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AIM: To assess the efficacy of photobiomodulation in reducing post-operative symptoms and use of analgesics in teeth with asymptomatic apical periodontitis treated with foraminal enlargement in a single visit. METHODOLOGY: This prospective double-blind, controlled, superiority, randomized clinical trial enrolled 70 patients requiring root canal treatment of one single-rooted tooth with asymptomatic apical periodontitis. The participants were randomized into one of the following two groups: 35 patients in the control group (C.G) - root canal treatment with foraminal enlargement, without any additional treatment and 35 patients in the photobiomodulation group (PBM.G) - root canal treatment with foraminal enlargement associated with photobiomodulation (antimicrobial photodynamic therapy and low-level laser therapy). The outcome variables were post-operative pain, tenderness, oedema and the use of analgesics. Pain intensity was measured using a visual analogue scale (recorded every day for 7 days, then the 14th and 30th days after root canal treatment). Facial oedema was assessed subjectively by two independent evaluators using photographs taken by one of the researchers at 48 h, 72 h and 7 days after the procedures. Data were tabulated and analysed using the Mann-Whitney U, Chi-Square, Fisher`s Exact, Student T and Ordinal Logistic Regression by Generalized Estimating Equations tests in SPSS software. RESULTS: There were no significant differences in post-operative pain and tenderness between the groups at any observation period (p > .05). Photobiomodulation (beta = -0.77 / p = .01), time (beta = -0.23 / p < .01), and male gender (beta = -1.20 / p < .01) were associated with decreased post-operative pain. Only time (beta: -0.10; p < .01) and male gender (beta: -1.04; p < .01) were associated with decreased tenderness. For oedema and use of analgesics, there was no difference between the groups (p > .05). CONCLUSIONS: Photobiomodulation had no significant effect on post-operative pain, tenderness, oedema and the use of analgesics after root canal treatment with foraminal enlargement, in single-rooted teeth treated in a single visit. Register of Clinical Trials: NCT03704857. Research Ethics Committee: no 2.353.996 / CAAE 74185417.9.0000.5626.
Assuntos
Periodontite Periapical , Preparo de Canal Radicular , Feminino , Humanos , Masculino , Dor Pós-Operatória , Periodontite Periapical/terapia , Estudos Prospectivos , Tratamento do Canal RadicularRESUMO
Antimicrobial photodynamic therapy (aPDT) is increasingly used in dentistry to treat a number of diseases. The procedure involves the activation of a photosensitizer by a visible light source to induce chemical reactions that create cytotoxic reactive oxygen species, cause oxidative stress, and result in inactivation of pathogenic microorganisms. The use of aPDT has been proven to reduce microorganisms present in dentin and therefore may be effective for treatment of deep caries. This case report describes the use of aPDT as an adjuvant therapy in the treatment of deep caries in the primary molar of a 7-year-old boy. The case also highlights the preservation of pulpal vitality-in accordance with the concepts of minimal intervention-as well as the reduction of chair time achieved by resolving the case in a single session, a factor that is important for the treatment of children.
Assuntos
Cárie Dentária/tratamento farmacológico , Cárie Dentária/microbiologia , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Criança , Humanos , Masculino , Dente DecíduoRESUMO
The systematic review and meta-analysis were undertaken to evaluate the effectiveness of antimicrobial photodynamic therapy (aPDT) in the microbiological alteration beneficial to peri-implantitis treatment. This study is registered with PROSPERO, number CRD42017064215. Bibliographic databases including Cochrane Library, Web of Science, Scopus and PubMed were searched from inception to 8 January 2017. The search strategy was assembled from the following MeSH Terms: "Photochemotherapy," "Dental Implants" and "Peri-Implantitis." Unspecific free-text words and related terms were also included. The Cochrane Collaboration's tool was used to evaluate the risk of bias of included studies. The random-effect model was chosen, and heterogeneity was evaluated using the I2 test. Three studies met the inclusion criteria. Meta-analysis demonstrated an association between aPDT and reduction in viable bacteria counts for: Aggregatibacter actinomycetemcomitans (OR = 1.31; confidence interval = 1.13, 1.49; P < 0.00001), Porphyromonas gingivalis (OR = 4.08; confidence interval = 3.22, 4.94; P < 0.00001) and Prevotella intermedia (OR = 1.66; confidence interval = 1.06, 2.26; P < 0.00001). A aPDT appears to be effective in bacterial load reduction in peri-implantitis and has a positive potential as an alternative therapy for peri-implantitis.
