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The introduction of immunotherapy has brought about a paradigm shift in the management of advanced non-small cell lung cancer (NSCLC). It has not only significantly improved the prognosis of patients but has also become a cornerstone of treatment, particularly in those without oncogenic driver mutations. Immune checkpoint inhibitors (ICIs) play a crucial role in the treatment of lung cancer and can be classified into two main groups: Anti-cytotoxic T lymphocyte antigen-4 (Anti-CTLA-4) and anti-T-cell receptor programmed cell death-1 or its ligand (Anti-PD-1 and Anti-PD-L1). Certainly, the landscape of approved first line immunotherapeutic approaches has expanded to encompass monotherapy, immunotherapy-exclusive protocols, and combinations with chemotherapy. The complexity of decision-making in this realm arises due to the absence of direct prospective comparisons. However, a thorough analysis of the long-term efficacy and safety data derived from pivotal clinical trials can offer valuable insights into optimizing treatment for different patient subsets. Moreover, ongoing research is investigating emerging biomarkers and innovative therapeutic strategies that could potentially refine the current treatment approach even further. In this comprehensive review, our aim is to highlight the latest advances in immunotherapy for advanced NSCLC, including the mechanisms of action, efficacy, safety profiles, and clinical significance of ICI.
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BACKGROUND: Low back pain (LBP) has a high economic burden and is strongly related to the degenerative process of the spine, especially in the intervertebral disc and of the facet joints. Numerous treatment modalities have been proposed for the management of LBP, and the use of platelet-rich plasma (PRP) has emerged as an innovative therapeutic option for degenerative disease of the spine. The present study aims to evaluate the efficacy of PRP injections in managing low back pain. METHODS: We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, a registered at PROSPERO Systematic Reviews Platform, under number CRD42021268491. The PubMed, Web of Science, and Scopus databases were searched to identify relevant articles, along with hand searching to identify gray literature articles, with no language restrictions. Randomized clinical trials (RCTs), nonrandomized trials (NRTs), and case series (CSs) with more than 10 patients were considered eligible. The quality assessment and the risk of bias of the randomized clinical trials were evaluated using the RoB II tool. An evaluation of the description of the preparation methods was performed using an adapted version of the MIBO checklist. RESULTS: An electronic database search resulted in 2324 articles, and after the exclusion of noneligible articles, 13 RCTs and 27 NRTs or CSs were analyzed. Of the 13 RCTs, 11 found favorable results in comparison to the control group in pain and disability, one showed no superiority to the control group, and one was discontinued because of the lack of therapeutic effect at eight-week evaluation. Description of the PRP preparation techniques were found in almost all papers. The overall risk of bias was considered high in 2 papers and low in 11. An adapted MIBO checklist showed a 72.7% compliance rate in the selected areas. CONCLUSIONS: In this systematic review, we analyzed articles from English, Spanish and Russian language, from large databases and grey literature. PRP was in general an effective and safe treatment for degenerative LPB. Positive results were found in almost studies, a small number of adverse events were related, the risk of bias of the RCTs was low. Based on the evaluation of the included studies, we graded as level II the quality of the evidence supporting the use of PRP in LBP. Large-scale, multicenter RCTs are still needed to confirm these findings.
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BACKGROUND: Total or partial calcification of the stylohyoid chain, elongation of the stylohyoid process of the temporal bone and/or calcification of the stylohyoid ligament are usually incidental radiographic findings. The purpose of this study was to evaluate the prevalence of morphological and structural changes within the stylohyoid chain in 4413 digital panoramic radiographs. MATERIAL AND METHODS: The images were evaluated for the presence or absence of changes in the stylohyoid chain by a specialist in dentofacial radiology and the information collected comprised gender, age, side, right and left measurements and classification of the chain side elongated or calcified stylohyoid process, as well as type and pattern of right or left calcification. RESULTS: 275 (6.2%) subjects presented alterations, mostly bilateral, in the stylohyoid chain, being 186 females (67.6%) and 89 males (32.4%), with a higher proportion elongation. Partial calcification was more prevalent than total calcification. The right side was most affected and the frequency of events increased with age. CONCLUSIONS: The findings of the present study demonstrate that the commonest alterations in the stylohyoid chain are bilateral, mainly elongation, with a clear trend to increased prevalence with increasing age, presenting a low incidence. Noneless, the clinicians must be aware of these alterations in the routinely radiographic examination. Key words:Stylohyoid process, Stylohyoid ligament calcification, Stylohyoid chain, Eagle's syndrome.
