evaluate the effects of Chinese scalp acupuncture in patients diagnosed with temporomandibular disorders (TMD) on pain, sleep, and quality of life (QOL), and compare these results with the results from traditional therapies. METHODS: Sixty patients diagnosed with TMD using the research diagnostic criteria for temporomandibular disorders (RDC/TMD) were allocated into four treatment groups: counseling (C = 15), occlusal splint (OS = 15), scalp acupuncture (SA = 15), and manual therapy (MT = 15). Participants were re-evaluated within 1 month. Three questionnaires were used to access sleep disorders, QOL, and pain: The Pittsburgh Sleep Quality Index (PSQI), World Health Organization Quality of Life (WHOQOL-bref), and the Visual Analogue Scale (VAS), respectively. The data obtained were analyzed using the Statistical Package for the Social Science program (SPSS 22.0). RESULTS: The SA group significantly improved pain (P = .015), as well as the OS (P = .01) and MT groups (P = .014). Only the OS (P = .002) and MT (P = .029) groups improved sleep. MT group significantly improved QOL in terms of the physical domain of the WHOQOL-bref (P = .011) and the OS group in the psychological domain (P = .012). CONCLUSIONS: The scalp acupuncture proved to be another alternative for pain relief in patients with TMD, demonstrating positive results in the short term. However, it was not as effective in improving quality of life and sleep.

Accuracy of CAD-CAM systems for removable partial denture framework fabrication: A systematic review.

STATEMENT OF PROBLEM: Removable partial dentures (RPDs) are traditionally made by casting, a complex, error-prone, and time-consuming process. Computer-aided design and computer-aided manufacturing (CAD-CAM) RPD systems may simplify the clinical steps and minimize errors; however, the accuracy of CAD-CAM RPD systems is unclear. PURPOSE: The purpose of this systematic review was to determine whether CAD-CAM systems are accurate for the manufacturing of RPD frameworks. MATERIAL AND METHODS: A literature search was conducted through Medline-PubMed, Scopus, Lilacs, Web of Science, and Cochrane Library databases using specific keywords for articles published up to November 2019. Three reviewers obtained data and compared the results. All studies evaluated the framework accuracy or fit of prostheses fabricated with conventional and digital techniques. RESULTS: A total of 7 articles, 2 clinical studies, and 5 in vitro studies that complied with the inclusion criteria were evaluated. One in vitro study compared indirect (extraoral) and direct (intraoral) scanning for partially edentulous ridges and shows that digital scans were better than conventional impressions in terms of trueness. In the other studies included, although the frameworks analyzed had clinically acceptable discrepancies (<311 µm), the material influenced the fit. Polyetheretherketone (PEEK) showed better fit than traditional metal cast RPDs. Co-Cr alloy RPDs produced by rapid prototyping exhibited the highest discrepancies when produced by sintering laser melting. CONCLUSIONS: The results show that the digital technique for RPD frameworks is accurate. In the studies included, the analyzed frameworks had clinically acceptable gaps, but the results were heterogeneous among studies because the articles used different measurement methods with small sample sizes. Few studies discussed the long-term clinical performance. The digital technique for RPD frameworks was accurate because the misfits and mismatches found in in vitro and clinical studies were within the acceptable clinical limit for RPDs.

Effects of cigarette smoke on color change of resin composites.

