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This study evaluates the effects of a green tea (Camellia sinensis) and hyaluronic acid gel on fibroblast activity and alveolar bone repair following third molar extractions. By examining the gene expression related to cell survival, proliferation, and angiogenesis, the study bridges in vitro findings with clinical outcomes in a split-mouth randomized trial. Human fibroblasts were exposed to the treatment gel, analysing gene expression through RT-qPCR. Twenty participants undergoing bilateral third molar extractions received the test gel on one side and a placebo on the other. Assessments included patient-reported outcomes, professional evaluations, and radiographic analyses at multiple postoperative intervals. The test gel significantly enhanced AKT, CDKs, and VEGF gene expressions, indicating a positive effect on angiogenesis and cell proliferation. Clinically, it resulted in reduced exudate, swelling, and secondary interventions, with radiographs showing improved alveolar bone density after 90 days. The green tea and hyaluronic acid gel significantly improves soft tissue and bone healing post-extraction, offering a promising adjunctive therapy for enhancing postoperative recovery. This gel represents a novel adjuvant treatment option for facilitating improved healing outcomes after third molar extractions, highlighting its potential utility in clinical dental practice.

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OBJECTIVE: To compare the use of PBMT in the soft tissue and bone healing after third molar extraction using the dual-wavelength laser directly into the post-extraction alveoli (PBMT-I), or PBMT with a red laser directly into the alveoli and with an infrared laser externally on the patient's face (PBMT-IE). METHODS: Twenty patients underwent extraction of four third molars were involved in this split-mouth double-blind randomized controlled trial. The Post-extraction alveoli were treated with the following protocols: PBMT-IE: Application of a red laser directly into the alveolus, and infrared laser irradiation transcutaneously and PBMT-I: Application of dual-wavelength laser intraorally. Patients were clinically evaluated 3, 7, 14, 30, and 90 days after the surgical procedure. The analyses in this study were divided into qualitative (centered on the patient's report and on the evaluators' analysis), and quantitative analyses (measurement of the vertical and horizontal dimensions of the face with the objective of measuring post-surgical edema and radiographic analyses for evaluation of the density and structure of the newly formed bone). RESULTS: A progressive improvement was observed in all parameters evaluated in this study, however, this improvement was time dependent, with no distinct effect observed between the PBMT treatments applied. CONCLUSION: The different dual-wavelength PBMT protocols induced a similar postoperative clinical course in third molar extraction surgeries, with a reduced occurrence of complications and a good healing pattern of hard and soft tissues.

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PURPOSE: The aim of this study was to compare the analgesic efficacy of 4% articaine associated with epinephrine (1:100,000), and 2% lidocaine associated with epinephrine (1:100,000) in third molar extraction surgery. METHODS: Sixty patients who underwent surgeries to extract upper and lower third molars were included in this split-mouth, double-blind, randomized, controlled trial. The groups in this study were divided according to the anesthetic solution used to provide local anesthesia during extraction of upper and lower third molars: (1) 4% articaine associated with epinephrine (1:100,000); (2) 2% lidocaine associated with epinephrine (1:100,000). The time to the beginning and end of the sensation of analgesia, pain sensation according to the VAS scale, and number of anesthetic tubes necessary for supplementation were analyzed. RESULTS: It was found that the onset time for analgesia was shorter on the side anesthetized with articaine compared to the side anesthetized with lidocaine (122.1 ± 52.90 s vs. 144.5 ± 68.85 s) (p < 0.05). In addition, the number of tubes used for anesthetic supplementation was also reduced on the articaine side compared to the lidocaine side (0.26 ± 0.48 vs. 0.50 ± 0.75) (p < 0.05). There were no differences between the anesthetic solutions in the other evaluated parameters. CONCLUSION: It can be concluded that the use of 4% articaine associated with epinephrine (1:100,000) reduced the time of onset of analgesia and the necessity for anesthetic supplementation in third molar extraction surgeries compared to the use of 2% lidocaine associated with epinephrine (1:100,000).