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BACKGROUND: The search for the ideal, healthy and reproducible position of the condyles is of utmost importance for dental diagnosis and treatment. Thus, the objective of this laboratory cross-sectional study was to verify the relationship between the posterior joint space and the mandibular lateral movements. MATERIAL AND METHODS: Dental casts from 15 women and 15 men with normal mastication, 28 natural teeth and no history of temporomandibular disorders or pain, were fabricated and mounted on a fully adjustable articulator. From the maximum intercuspal position, condylar displacement was evaluated and measured on the working and nonworking sides during mandibular lateral movement, both to the right and left sides. RESULTS: The correlation between the measures of interest was assessed with the Pearson correlation coefficient (α=.05). Condylar displacement on the working side and nonworking side condyle was 0.88±0.71 mm and 3.57±1.11 mm (right mandibular lateral movement); and 0.91±0.58 mm and 3.51±0.78mm (left mandibular lateral movement), respectively. No significant correlation in the condylar displacement between the working side condyles on the right and on the left sides was observed (r=.22; P=.248). The condylar poles of the articulator moved posteriorly, simulating the functional movements of the mandible during mastication. In all cases, condylar displacement during mandibular lateral movement both to the right and left occurred posteriorly on the working side condyle. CONCLUSIONS: The condylar poles of the articulator moved posteriorly simulating the functional movements of the mandible during mastication. Moreover, left and right working condyles may require slightly different spaces to function, suggesting minor anatomical asymmetries. Key words:Mastication, dental occlusion, prosthodontics.
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PURPOSE: Due to the bite force importance in functionality of the masticatory system, this study aimed to characterize it in dolichofacial and brachyfacial individuals. METHODS: A sample comprised by 190 patients was divided into two groups: 90 severe dolichofacial, and 100 severe brachyfacial individuals classified according to the VERT index and the face height ratio (Jarabak quotient). Bite force was measured by using an adjusted digital dynamometer and proper methodology. RESULTS: The sample met the parametric assumptions and presented statistical significance when right and left sides of dolichofacial and brachyfacial individuals were compared. However, within the same group, no differences between the left and right sides were found. Generally, bite force was higher for male, left masticator, age between 41-50 years, weighing over 100kg and between 1.81 and 1.90m tall. CONCLUSIONS: Based on the results of this cross-sectional study, it was possible to conclude that the bite force in severe brachyfacial individuals was significantly higher than in severe dolichofacial individuals, being influenced by gender, weight and height.
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Força de Mordida , Estatura , Peso Corporal , Face/anatomia & histologia , Mastigação/fisiologia , Caracteres Sexuais , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Dimensão Vertical , Adulto JovemRESUMO
AIM: To report on a patient with Eagle's syndrome with a complete and very large ossification of the stylohyoid complex on the right side that to our best knowledge has never been published previously. BACKGROUND: Eagle's syndrome is characterized by a set of symptoms that are caused by the irritation of the neurovascular and soft-tissues caused by an elongated styloid process or ossification of stylohyoid ligament. CASE DESCRIPTION: Because of the high discomfort and pain degree as well as limitations of mandibular and head mobility and also the thickness of the ossifed stylohyoid chain, the patient was treated surgically by removing the hypertrophic segment. CONCLUSION: These symptoms subsided completely after the surgical excision of the anomaly. The elongated styloid process on the left side was symptom free. CLINICAL SIGNIFICANCE: Eagle's syndrome symptoms are not specific and can mimic those of other disorders, the syndrome must be included in the differential diagnosis of patients with pain in the orofacial, pharyngeal and cervical area.
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Ossificação Heterotópica/diagnóstico , Osso Temporal/anormalidades , Transtornos de Deglutição/diagnóstico , Diagnóstico Diferencial , Dor de Orelha/diagnóstico , Dor Facial/diagnóstico , Humanos , Imageamento Tridimensional/métodos , Ligamentos/patologia , Masculino , Pessoa de Meia-Idade , Cervicalgia/diagnóstico , Síndrome da Disfunção da Articulação Temporomandibular/diagnóstico , Tomografia Computadorizada por Raios X/métodosRESUMO
AIMS: To translate the Pictorial Representation of Illness and Self Measure (PRISM) instrument from German to Portuguese (Brazilian) and adapt it to the Brazilian cultural context, and then assess its reliability and validity in orofacial pain patients. METHODS: The PRISM was translated to Portuguese then back-translated to German. The translated PRISM was evaluated by a multidisciplinary committee and administered as a pre-test to 30 Portuguese-speaking orofacial pain patients. Psychometric properties were obtained after testing 116 orofacial pain patients. Validity was obtained through correlation analyses of scores obtained from PRISM and other psychometric tests, including the Numerical Pain Scale (NPS), Insomnia Severity Index (ISI), and Hospital Anxiety and Depression Scale (HAD). RESULTS: The adapted instrument showed high levels of reliability, proven by means of the test-retest procedure, and calculation of the Intraclass Correlation Coefficient (ICC = 0.991). Significant correlations were found between PRISM and the other tests. Correlation with NPS was moderate (-0.42), whereas correlations with ISI (-0.24), HAD-anxiety (-0.25), and HAD-depression (-0.22) were weak. CONCLUSION: The cross-cultural adaptation process of PRISM was successful and the adapted version offers reliable and valid psychometric properties in the Brazilian context.