PURPOSE: To evaluate the color change caused by cigarette smoke in both microhybrid and nanohybrid resin composites of three different manufacturers (Z100, Z350, Charisma, and Opallis). METHODS: Samples of microhybrid (n= 40) and nanohybrid (n= 40) resin composites (A2) were prepared for each resin brand, totaling 240 samples. The samples were divided into subgroups: Control: control group without exposure; C5: five cigarettes, 25 minutes/ exposure; C10: 10 cigarettes, 50 minutes/ exposure; C20: 20 cigarettes, 100 minutes/ exposure. The samples were then photographed and color change was measured by a computerized image analysis. L*a*b* values were obtained and color change was calculated. The Kolmogorov-Smirnov test was used to examine data normality; color change associated with an individual brand and the number of smoked cigarettes was analyzed with differentiation across the groups by the Tukey test (P≤ 0.05). The student t-test (P≤ 0.05) was used for the differentiation of inorganic fillers. RESULTS: The color change was significant between five and 10 cigarettes (P= 0.01), between five and 20 cigarettes (P= 0.000), and not significant between 10 and 20 cigarettes (P= 0.585). Charisma showed a significant color change when compared to Opallis (P= 0.008) and Z100 and Z350 (P= 0.000). CLINICAL SIGNIFICANCE: Different brands, inorganic fillers, and number of smoked cigarettes are variables that influence color change of resin composites. Nanohybrid resins Z100, Z350, and Opallis exhibited less color variation when they were exposed to cigarette smoke.

Effects of carbonated beverages on resin composite stability.

PURPOSE: To evaluate the effect of four distinct carbonated beverages on the color stability of two resin composites, microhybrid and nanofilled, from the same manufacturer but with different inorganic filler compositions and different finishing and polishing methods. METHODS: A total of 150 specimens were prepared in microhybrid (n= 75) and nanofilled (n= 75) resin composites, with the color shade A2E. The samples, subdivided into groups (n = 25), underwent different surface treatments: G1, a sequence of sandpaper discs; G2, universal polishing paste; and G3, disc sequence, and polishing paste. Subsequently, the samples were immersed in five solutions: Coca-Cola, Fanta Orange Soda, Guaraná Antarctica, Sprite, and distilled water (as the control group) (n= 5). Photographic images were taken at four times: baseline and after immersion for 7, 15, and 30 days. Color change was calculated with computerized image analysis using the Commission Internationale de l'Eclairage (CIE) L* a* b* values. Color change variations by time, beverage type, and polishing were calculated by ANOVA followed by Tukey's test for differentiation (P≤ 0.05). Student's t-test was used for differentiation of inorganic loads (P≤ 0.05). Color variation was significant at Day 30 when compared to Day 7 (P= 0.000) and Day 15 (P= 0.004). RESULTS: There was no significant difference between the finishing and polishing methods. When compared to other soft drinks, Guaraná presented statistical significance. There was no significance between nanofilled and microhybrid resins (P= 0.239). Soft drink type and immersion time influenced the color stability of resin composites. Inorganic fillers, as well as finishing and polishing methods, did not influence color change. CLINICAL SIGNIFICANCE: Inorganic fillers, finishing and polishing methods and carbonated beverages are variables that may influence color change of resin composites. Soft drink type and immersion time influenced the color stability of resin composites. Inorganic fillers, as well as finishing and polishing methods, did not influence color change.

Stress Over Implants of One-Piece Cast Frameworks Made With Different Materials.

This study aims to compare stress transmitted to implants and passive fit of one-piece cast frameworks fabricated with 3 different materials: commercially pure titanium (G1-CP Ti), cobalt-chromium alloy (G2-Co-Cr), and nickel-chromium-titanium alloy (G3-Ni-Cr-Ti). In total, 12 frameworks simulating bars for fixed prosthesis in a model with 5 implants were fabricated. The passive fit of the framework interface was measured using an optical microscope and the stresses transmitted to implants were measured using quantitative photoelastic analysis. Data were statistically analyzed by analysis of variance (ANOVA) and least significant difference (LSD) tests (α = 0.05). Mean and standard deviation values of passive fit and stress over implants are presented, respectively: G1 [472.49 (109.88) µm and 11.38 (9.23) KPa], G2 [584.84 (120.20) µm and 15.83 (9.30) KPa], and G3 [462.70 (179.18) µm and 16.39 (9.51) KPa]. For stress over implants, there were significant differences between G1, G2, and G3 (P = 0.035), being the lowest values for the G1. There were no significant differences for passive fit between G1 and G3 (P = 0.844), but both were statistically different from G2 (P = 0.028 and P = 0.035, respectively), which showed the worse results. It may be concluded that the stress over implants was affected by the tested materials. The CP Ti presented the best values for the evaluated items.

