RESUMO

Bisphosphonates (BPs) are being increasingly used for the treatment of metabolic and oncological pathologies involving the skeletal system. Because of the severity of the BP associated osteonecrosis of the jaws, the difficulties of treatment, and patient discomfort, additional support methods for their management are needed. Laser therapy has an easy handling, photobiostimulator effect on tissues healing, so it can be considered a preferred therapy. The aim of this study was to evaluate the influence of low-level laser therapy in the 685- and 830-nm wavelength in the healing process of the bone and soft tissues in rats under BP therapy [zoledronic acid (ZA)] and dexamethasone concomitantly that underwent a surgery for the extraction of upper molars. There were statistically significant differences in the clinical evaluation of the wound and the weight of the animals. Regarding the histological evaluation, it was possible to observe the different maturations of the healing stage between groups. The effect of drug therapy with ZA and dexamethasone in the bone tissue repair process induces osteonecrosis of the jaw in rats and slows down the healing process. In the laser groups, at the stipulated dosimetry, a positive influence on the bone and soft tissue repair process was observed.

Assuntos

RESUMO

Bisphosphonate-related osteonecrosis of the jaw is a well-known potential side effect of long-term bisphosphonate therapy; the primary objective of the treatment should be to improve patient quality of life through pain and infection management, to prevent the development of new lesions, and to slow disease progression. In recent years, the use of laser for bisphosphonate-related osteonecrosis of the jaw has become more widespread, due to its use of administration and widely reported beneficial effects on tissue healing. The present systematic review of the literature sought to elucidate whether low-level laser therapy has positive effects on the treatment of bisphosphonate-related osteonecrosis of the jaw. We conducted a systematic search of the PubMed, EMBASE, and Cochrane Library electronic databases, with no restrictions on language or year of publication. Search strategies were formulated using keywords and Boolean operators. The electronic search strategy retrieved 55 records. From 55 articles, 16 were selected for full-text review, and of these, 10 were ultimately included for data analysis in this review. Our findings show that treatment modalities including laser were associated with superior outcomes in terms of cure or improvement of bisphosphonate-related osteonecrosis of the jaw lesions as compared with conventional surgical and/or conservative drug therapy. It can be concluded that combined treatment with antibiotics, minimally invasive surgery (including Er:YAG laser surgery), and low-level laser therapy in the early stages of the disease should be the gold standard for bisphosphonate-related osteonecrosis of the jaw management.

Assuntos

RESUMO

Hereditary gingival fibromatosis (HGF), also known as hereditary gingival hyperplasia, idiopathic gingival fibromatosis, and hereditary gingival overgrowth, is a rare condition but the most common form of gingival hyperplasia. Overgrowth of gingival tissue is usually slow and progressive and may delay or prevent tooth eruption, resulting in cosmetic and functional impairments. Hypertrichosis, epilepsy, and intellectual disability may be associated with HGF, which can occur in isolation or as part of a syndrome. The purpose of this case report is to describe a diode laser resection of gingival hyperplasia in a seven-year-old patient with nonsyndromic HGF and hypertrichosis. The diode laser enabled efficient removal of hypertrophic gingival tissue with good healing and minimal postoperative discomfort.

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RESUMO

Objetivo: este trabalho busca demonstrar, a partir de uma revisão da literatura, as possibilidades de utilização do hormônio de crescimento (GH) em tratamentos e procedimentos na área das ciências da saúde, e as perspectivas na Odontologia. Revisão de literatura: reconstruções ósseas são frequentes na rotina de cirurgias bucomaxilofaciais, indicadas em traumas de face, patologias, cirurgia ortognática e implantodontia. Biomateriais osteoindutores apresentam benefícios na realização de enxertos ósseos, devido à menor morbidade, à grande disponibilidade e à quantidade de materiais, além de maior aceitação pelo paciente. Os fatores de crescimento podem surgir como uma alternativa interessante na reconstrução de tecidos, destacando-se o GH, o qual é um regulador do crescimento e responsável pelo remodelamento ósseo, que tem um papel fundamental, exercendo efeito sobre os condrócitos, osteoclastos e osteoblastos. Atua, também, como um fator de crescimento produzido localmente, sendo secretado por diversos tipos de células. Na literatura, encontrou-se o uso de GH relacionado a reparo de fraturas ósseas, implantes dentários, regeneração óssea guiada, tratamento de nanismo de mulibrey, enxertos ósseos com biomateriais, reparo de feridas, preservação de alvéolo e em ATM. Considerações finais: os biomateriais estão presentes nas mais diversas reconstruções ósseas em Odontologia. Substitutos ósseos de diferentes origens são utilizados em grande volume na prática cirúrgica. O GH parece ser, em um futuro próximo, um importante contribuinte na evolução desse conceito. Dessa forma, pesquisas e testes de associação com outros biomateriais com características osteocondutoras, são de grande interesse para a área da Odontologia.