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Comparação Transcultural , Autoavaliação Diagnóstica , Dor Facial/diagnóstico , Testes Psicológicos , Adulto , Brasil , Estudos Transversais , Dor Facial/psicologia , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Medição da Dor , Fotografação , Estudos Prospectivos , Psicometria , Qualidade de Vida , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Estresse PsicológicoRESUMO
The retinoblastoma (Rb) and p53 genes play a fundamental role in cell cycle mechanisms, and their deregulation is related to many steps of oral cancer carcinogenesis. This study was conducted to evaluate the expression of the p53 and Rb proteins in malignant and pre-malignant oral cavity lesions. This retrospective study was conducted at the Federal University of Bahia, Salvador, Brazil, and the Molecular Biology Laboratory of the Otorhinolaryngology Department at the University of Heidelberg, Heidelberg, Germany. Excisional biopsy samples of oral cavities were collected from patients with suspected oral lesions. The samples were processed by immunohistochemistry to be classified by a semi-quantitative score: samples with a ≤ 10% positivity were considered to have weak/negative expression (-); those with 11-50% positivity, moderate expression (+); and those with >50% positivity, high expression (++). Seventy-one patients were studied (75% male; median age, 52 years; range, 24-84). Of the samples studied, 59.4% were oral squamous cell carcinoma (OSCC) and 40.6% were pre-neoplastic lesions (leukoplakia and actinic cheilitis). OSCC presented higher expression of Rb protein compared to pre-malignant lesions: 75 vs. 25% (p<0.001). Pre-neoplastic lesions presented higher expression of p53 protein compared to OSCC lesions: 55.2 vs. 44.8% (p = 0.030). Despite the small number of samples, the expression of these cell cycle biomarkers (p53 and Rb protein) in excisional biopsies suggests that molecular lesion assessment can determine pre-malignant lesions, and that its use may improve the clinical and surgical treatment of early lesions. Thus, p53 protein expression may be related to the early steps of carcinogenesis in OSCC. Finally, a higher Rb expression was also observed in malignant lesions.
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Carcinoma de Células Escamosas/metabolismo , Queilite/metabolismo , Leucoplasia Oral/metabolismo , Neoplasias Bucais/metabolismo , Proteína do Retinoblastoma/metabolismo , Proteína Supressora de Tumor p53/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Imuno-Histoquímica , Leucoplasia Oral/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Gradação de Tumores , Adulto JovemRESUMO
OBJECTIVES: To investigate apicectomies performed using burs, a CO2 laser or an Er:YAG laser and to evaluate the following aspects: morphology of apicectomized surfaces, presence of failures at the dentin/obturation material interface (marginal fit) of the apical portions of the root canals, and the proportions of chemical elements in the apicectomized surfaces. STUDY DESIGN: Twenty-four teeth were divided into three groups of eight and each group underwent apicectomy by one of three different ablation techniques: bur, CO2 laser or Er:YAG laser. The morphology of the apicectomized surfaces was then analyzed using scanning electron microscopy and their chemical composition was analyzed by energy dispersive spectroscopy. RESULTS: Surfaces produced with ablation by bur exhibited less surface irregularities and better marginal fit, while ablation with the CO2 laser caused intense surface carbonization and failures in obturation material fit. CONCLUSIONS: Our results suggest that, taking into consideration their clinical application, ablation of tooth apices using burs proved to be the best option among those tested here.