Biotechnological potential of yeast isolates from cachaça: the Brazilian spirit.

This study identified phenotypic traits appropriate for biotechnological applications of 118 yeasts isolated from cachaça distilleries. Different properties were verified: capacity to use alternative carbon sources; ability to tolerate high concentrations of sucrose, ethanol, methanol, aluminum and zinc as well as different pH values and foam production. Pichia guilliermondii and Pichia anomala strains were identified as the most promising ones for application in the second-generation biofuel industry, showing ability to grow on high glycerol concentrations. Other isolates, identified as Saccharomyces cerevisiae, produced bioethanol comparable to the industrial strains, and were therefore ideal for use in the first-generation ethanol industry. Some of these strains also showed high resistance to aluminum, as observed in sugarcane juice, and to inter-cycle washings with diluted sulphuric acid, as performed in the industrial bioethanol production process. In summary, yeast isolates from cachaça distilleries displayed robustness and phenotypic plasticity, which makes them interesting for biotechnological applications.

Influence of CAD/CAM on the fit accuracy of implant-supported zirconia and cobalt-chromium fixed dental prostheses.

STATEMENT OF PROBLEM: Relatively little information is available on the accuracy of the abutment-implant interface in computer-aided design and computer-aided manufacturing (CAD/CAM)-fabricated zirconia and cobalt-chromium frameworks. PURPOSE: The purpose of this study was to compare the fit accuracy of CAD/CAM-fabricated zirconia and cobalt-chromium frameworks and conventionally fabricated cobalt-chromium frameworks. MATERIAL AND METHODS: Four groups of 3-unit, implant-supported, screw-retained frameworks were fabricated to fit an in vitro model with 3 implants. Eight frameworks were fabricated with the CAD/CAM system: 4 in zirconia and 4 in cobalt-chromium. Another 8 were cast in cobalt-chromium with conventional casting, including 4 with premachined abutments and 4 with castable abutments. The vertical misfit at the implant-framework interface was measured with scanning electron microscopy when only 1 screw was tightened and when all screws were tightened. Data were analyzed with the Kruskal-Wallis and Mann-Whitney tests (α=.05). RESULTS: The mean vertical misfit values when all screws were tightened was 5.9 ±3.6 µm for CAD/CAM-fabricated zirconia, 1.2 ±2.2 µm for CAD/CAM-fabricated cobalt-chromium frameworks, 11.8 ±9.8 µm for conventionally fabricated cobalt-chromium frameworks with premachined abutments, and 12.9 ±11.0 µm for the conventionally fabricated frameworks with castable abutments; the Mann-Whitney test found significant differences (P<.05) among all frameworks, except between the conventionally fabricated frameworks (P=.619). No significant differences were found among the groups for passive fit gap measurements (P>.05). CONCLUSIONS: When all of the screws were tightened, the CAD/CAM frameworks exhibited better fit accuracy compared with the conventionally fabricated frameworks. High levels of passive fit were achieved for the evaluated techniques.

Biological characteristics of Heliothis virescens fed with Bt-soybean MON 87701 × MON 89788 and its conventional isoline.

This study aimed to evaluate the larval biology of Heliothis virescens in soybean MON 87701 x MON 89788 and its isogenic non-Bt. In general, the impact of soybean MON 87701 x MON 89788 on H. virescens was evidenced in all bioassays, 100% larval mortality, independent of the structure (leaf or pod) consumed by the pest. The small larvae (1st and 3rd instar) demonstrated that they were unable to damage fresh pods of soybean, regardless of whether Bt or not Bt. The large larvae (5th instar) fed on soybean MON 87701 x MON 89788 soybeans consumed three times less compared to larvae fed on non-Bt soybeans, and resulted in reduced longevity and larval survival. When soybean plants were infested with 5th instar larvae, H. virescens caused injuries in the steams of the conventional soybean. It was recorded that the insects moves quickly to this region of the plant. However the soybean MON 87701 x MON 89788 was an effective tool in controlling H. virescens.