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PURPOSE: This study evaluated the effects of advanced platelet-rich fibrin (A-PRF +) on the healing of upper third molar post-extraction sockets. METHODS: Sixteen patients who underwent extractions of the upper third molars (18 and 28) were included in this randomized split-mouth study. The alveoli on the test side were filled with A-PRF + , while the control side was maintained with blood clot. The side that received treatment was randomly defined. Alveolar bone regeneration was evaluated by CBCT scans to assess healing stage, bone density, and fractal analysis 1 week and 90 days post-extraction. Additionally, pain, edema, bleeding, and soft tissue alveolar repair were evaluated by clinical analyses 3, 7, 14, 30, and 90 days after the surgical procedure using a visual analog scale. RESULTS: There were no clinical differences regarding treatments in any experimental period. In the tomographic evaluation, at 7 days, the alveoli treated with A-PRF + presented a suggestive sign of higher bone density than the control alveoli, which was not confirmed 90 days after the surgical procedure. CONCLUSION: Thus, the use of A-PRF + does not demonstrate a clinical advantage in the repair of post-extraction sockets of upper third molars.

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Introduction: Third molar extraction surgery is a common dental procedure, often challenging with increased post-operative complications. The need for antibiotic prophylaxis in these cases remains debated. Objective: The aim of this study was to evaluate the effect of antibiotic prophylaxis on the postoperative clinical course of third molar extraction surgeries. Material and method: Sixty-three patients were randomly allocated into two groups after extraction of the four third molars. ATB group (N = 33) the patients received 1g of amoxicillin one hour before the surgical procedure, CTR group (N = 30) the patients did not receive antibiotic prophylaxis. Clinical analyses were performed at 3, 7, 14, and 30 days after the surgical procedure. These analyses consisted of assessing oedema, variation in mouth opening, and soft tissue healing. Furthermore, patient-centered analyses were also carried out through the application of the visual analogue scale (VAS) to assess pain, inflammation, bleeding, difficulty opening the mouth, and chewing. Result: No influence of antibiotic prophylaxis was observed on the evolution of clinical parameters of healing, oedema, and mouth opening. Patients did not notice differences regarding their comfort during the postoperative period. Conclusion: The incidence of complications observed in the present study was low and was not related to infectious processes. The use of prophylactic antibiotic therapy has no beneficial effects on the postoperative clinical course in third molar extraction.

Introdução: Exodontia de terceiro molar é um procedimento odontológico comum, frequentemente desafiador, com complicações pós-operatórias aumentadas. A necessidade de profilaxia com antibióticos nesses casos ainda é motivo de debate. Objetivo: O objetivo deste estudo foi avaliar o efeito da profilaxia com antibióticos no curso clínico pós-operatório das cirurgias de extração do terceiro molar. Material e método: Sessenta e três pacientes foram randomicamente alocados em dois grupos posteriormente a cirurgia de exodontia dos quatro terceiros molares. Grupo ATB (N = 33) utilizou 1g de amoxicilina uma hora antes do procedimento cirúrgico e grupo CTR (N = 30) sem profilaxia antibiótica. Os dentes foram classificados de acordo com Pell & Gregory e Winter. Análises clínicas foram realizadas nos períodos de 3, 7, 14 e 30 dias após o procedimento cirúrgico. As análises consistiram na avaliação do edema, variação de abertura de boca e a cicatrização dos tecidos moles. Também foram executadas análises centradas nos pacientes por meio da aplicação da escala visual analógica (VAS) para avaliação de dor, inflamação, sangramento, dificuldade de abertura bucal e de mastigação. Resultado: Não houve diferenças entre os grupos em relação ao posicionamento dos dentes. Não foi observada influência da profilaxia antibiótica nos parâmetros clínicos de cicatrização, edema e abertura de boca. Os pacientes não notaram diferenças em relação ao seu conforto no pós-operatório. Conclusão: A incidência de complicações foi baixa e não foi relacionada a processos infecciosos. O uso de antibioticoterapia profilática não apresentou efeitos benéficos para o curso clínico pós-operatório em exodontia de terceiros molares.