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Técnicas de Ablação , Ápice Dentário/anatomia & histologia , Ápice Dentário/cirurgia , Adulto , Humanos , Lasers de Gás , Lasers de Estado Sólido , Pessoa de Meia-IdadeRESUMO
Diferentes metodologias para verificar o sucesso de materiais odontológicos em apicoplastias com retro-obturaçãotêm sido utilizadas em estudos de infiltração marginal por corante. Apicoplastia é o aplainamento de umápice radicular sem a necessidade de sua amputação, com sua plástica correta. Objetivo: Esta pesquisa objetivou avaliar os resultados de infiltração da rodamina B a 1 por cento num grupo experimental, comparando-se a profundidadede penetração do corante com a sua área de impregnação nas mesmas amostras em apicoplastias comretro-obturação. Métodos: Para tanto utilizaram-se doze caninos humanos superiores tratados endodonticamentee retro-obturados com MTA. Na análise das amostras utilizou-se o software Image Tool® para realizar a morfometriacomputadorizada. Resultados: Os resultados demonstraram um desvio-padrão baixo (4,79) para a mensuração da área e alto (15,05) para mensuração da profundidade de penetração do corante. O teste Mann- Whitney demonstrou diferenças estatisticamente significativas entre os grupos, com p < 0,0001. Conclusão: A utilização da área impregnada por corante, em substituiçãoà profundidade de sua penetração, apresentouse como uma melhor alternativa para mensuração dos escores de infiltração marginal, considerando-se os parâmetros metodológicos utilizados nesta pesquisa
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Infiltração Dentária , Obturação RetrógradaRESUMO
OBJECTIVES: CO(2), Er:YAG and Nd:YAG lasers have been used in endodontic surgery. This in vitro study evaluated 1% Rhodamine B dye penetration using computer-assisted morphometry (ImageTool Software) of 108 endodontically treated human permanent canines. MATERIAL AND METHODS: Teeth were divided into 9 groups according to the technique used: A: 90-degree apicoectomy with bur, root-end cavity preparation with ultrasound and filled with MTA; B: 90-degree apicoectomy with bur, root-end cavity prepared with ultrasound and filled with MTA, and treatment of apical surface with CO(2) laser (1 W, CW/CW); C: 90-degree apicoectomy with bur, and treatment of apical surface with Nd:YAG laser (150 mJ, 10 Hz); D: 90-degree apicoectomy with bur, and treatment of apical surface with CO(2) laser,(1 W, CW/CW); E: apicoectomy with Er:YAG laser (400 mJ, 10 Hz), root-end cavity prepared with ultrasound and filled with MTA; F: apicoectomy with Er:YAG laser (400 mJ, 10 Hz) and treatment of apical surface with Nd:YAG laser (150 mJ, 10Hz); G: apicoectomy with CO(2) laser (5W, CW/SP), root-end cavity prepared with ultrasound and filled with MTA; H: irradiation of apical end with CO(2) laser (1 W, CW/CW); I: irradiation of apical end with Nd:YAG laser (150 mJ, 10 Hz). RESULTS: Dye penetration was found in all specimens at different rates, the lowest penetration occurring in groups C (16.20%), B (17.24%) and F (17.84%). CONCLUSIONS: Groups B, C and F represent the best technical sequences to perform endodontic surgery.
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Apicectomia/métodos , Terapia a Laser/métodos , Lasers de Gás/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Ápice Dentário/patologia , Compostos de Alumínio/uso terapêutico , Apicectomia/instrumentação , Compostos de Cálcio/uso terapêutico , Dente Canino/patologia , Dente Canino/cirurgia , Infiltração Dentária/classificação , Dentina/patologia , Combinação de Medicamentos , Corantes Fluorescentes , Humanos , Processamento de Imagem Assistida por Computador , Óxidos/uso terapêutico , Obturação Retrógrada/métodos , Rodaminas , Materiais Restauradores do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Silicatos/uso terapêutico , Terapia por Ultrassom/métodosRESUMO
OBJECTIVES: CO2, Er:YAG and Nd:YAG lasers have been used in endodontic surgery. This in vitro study evaluated 1 percent Rhodamine B dye penetration using computer-assisted morphometry (ImageTool Software®) of 108 endodontically treated human permanent canines. MATERIAL AND METHODS: Teeth were divided into 9 groups according to the technique used: A: 90-degree apicoectomy with bur, root-end cavity preparation with ultrasound and filled with MTA; B: 90-degree apicoectomy with bur, root-end cavity prepared with ultrasound and filled with MTA, and treatment of apical surface with CO2 laser (1 W, CW/CW); C: 90-degree apicoectomy with bur, and treatment of apical surface with Nd:YAG laser (150 mJ, 10 Hz); D: 90-degree apicoectomy with bur, and treatment of apical surface with CO2 laser,(1 W, CW/CW); E: apicoectomy with Er:YAG laser (400 mJ, 10 Hz), root-end cavity prepared with ultrasound and filled with MTA; F: apicoectomy with Er:YAG laser (400 mJ, 10 Hz) and treatment of apical surface with Nd:YAG laser (150 mJ, 10Hz); G: apicoectomy with CO2 laser (5W, CW/SP), root-end cavity prepared with ultrasound and filled with MTA; H: irradiation of apical end with CO2 laser (1 W, CW/CW); I: irradiation of apical end with Nd:YAG laser (150 mJ, 10 Hz). RESULTS: Dye penetration was found in all specimens at different rates, the lowest penetration occurring in groups C (16.20 percent), B (17.24 percent) and F (17.84 percent). CONCLUSIONS: Groups B, C and F represent the best technical sequences to perform endodontic surgery.