Correlation between vertical misfits and stresses over implants from castable frameworks made of different alloys.

This study aims to investigate a possible correlation between vertical misfits and the stresses transmitted to implants from one-piece casted frameworks fabricated with 3 different materials: commercially pure titanium, cobalt chromium alloy, and nickel chromium titanium alloy. Twelve frameworks simulating screw-retained prosthesis were fabricated from a master cast with 5 implants. Each framework was screwed (20 Ncm) over a metal cast and the vertical mesial and distal misfits were measured using an optical microscope. The stresses transmitted to the implants were measured in a third model by a quantitative photoelastic analysis. Stress and vertical misfit data were statistically analyzed by ANOVA and least significant difference tests and the correlation tests were performed using Pearson Correlation Test (α = 0.05). Mean and standard deviation values of vertical misfit and stress over implants are presented, respectively: commercially pure titanium (29.09 ± 13.24 µm and 11.38 ± 9.23 kPa), cobalt chromium alloy (27.05 ± 10.30 µm and 15.83 ± 9.30 kPa), nickel chromium titanium alloy (24.95 ± 11.14 µm and 16.39 ± 9.51 kPa). There were no significant differences for vertical misfit (P = 0.285). Regarding the stress analysis, there were significant differences between commercially pure titanium, cobalt chromium alloy, and nickel chromium titanium alloy (P = 0.035), with the lowest values for the commercially pure titanium. It may be concluded that stress over implants was affected by different procedures and materials for framework production.

Effect of Cantilever Extension on Bone Loss in Mandibular Complete-Arch Implant-Supported Fixed Prostheses with Three and Four Implants.

PURPOSE: To compare the peri-implant bone loss of mandibular complete-arch implant-supported fixed prostheses (FPSs) supported by three and four implants and to correlate with the size of the horizontal and vertical distal cantilever at prosthesis placement (T1) and after 1 year (T2). MATERIALS AND METHODS: A total of 72 external hexagon (EH) type implants were placed in 20 participants. Of these, 24 supported an FPS with three implants (G3I) and 48 with four implants (G4I). The mandibular implants were named 1, 2, 3, and 4 according to their location in the arch, in a clockwise direction. Digital periapical radiographs were taken at times T1 and T2 for analysis and measurement of peri-implant bone loss. The horizontal and vertical distal cantilevers were measured with a digital caliper and correlated with peri-implant bone loss. RESULTS: The survival rate of implants in G3I was 91.66%, and in G4I it was 97.91%. The mean bone loss in G3I was 0.88 ± 0.89 mm, and in G4I it was 0.58 ± 0.78 mm (P = .225). There was no correlation between distal horizontal cantilevers and bone loss in the studied groups, with G3I being -0.25 (P = .197) and G4I -0.22 (P = .129). Larger vertical cantilevers of implants 1 (P = .018), 3 (P =.015), and 4 (P = .045) correlated with greater bone loss in G4I. CONCLUSIONS: The number of implants in an FPS did not influence peri-implant bone loss after 1 year of follow-up. Larger vertical cantilevers influenced greater bone loss in complete-arch implant-supported fixed prostheses supported by four implants.

Translation and cultural adaptation of the Positive Aspects of Caregiving Scale for caregivers of people living with dementia in Brazilian context: a methodological study.

