Late hyaluronidase injection in local anesthesia : morphofunctional evaluation in rat sciatic nerve block

Introduction: Despite the enhancing effects of hyaluronidase (HYAL) over duration of anesthesia, this enzyme could cause adverse effects when injected concomitantly with local anesthetics in dental blocks. Objective: This study aimed to assess the tissue alterations caused by a local anesthetic protocol consisting of a late HYAL injection and confirm its functional effectiveness. Materials and Methods: The protocol efficacy was proved by evaluating sensory and motor functions in rats. The sciatic nerve was blocked with 2% lidocaine (LID) with epinephrine (n = 25). Thirty minutes later, 75 TRU/ml HYAL was injected into the same site (experimental group, LID/HYAL). One week later, this protocol was repeated in the contralateral hindlimb, injecting only HYAL’s vehicle (control group, LID/vehicle [LID/V]). To observe the integrity of the local tissues, histological specimens were obtained 1, 24, 48, and 72 h after treatment with LID/HYAL or LID/V (n = 16 each) and stained with hematoxylin/eosin and picrosirius red. Results: Local inflammation was similar in both groups. The integrity of the nerve fibers was preserved, in spite of some inflammation‑associated injuries in the surrounding tissues. The reversible tissue disorganization caused by HYAL, probably facilitated the diffusion of the residual anesthetic to the nerve, resulting in a prolonged anesthetic effect (P < 0.05). Conclusions: No irreversible morphological alterations are caused by the administration of HYAL prior the end of the LID‑induced block. Moreover, this protocol prolongs LID’s anesthetic effect

Photobiomodulation and myofascial temporomandibular disorder : systematic review and meta-analysis followed by cost-effectiveness analysis

Photobiomodulation (PBM) is a non-invasive and non-pharmacological treatment, which, has shown beneficial results in the treatment of temporomandibular disorders (TMD) related pain. This systematic review and meta-analysis study aimed to evaluate the eff

Microleakage of “bulk-fill” composite resin for class II restorations pretreated with CO2 laser in deciduous molars: an in vitro study

Introduction: Microleakage has been reported to cause dentin hypersensitivity because of the passage of bacteria and their products through the restoration-tooth interface and is one of the main reasons for replacement of restorations. CO2 laser can be used for treatment of dentin hypersensitivity. Thus, this study aimed to evaluate in vitro the microleakage in composite restorations following surface pretreatment with acid etching and CO2 laser.Methods: Twelve human caries-free primary molars were selected. Class II cavities were prepared on occlusal mesial and occlusal distal surfaces. Specimens were randomly divided into four groups (n = 6): Group 1 (G1) – 37% phosphoric acid gel etching + Beautiful-Bulk Restorative – Giomer (Shofu Inc); Group 2 (G2) – 37% phosphoric acid gel etching + SDR Bulk-Fill Flow (Dentsply); Group 3 (G3) – CO2 laser irradiation + Beautiful-Bulk Restorative – Giomer (Shofu Inc); Group 4 (G4) – CO2 laser irradiation + SDR Bulk-Fill Flow (Dentsply). Surfaces were restored with bonding agent (Natural Bond DE, DFL). Specimens were cut longitudinally and immersed in 0.5% methylene blue solution for 4 hours. Microleakage scores were assessed under a magnifying glass at x3,5 and qualitatively analyzed by scanning electron microscope (SEM). Data were analyzed using nonparametric Wilcoxon test (P &lt; 0.05).Results: Scores prevailed between 0 and 2, however, no statistically significant difference was found among the groups (P = 0.05).Conclusion: It could be concluded that all composite resins bulk fill did not show significant difference among them regarding microleakage using either CO2 laser or 37% phosphoric acid etching.  

Parameters for antimicrobial photodynamic therapy on periodontal pocket-Randomized clinical trial.

BACKGROUND: Antimicrobial photodynamic therapy (aPDT) has been investigated as an adjunctive to periodontal treatment but the dosimetry parameters adopted have discrepancies and represent a challenge to measure efficacy. There is a need to understand the clinical parameters required to obtain antimicrobial effects by using aPDT in periodontal pockets. The aim of this study was to investigate parameters relating to the antimicrobial effects of photodynamic therapy in periodontal pockets. MATERIAL AND METHODS: This randomized controlled clinical trial included 30 patients with chronic periodontitis. Three incisors from each patient were selected and randomized for the experimental procedures. Microbiological evaluations were performed to quantify microorganisms before and after treatments and spectroscopy was used to identify methylene blue in the pocket. A laser source with emission of radiation at wavelength of ʎ = 660 nm and output radiant power of 100 mW was used for 1, 3 and 5 min. One hundred μM methylene blue was used in aqueous solution and on surfactant vehicle. RESULTS: The results demonstrated the absence of any antimicrobial effect with aqueous methylene blue-mediated PDT. On the other hand, methylene blue in the surfactant vehicle produced microbial reduction in the group irradiated for 5 min (p < 0.05). Spectroscopy showed that surfactant vehicle decreased the dimer peak signal at 610 nm. CONCLUSION: Within the parameters used in this study, PDT mediated by methylene blue in a surfactant vehicle reached significant microbial reduction levels with 5 min of irradiation. The clinical use of PDT may be limited by factors that reduce the antimicrobial effect. Forms of irradiation and stability of the photosensitizers play an important role in clinical aPDT