Assuntos
Antibacterianos/uso terapêutico , Contagem de Colônia Microbiana , Peri-Implantite/tratamento farmacológico , Peri-Implantite/microbiologia , Fotoquimioterapia/métodos , Antibacterianos/farmacologia , Fusobacterium/efeitos dos fármacos , Fusobacterium/isolamento & purificação , Humanos , Pasteurellaceae/efeitos dos fármacos , Pasteurellaceae/isolamento & purificação , Porphyromonas gingivalis/efeitos dos fármacos , Porphyromonas gingivalis/isolamento & purificação , Prevotella intermedia/efeitos dos fármacos , Prevotella intermedia/isolamento & purificaçãoRESUMO
Actinic cheilitis (AC) is a disease caused by prolonged and cumulative sun exposure that mostly affects the lower lip, which can progress to a lip squamous cell carcinoma. Routine diagnosis relies on clinician experience and training. We investigated the diagnostic efficacy of wide-field fluorescence imaging coupled to an automated algorithm for AC recognition. Fluorescence images were acquired from 57 patients with confirmed AC and 46 normal volunteers. Three different algorithms were employed: two based on the emission characteristics of local heterogeneity, entropy and intensity range, and one based on the number of objects after K-mean clustering. A classification model was obtained using a fivefold cross correlation algorithm. Sensitivity and specificity rates were 86% and 89.1%, respectively.
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Objetivo: realizar um levantamento epidemiológico acerca das alterações na mucosa oral dos pacientes acima de 60 anos, atendidos no serviço de Estomatologia do Instituto de Saúde de Nova Friburgo - UFF/RJ, no período de 2013 a 2018, e estabelecer as principais causas e formas de tratamento. Materiais e Métodos: estudo retrospectivo e observacional, com análise descritiva, através da coleta de dados nos prontuários: idade, sexo, cor da pele, ocupação, lesão e sua localização. Resultados: foram analisados 640 prontuários, destes, 395 (61,7%) apresentaram lesão, sendo 132 (20,6%) deles com mais de uma lesão. Dos 395 com lesão, 57,0% (225) eram do sexo feminino. A cor de pele branca representou 56,7% (224), porém 107 prontuários não apresentaram essa informação. A amostra contou com pacientes de 60 a 91 anos, com média de 65 anos. No total foram encontradas 613 lesões. Queilite actínica foi a mais prevalente 15,5% (95), seguida da estomatite protética 14,0% (86) e hiperplasia fibrosa 13,4% (82). Conclusão: os indivíduos idosos do presente estudo apresentaram alta frequência de lesões orais, sendo a queilite actínica, estomatite protética e hiperplasia fibrosa as mais comuns.
