RESUMO
The purpose of this study was to address the following question: among patients with acute or chronic temporomandibular disorders (TMD), does low-level laser therapy (LLLT) reduce pain intensity and improve maximal mouth opening? The sample comprised myogenic TMD patients (according Research Diagnostic Criteria for TMD). Inclusion criteria were: male/female, no age limit, orofacial pain, tender points, limited jaw movements and chewing difficulties. Patients with other TMD subtypes or associated musculoskeletal/rheumatologic disease, missing incisors teeth, LLLT contra-indication, and previous TMD treatment were excluded. According to disease duration, patients were allocated into two groups, acute (<6 months) and chronic TMD (≥ 6 months). For each patient, 12 LLLT sessions were performed (gallium-aluminum-arsenide; λ = 830 nm, P = 40 mW, CW, ED = 8 J/cm(2)). Pain intensity was recorded using a 10-cm visual analog scale and maximal mouth opening using a digital ruler (both recorded before/after LLLT). The investigators were previously calibrated and blinded to the groups (double-blind study) and level of significance was 5% (p < 0.05). Fifty-eight patients met all criteria, 32 (acute TMD), and 26 (chronic TMD). Both groups had a significant pain intensity reduction and maximal mouth opening improvement after LLLT (Wilcoxon test, p < 0.001). Between the groups, acute TMD patient had a more significant pain intensity reduction (Mann-Whitney test, p = 0.002) and a more significant maximal mouth opening improvement (Mann-Whitney test, p = 0.011). Low-level laser therapy can be considered as an alternative physical modality or supplementary approach for management of acute and chronic myogenic temporomandibular disorder; however, patients with acute disease are likely to have a better outcome.
Assuntos
Dor Facial/radioterapia , Terapia com Luz de Baixa Intensidade/métodos , Transtornos da Articulação Temporomandibular/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estatísticas não Paramétricas , Resultado do TratamentoRESUMO
A evolução da Implantodontia vem trazendo o desenvolvimento de novas técnicas, que levam cada vez mais conforto ao paciente, seja pelo fato de menos intervenções cirúrgicas com o implante imediato, seja pelo menor tempo que ele passe desdentado, pela técnica da carga imediata. O implante imediato é utilizado, geralmente, logo após a realização de exodontia, para que futuramente seja colocada a prótese. Sua principal vantagem é de redução das etapas cirúrgicas e de evitar a reabsorção óssea, principalmente em áreas estéticas. O uso da carga imediata em implantes tem a finalidade de reduzir o tempo de tratamento, possibilitando que o procedimento protético seja realizado logo após a colocação do implante, porém, o cirurgião-dentista deve saber indicar adequadamente a sua aplicação, seguindo todos os critérios necessários para evitar que ocorram insucessos do tratamento. Este trabalho teve por objetivo revisar a literatura acerca de dois métodos de instalação de implantes, de carga imediata e imediatos, que visem reduzir o tempo de espera pela prótese por parte dos pacientes e apontar suas principais indicações e contraindicações.
he evolution of dental implants has led to the development of new techniques that bring more comfort to the patient, either by the need for fewer surgical interventions with the immediate implant or by the short time period patients spent toothless on immediate loading. The immediate implant is used soon after tooth extraction for prosthesis delivery. Its advantages include reduction of surgical steps and bone resorption, particularly in esthetics areas. The use of immediate loading is intended to reduce overall treatment time, allowing prosthetic installation immediately after implant placement; however, proper indications are necessary as well as the correct protocol for preventing the incidence of treatment failures. This paper aims to review the literature on these two methods for implant placement (immediate implants and immediate loading) which reduce time until prosthesis delivery, highlightening their main indications and drawbacks.