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The aim of this study was to evaluate the effect of photobiomodulation therapy (PBMT) with the association of red and infra-red laser therapy in the healing of the post-extraction sockets of third lower molars. Twenty patients were submitted to extraction of lower third molars and the post-extraction sockets were treated using two different approaches in a randomized split-mouth design: The test side received the PBMT with red (λ 660 nm) and infra-red laser therapy (λ 808 nm) and the control side was not irradiated. The PBMT was applied immediately and 3 and 7 days after the surgical procedure. Post-extraction socket healing was assessed by the bone repair score, bone density, and fractal dimension analysis 7 and 90 days after the surgical procedure, using cone-beam computed tomography images. Additionally, clinical analyses were performed 3, 7, 14, 30, and 90 days after the surgical procedure, considering the occurrence of pain, edema, and bleeding, as well as the quality of the oral mucosa repair, assessed using a visual analogue scale. The clinical analysis showed that PBMT reduced edema and improved the repair of oral mucosa at 7 days after surgery, while the tomographic analysis showed no significant differences between groups. Dual-wavelength PBMT improved the post-operative clinical course in patients undergoing lower third molar extraction, without altering bone repair.

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Pleomorphic adenoma is a benign neoplasm of the salivary glands that affects most frequently females in the fourth and sixth decade of life. As it is usually an asymptomatic lesion, it is diagnosed upon routine physical examination. Treatment consists in surgical removal with partial or total involvement of the parotid gland. Conservative enucleation is the least invasive surgical option for this type of lesion. The present work aimed to report a case of pleomorphic adenoma of the parotid gland with eight years of evolution. The tumor was treated conservatively. Patient has been followed for sixth months, and no sensory alterations, fistulae, clinical signs of recurrence, nor any other alteration have been observed so far. Due to the benign nature of the lesion, an evolution with favorable prognosis is expected. (AU)

O Adenoma pleomórfico é uma neoplasia benigna de glândulas salivares, que acomete com maior frequência pessoas do sexo feminino entre a quarta e sexta década de vida. Por se tratar de uma lesão muitas vezes assintomática, geralmente é descoberta através do exame físico de rotina. O seu tratamento consiste em remoção cirúrgica podendo envolver ou não a glândula parótida de maneira parcial ou total. A enucleação conservadora é a modalidade cirúrgica menos invasiva para este tipo de lesão. O presente trabalho tem por objetivo relatar um caso de adenoma pleomórfico em glândula parótida com oito anos de evolução. O tumor foi tratado de maneira conservadora. A paciente está sendo acompanhada há 6 meses e não foram observados até momento alterações sensoriais, fistulas, indícios clínicos de recidiva ou qualquer outra alteração. Devido ao caráter benigno da lesão, espera-se evolução com prognóstico favorável. (AU)

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A constante busca por tratamentos odontológicos estéticos e por um sorriso bonito e harmônico é o que a maioria das pessoas almeja, o que contribui para a realização de procedimentos restauradores que possibilitem mimetização do natural para atingir as expectativas e necessidades dos pacientes. A presença de diastemas pode resultar em problemas funcionais e estéticos. Sendo assim, o presente caso clínico relata reabilitação de um extenso diastema entre os incisivos centrais superiores, após intervenção cirúrgica para remoção do freio labial e clareamento dental. Foram realizadas restaurações diretas minimamente invasivas nos dentes anteriores, com resina composta nanoparticulada. O acabamento e polimento foram realizados de forma a evidenciar anatomia e textura de superfície dos dentes. Em conclusão, o tratamento realizado utilizou materiais com comportamento biomecânico favorável, estabelecendo função, harmonia do sorriso e resultado estético satisfatório...

The constant search for dental aesthetic treatments in order to achieve a nice and harmonic smile has contributed to the development of restorative procedures enabling mimicry of natural teeth to meet expectations and needs of patients. The presence of diastemas can result in functional and aesthetic problems. Therefore, the present clinical case reports rehabilitation of a large diastema between the maxillary central incisors, after surgery for removal of labial frenum and tooth bleaching. Minimally invasive direct restorations were performed in anterior teeth with nanofilled composite resin. Finishing and polishing were done in order to demonstrate anatomy and surface texture of the teeth. In conclusion, the treatment used materials with biomechanical behavior, setting function, harmony of the smile and satisfactory aesthetic result...

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