BACKGROUND: The Positive Aspects of Caregiving (PAC) scale is used to assess psychosocial benefits provided to caregivers by the task of caring. The PAC scale consists of nine items, assessed using a five-point Likert scale, with higher values indicating greater positive perceptions and gains from the caregiving experience. OBJECTIVE: To translate and culturally adapt the PAC scale for informal Brazilian caregivers of people with dementia. DESIGN AND SETTING: A methodological study was conducted at the Federal University of São Carlos. METHODS: The following stages were carried out: Translation; Synthesis of the translations; Back-translation; Evaluation by an experts' committee; and Pre-test. RESULTS: Two independent professionals translated the PAC scale. The consensus version was obtained by merging both translations, which were back-translated into English by a third translator. The expert committee comprised three specialists in the area and project researchers. All scale items presented a Content Validity Index of 1 (CVI = 1.0), and thus remained in the pre-final version of the instrument. The instrument was pre-tested with seven caregivers of people with dementia, the majority of whom were women (57.1%), with a degree of kinship corresponding to sons/daughters (57.1%) and an average age of 55.2 (± 4.1) years. The caregivers considered it clear and understandable and made no suggestions for changes. CONCLUSION: The PAC scale was translated and culturally adapted for use by informal caregivers of people with dementia in Brazil. However, a psychometric analysis of the instrument is necessary to provide normative data for this population group.

Adaptation, testing, and use of the "iSupport for Dementia" program in different countries: a systematic review.

The World Health Organization developed the "iSupport for Dementia" program for family caregivers of people with dementia. Objective: To explore studies on adaptation, randomized clinical trial protocols, and preliminary results of iSupport by unpaid caregivers of people living with dementia in different countries. Methods: Systematic review. Results: Ten cultural adaptation studies, eight randomized clinical trial protocols, and two preliminary results were included. Adaptation studies showed adjustments in terminology, design, and additional resources. Clinical trial protocols included burden as the primary outcome, and baseline, three months of intervention, and follow-up after six months. Studies with preliminary results found positive effects on the mental health and well-being of caregivers after using the program. Conclusion: iSupport is an online program of the World Health Organization in response to dementia in implementation in different countries.

A Organização Mundial da Saúde desenvolveu o programa "iSupport for Dementia" para cuidadores familiares de pessoas com demência. Objetivo: Explorar estudos sobre adaptação, protocolos de ensaio clínico randomizado e resultados preliminares do "iSupport" por cuidadores não remunerados de pessoas que vivem com demência em diferentes países. Métodos: Revisão sistemática. Resultados: Foram incluídos dez estudos de adaptação cultural, oito protocolos de Ensaio Clínico Randomizado e dois resultados preliminares. Os estudos de adaptação apresentaram os ajustes nas terminologias, design e recursos adicionais. Os protocolos de ensaio clínico incluíram a sobrecarga como desfecho primário, e com linha de base, três meses de intervenção e acompanhamento após seis meses. Os estudos com resultados preliminares encontraram efeitos positivos na saúde mental e bem-estar dos cuidadores após o uso do programa. Conclusão: O iSupport é um programa online da Organização Mundial da Saúde em resposta à demência na implantação em diferentes países.

Bruxism. Masticatory implications and anxiety.

In this study we investigate the phenomenon of bruxism, defined as the act of clenching and/or grinding the teeth, a habit that compromises the orofacial region. It is often associated with emotional aspects, such as anxiety and stress, and may result in alterations to orofacial structures, functional modifications and social repercussions. The aim of this study was to determine a possible association between bruxism and anxiety underscoring the primary complaints related to masticatory function. Eighty volunteers participated in the study. They were divided into bruxers (N = 40) and non-bruxers (N = 40) of both sexes. The diagnosis of bruxism was made by clinical examination. The Trait-State Anxiety Inventory was used to assess anxiety levels and a questionnaire with structured questions related to daily activities, focusing on masticatory function (for the bruxism group), was applied to evaluate psychosocial aspects. The results of the study show a significant difference in state anxiety. Mean and standard deviation of state anxiety in the bruxism and non-bruxism groups was 42.7 +/- 9.6 and 38.6 +/- 8.2 (p < or = 0.04), respectively, while trait anxiety had a mean and standard deviation of 44.5 +/- 11.0 and 40.7 +/- 9.5 (p < or = 0.11). The main complaints of bruxers during mastication were facial pain and headache while chewing as well as the presence of clicking sounds in the jaw joint. Findings demonstrate an association between emotional factors such as anxiety and bruxism, resulting in compromised masticatory function.