Objective: to carry out an epidemiological survey of oral mucosa lesions of patients aged over 60 years, attended at the Stomatology Service of the Nova Friburgo Health Institute - UFF/RJ, from 2013 to 2018, and to establish the main etiologies and forms of treatment. Materials and Methods: retrospective and observational study through data collection from medical records as: age, gender, skin color, occupation, lesion and its location. Results: 640 medical records were analyzed, of which 395 (61.7%) had lesions, 132 (20.6%) had more than one lesion. Of the 395 with injuries, 57.0% (225) were female. White skin color represented 56.7% (224), but 107 medical records did not present this information. The sample included patients aged 60 to 91 years, with a mean of 65 years. In total, 613 injuries were found. Actinic cheilitis was the most prevalent 15.5% (95), followed by prosthetic stomatitis 14.0% (86) and fibrous hyperplasia 13.4% (82). Conclusion: the elderly individuals in the present study had a high frequency of oral lesions, with actinic cheilitis, denture stomatitis and fibrous hyperplasia being the most common.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Saúde Bucal , Doenças da Boca/epidemiologia , Brasil/epidemiologia , Prevalência , Estudos RetrospectivosRESUMO
This study aimed to perform a systematic review to assess the effectiveness of antimicrobial photodynamic therapy (aPDT) in the reduction of microorganisms in deep carious lesions. An electronic search was conducted in Pubmed, Web of Science, Scopus, Lilacs, and Cochrane Library, followed by a manual search. The MeSH terms, MeSH synonyms, related terms, and free terms were used in the search. As eligibility criteria, only clinical studies were included. Initially, 227 articles were identified in the electronic search, and 152 studies remained after analysis and exclusion of the duplicated studies; 6 remained after application of the eligibility criteria; and 3 additional studies were found in the manual search. After access to the full articles, three were excluded, leaving six for evaluation by the criteria of the Cochrane Collaboration's tool for assessing risk of bias. Of these, five had some risk of punctuated bias. All results from the selected studies showed a significant reduction of microorganisms in deep carious lesions for both primary and permanent teeth. The meta-analysis demonstrated a significant reduction in microorganism counts in all analyses (p<0.00001). Based on these findings, there is scientific evidence emphasizing the effectiveness of aPDT in reducing microorganisms in deep carious lesions.
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ABSTRACT Objective: This study aim to evaluate the effectiveness of sclerotherapy protocols with different dilutions of ethanolamine oleate in the treatment of oral varicose veins. Methods: Clinical data and images of 14 cases treated with sclerotherapy were analyzed and descriptive analyses were performed. Results: Females (58%) and white skin color (83%) prevailed. Age varied between 14 and 79 years, with 47 years on mean (SD = 19 years). The most common anatomical locations were the buccal mucosa and lower lip. The final volume of the sclerosing agent (Ethamolin®) ranged from 0.4 to 4.3ml and the concentration ranged from 5% to 100%. The number of sessions ranged from 1 to 12 and the number of points per application was 1 to 7 points. Pain and edema were seen in 43% and 29% of patients, respectively. Conclusion: Sclerotherapy with monoethanolamine oleate diluted in anesthetic is a safe and effective option for the treatment of this lesion, regardless of concentration. However, edema and pain seem to be directly associated with increased drug concentration.
RESUMO Objetivos: Este estudo tem como objetivo avaliar a efetividade de protocolos de escleroterapia com diferentes diluições de oleato de etanolamina no tratamento de varizes orais. Métodos: Dados clínicos e imagens de 14 casos tratados com escleroterapia foram avaliados, sendo realizado análises descritivas. Resultados: As mulheres (58%) e a cor de pele branca (83%) prevaleceram na amostra. A idade variou entre 14 e 79 anos, com média de 47 anos (DP = 19 anos). As localizações anatômicas mais comuns foram a mucosa jugal e o lábio inferior. O volume final do agente esclerosante (Ethamolin®) variou de 0,4 a 4,3ml e a concentração variou de 5% a 100%. O número de sessões variou de 1 a 12 e o número de pontos por aplicação foi de 1 a 7 pontos. Dor e edema foram observados em 43% e 29% dos pacientes, respectivamente. Conclusão: A escleroterapia com oleato de monoetanolamina diluído em anestésico é uma opção segura e eficaz para o tratamento das varizes orais, independentemente da concentração. No entanto, edema e dor parecem estar diretamente associados ao aumento da concentração do medicamento.