Low-Level Laser Therapy Reduces Lung Inflammation in an Experimental Model of Chronic Obstructive Pulmonary Disease Involving P2X7 Receptor

Chronic obstructive pulmonary disease (COPD) is a progressive disease characterized by irreversible airflow limitation, airway inflammation and remodeling, and enlargement of alveolar spaces. COPD is in the top five leading causes of deaths worldwide and presents a high economic cost. However, there are some preventive measures to lower the risk of developing COPD. Low-level laser therapy (LLLT) is a new effective therapy, with very low cost and no side effects. So, our objective was to investigate if LLLT reduces pulmonary alterations in an experimental model of COPD. C57BL/6 mice were submitted to cigarette smoke for 75 days (2x/day). After 60 days to smoke exposure, the treated group was submitted to LLLT (diode laser, 660 nm, 30 mW, and 3 J/cm(2)) for 15 days and euthanized for morphologic and functional analysis of the lungs. Our results showed that LLLT significantly reduced the number of inflammatory cells and the proinflammatory cytokine secretion such as IL-1 beta, IL-6, and TNF-alpha in bronchoalveolar lavage fluid (BALF). We also observed that LLLT decreased collagen deposition as well as the expression of purinergic P2X7 receptor. On the other hand, LLLT increased the IL-10 release. Thus, LLLT can be pointed as a promising therapeutic approach for lung inflammatory diseases as COPD.Sao Paulo Research Foundation (FAPESP) [2012/16498-5, 2012/15165-2]FAPESP [2015/23152-6, 2014/14604-8, 2015/13486-4]Univ Nove Julho UNINOVE, Post Grad Program Biophoton Appl Hlth Sci, Sao Paulo, SP, BrazilBrazilian Inst Teaching & Res Pulm & Exercise Imm, Sao Jose Dos Campos, SP, BrazilUniv Nove Julho UNINOVE, Masters Degree & PhD Program Rehabil Sci, Expt Cardioresp Physiol Lab, Sao Paulo, SP, BrazilUniv Calif San Diego UCSD Hlth Sci, Div Trauma Surg Crit Care Burns & Acute Care Surg, Dept Surg, San Diego, CA USAFed Univ Sao Paulo UNIFESP, Inst Sci & Technol, Sao Jose Dos Campos, SP, BrazilUniv Brasil, Postgrad Program Bioengn, Sao Paulo, SP, BrazilFed Univ Sao Paulo UNIFESP, Postgrad Program Sci Human Movement & Rehabil, Santos, SP, BrazilFed Univ Sao Paulo UNIFESP, Inst Sci & Technol, Sao Jose Dos Campos, SP, BrazilFed Univ Sao Paulo UNIFESP, Postgrad Program Sci Human Movement & Rehabil, Santos, SP, BrazilFAPESP [2012/16498-5, 2012/15165-2]FAPESP [2015/23152-6, 2014/14604-8, 2015/13486-4]Web of Scienc

Comparative study between photodynamic therapy with urucum + Led and probiotics in halitosis reduction-protocol for a controlled clinical trial.

BACKGROUND: Halitosis is a term that defines any foul odor emanating from the oral cavity. The origin may be local or systemic. The aim of the proposed protocol is to determine whether treatment with antimicrobial photodynamic therapy (aPDT) and treatment with probiotics are effective at eliminating halitosis. MATERIALS AND METHODS: Eighty-eight patients, from 18 to 25 years old with a diagnosis of halitosis (H2S≥112 ppb, determined by gas chromatography) will be randomly allocated to four groups (n = 22) that will receive different treatments: Group 1 -treatment with teeth brushing, dental floss and tongue scraper; Group 2 -brushing, dental floss and aPDT; Group 3 -brushing, dental floss and probiotics; Group 4 -brushing, flossing, aPDT and probiotics. The results of the halimetry will be compared before, immediately after, seven days and thirty days after treatment. The microbiological analysis of the coated tongue will be performed at these same times. The normality of the data will be determined using the Shapiro-Wilk test. Data with normal distribution will be analyzed using analysis of variance (ANOVA). Non-parametric data will be analyzed using the Kruskal-Wallis test. The Wilcoxon test will be used to analyze the results of each treatment at the different evaluation periods. CLINICAL TRAIL REGISTRATION: NCT03996044

Photobiomodulation for the Treatment of Primary Headache: Systematic Review of Randomized Clinical Trials.

peer reviewedThe purpose of this study was to evaluate the efficacy and safety of photobiomodulation as an adjuvant treatment for primary headache. A systematic review of randomized clinical trials was performed. For such, electronic searches were performed in the MEDLINE, Embase, Cochrane Library, LILACS, PEDro, PsycInfo, Clinicaltrials.gov., and WHO/ICTRP databases, with no restrictions imposed regarding language or year of publication. We included studies that assessed any photobiomodulation therapy as an adjuvant treatment for primary headache compared to sham treatment, no treatment, or another intervention. The methodological assessment was conducted using the Cochrane Risk of Bias tool. The certainty of the evidence was classified using the GRADE approach. Four randomized clinical trials were included. Most of the included studies had an overall high risk of bias. Compared to sham treatment, photobiomodulation had a clinically important effect on pain in individuals with primary headache. Despite the benefits reported for other outcomes, the estimates were imprecise, and the certainty of the evidence was graded as low. These findings are considered insufficient to support the use of photobiomodulation in the treatment of primary headache. Randomized clinical trials, with higher methodological quality, are needed to enhance the reliability of the estimated effects