Temporomandibular disorders and the use of traditional and laser acupuncture: a systematic review.

OBJECTIVE: To evaluate current studies to establish and compare the efficacy of traditional and laser acupuncture in reducing the signs and symptoms of temporomandibular disorders (TMD). METHODS: PubMed, Cochrane, Scopus, and Web of Science databases were searched. Clinical, controlled, and randomized trials written in English and having used traditional or laser acupuncture as therapy for TMD and RDC/TMD or DC/TMD as a diagnostic criterion for TMD were included. RESULTS: Six studies that evaluated the intensity of pain and the level of mouth opening of the patients submitted to acupuncture were selected, and all showed improvement. However, similar results were also observed in the groups treated with occlusal splint and placebo acupuncture. Only one study evaluated laser acupuncture and showed a higher proportion of patients with remission of symptoms in the experimental group. CONCLUSION: The traditional acupuncture seems to relieve the signs and symptoms of TMD, as well as laser acupuncture when associated with occlusal splint. However, more rigorous and high-quality clinical trials are needed.

Pain, deep neck flexors performance, disability, and head posture in individuals with temporomandibular disorder with and without otological complaints.

BACKGROUND: Otological complaints (OC) are highly prevalent in subjects with temporomandibular disorders (TMD) and so is the risk of neck dysfunctions. OBJECTIVE: To evaluate pain, deep neck flexor (DNF) performance, disability, and head and neck posture of individuals with TMD with and without OC. METHODS: In this cross-sectional study, 57 individuals were divided into a group with TMD and OC (n= 31) and a group with TMD without OC (n= 26). Self-reported pain intensity, masticatory and neck muscles pressure pain thresholds, DNF performance, neck disability, and head and neck posture were evaluated. Data were compared between groups using the independent t test and Mann-Whitney test with Bonferroni correction for multiple comparisons. Effect sizes were evaluated using Cohen's index. RESULTS: The TMD with OC group presented less muscle activation [26 (24-28) vs. 24 (24-26) mmHg; p< 0.05], less endurance [105 (46-140) vs. 44 (28-78) points; p< 0.05], and greater neck disability (8.15 ± 5.89 vs. 13.32 ± 6.36 points; p< 0.05). No significant difference was observed in self-reported pain, head and neck posture, or pressure pain thresholds. CONCLUSION: Individuals with TMD with OC presented decreased DNF performance and increased neck disability compared to individuals with TMD without OC.

An In-House-Built and Light-Emitting-Diode-Based Photodynamic Therapy Device for Enhancing Verteporfin Cytotoxicity in a 2D Cell Culture Model.

This paper describes a novel, simple, and low-cost device to perform in vitro photodynamic therapy (PDT) assays, named the PhotoACT. The device was built using a set of conventional programmable light-emitting diodes (LEDs), a liquid crystal display (LCD) module, and a light sensor connected to a commercial microcontroller board. The box-based structure of the prototype was made with medium-density fiberboards (MDFs). The internal compartment can simultaneously allocate four cell culture multiwell microplates. As a proof of concept, we studied the cytotoxic effect of the photosensitizer (PS) verteporfin against the HeLa cell line in two-dimensional (2D) culture. HeLa cells were treated with increasing concentrations of verteporfin for 24 h. The drug-containing supernatant medium was discarded, the adherent cells were washed with phosphate-buffered saline (PBS), and drug-free medium was added. In this study, the effect of verteporfin on cells was examined either without light exposure or after exposure for 1 h to light using red-green-blue (RGB) values of 255, 255, and 255 (average fluence of 49.1 ± 0.6 J/cm2). After 24 h, the cell viability was assessed by the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyltetrazolium bromide (MTT) assay. Experimental results showed that exposure of cells treated with verteporfin to the light from the device enhances the drug's cytotoxic effect via a mechanism mediated by reactive oxygen species (ROS). In addition, the use of the prototype described in this work was validated by comparing the results with a commercial PDT device. Thus, this LED-based photodynamic therapy prototype represents a good alternative for in vitro studies of PDT.