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Oral cytopathology is a simple, non-invasive technique that could be used for early detection of oral premalignant and malignant lesions, but the effectiveness of this diagnostic approach remains controversial. The aim of this study was to evaluate the sensitivity, specificity, positive and negative predictive values, and accuracy of cytopathology for diagnosing oral squamous cell carcinoma (OSCC) and the diagnostic concordance between cytopathological and histopathological diagnoses. The study enrolled 172 patients at outpatient clinics who presented with oral lesions suspicious of malignancy. All patients underwent oral cytological scrapes followed by an incisional biopsy. Of 148 cases that were histopathologically diagnosed with OSCC, the cytopathological method diagnosed 123 positive cases and resulted in a suspicion of OSCC in 16 patients. Based on these data, the sensitivity was 83.1%, the specificity was 100.0%, the positive predictive value was 100.0%, the negative predictive value was 49.0%, and the accuracy was 85.5%. The diagnostic concordance between histopathological and cytopathological examinations was 83.1% for OSCC and 85.7% for non-neoplastic lesions. The results indicate that cytopathological diagnosis had good concordance with histopathological diagnosis and showed high sensitivity, specificity, positive predictive value, and accuracy. We conclude that the sensitivity of oral cytopathology is sufficient to justify its use as a diagnostic screening test and to confirm the malignant nature of epithelial cells, mainly for the classification of OSCC. Therefore, cytopathology may be a reliable method for referring patients who require diagnosis of suspected oral cancer for starting treatment.
Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia/métodos , Carcinoma/patologia , Intervalos de Confiança , Diagnóstico Precoce , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Sensibilidade e Especificidade , Adulto JovemRESUMO
A citopatologia é uma técnica que propicia diagnósticos rápidos para lesões em mucosas, além de ser bastante acessível do ponto de vista econômico. Na odontologia, pode ser um bom exame auxiliar no diagnóstico de lesões bucais, principalmente lesões infecciosas, bem como na detecção precoce do câncer de boca. Objetivos: estabelecer a técnica de citopatologia no laboratório de Patologia Oral do Instituto de Saúde de Nova Friburgo da UFF, bem como avaliar dados demográficos e discutir os diagnósticos citopatológicos desses pacientes. Métodos: foram selecionados 90 pacientes atendidos na clínica de Estomatologia da UFF-NF com lesões orais que tinham indicação para realização da citopatologia oral. Após obtenção de dados demográficos, a coleta de material foi feita, seguida da realização do esfregaço em duas lâminas de vidro. Resultados: Dos 90 pacientes, 54 (60%) eram mulheres e 36 (40%) homens. A idade dos pacientes variou de 30 a 82 anos, com média de 56,60 anos. Desses pacientes, 23 (26%) declararam-se tabagistas, 27 (30%) declararam-se etilistas e 77 (86%) eram usuários de próteses dentárias. Os esfregaços dos 90 pacientes foram diagnosticados de acordo com as classes de Papanicolaou, sendo a maioria, 84 pacientes (93%), diagnosticada como Classe II. Desses 84 pacientes, 34 (40,4%) apresentaram candidíase. Conclusão: após a realização deste trabalho, além da técnica de citopatologia ser estabelecida, pode-se perceber que os esfregaços inflamatórios e apresentando fungo foram predominantes, o que demonstra a boa capacidade diagnóstica da técnica de citopatologia para lesões infecciosas(AU)
Objectives: to establish the technique of cytopathology in the laboratory of Oral Pathology of the Institute of Health of Nova Friburgo of the UFF, as well as to evaluate demographic data and to discuss the cytopathological diagnoses of these patients. Methods: 90 patients attended at the Stomatology clinic of the UFF-NF with oral lesions that had been indicated for oral cytopathology were selected. After obtaining demographic data, the material was collected, followed by the smearing on two glass slides. Results: Of the 90 patients, 54 (60%) were women and 36 (40%) were men. The patients' ages ranged from 30 to 82 years, with a mean of 56.60 years. Of these patients, 23 (26%) declared themselves smokers, 27 (30%) declared themselves alcoholics and 77 (86%) were users of dental prostheses. The smears of the 90 patients were diagnosed according to the classes of Papanicolau, being the majority, 84 patients (93%), diagnosed as Class II. Of these 84 patients, 34 (40.4%) presented candidiasis. Conclusion: after this work, besides the cytopathology technique was established, it can be noticed that the inflammatory smears and presenting fungus were predominant, which demonstrates the good diagnostic capacity of the cytopathology technique for infectious lesions(AU)