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Humanos , Apicectomia/métodos , Terapia a Laser/métodos , Lasers de Gás/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Ápice Dentário/patologia , Compostos de Alumínio/uso terapêutico , Apicectomia/instrumentação , Compostos de Cálcio/uso terapêutico , Dente Canino/patologia , Dente Canino/cirurgia , Combinação de Medicamentos , Infiltração Dentária/classificação , Dentina/patologia , Corantes Fluorescentes , Processamento de Imagem Assistida por Computador , Óxidos/uso terapêutico , Obturação Retrógrada/métodos , Rodaminas , Materiais Restauradores do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Silicatos/uso terapêutico , Terapia por Ultrassom/métodosRESUMO
OBJECTIVE: To evaluate, using histological analysis, the systemic action and repair process of wounds produced on the back of rats and treated with red, infrared, or both lasers applied directly or indirectly to the wounds. BACKGROUND DATA: Skin tissue repair and wound healing are complex processes that involve a series of dynamic events. Many benefits are associated with biomodulation using laser therapy. METHODS: Thirty-six male Wistar rats were divided into four groups: control (without laser), red laser (aluminium gallium indium phosphide (AlGaInP); lambda=685 nm; phi=0.0314 cm2; CW; P=30 mW; D=20 J, time of irradiation=667 sec), infrared laser (gallium-aluminum-arsenide (GaAlAs): lambda=830 nm; phi=0.0314 cm2; CW; P=50 mW; D=20 J, time of irradiation=401 sec), and both lasers (infrared laser: GaAlAs; lambda=830 nm; phi=0.0314 cm2; CW; P=50 mW; D=10 J, time of irradiation=201 sec+red laser: AlGaInP; lambda=685 nm; phi=0.0314 cm2; CW; P=30 mW; D=10 J, time of irradiation=334 sec; total dose=20 J). Three subgroups were formed according to observation time points. Three wounds were produced on the back of each animal. Only the wound closest to the head was irradiated in the experimental groups. For the evaluation of skin reaction and wound healing, three animals of each group were killed at 3, 5, and 7 days postoperatively. The irradiation protocol established 48-hour intervals between applications, with the first application immediately after the surgical procedure. RESULTS: In the red and infrared laser group, healing was more advanced in the wound located furthest from the point of laser application. The most effective healing of a proximal wound was verified in the control group on the 7th postoperative day. CONCLUSION: The combined application of red and infrared lasers resulted in the most evident systemic effect on the repair of skin wounds produced in rats.
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Terapia com Luz de Baixa Intensidade/métodos , Pele/lesões , Cicatrização/efeitos da radiação , Compostos de Alumínio , Animais , Dorso , Gálio , Índio , Raios Infravermelhos , Terapia com Luz de Baixa Intensidade/instrumentação , Masculino , Fosfinas , Fotomicrografia , Ratos , Ratos Wistar , Pele/efeitos da radiação , Estatísticas não Paramétricas , Fatores de TempoRESUMO
AIM: This study used histologic analysis and HE staining to evaluate laser biomodulation of bone repair in cavities made in the femurs of rats that underwent non-ablative laser irradiation. METHODS AND MATERIALS: Eighteen male Wistar rats weighing 300 to 400 grams were randomly assigned to three groups of six animals each. A surgical defect site was produced with a trephine about 2 mm in diameter under abundant irrigation. In Group I the complete surgical protocol to produce a bone defect was followed but without laser radiation (control). In Group II a continuous wave 830 nm infrared laser was used at 10 J/cm2 and 50 mW at each point of the surgical site. In Group III a continuous wave 685 nm infrared laser at 10J/cm2 and 35 mW was used at each point of surgical site. The animals were irradiated at intervals of 48 hours beginning immediately after the preparation of the defect and were sacrificed on the 15th, 21st, and 30th days. Slides were studied by means of descriptive analysis. RESULTS: Greater degrees of new bone formation and vertical regeneration were found in the irradiated groups than in the control group. CONCLUSION: Laser therapy in this study protocol was efficient in promoting bone repair. CLINICAL SIGNIFICANCE: The use of laser technology has been used to improve the clinical results of bone surgeries and to promote a more comfortable postoperative period and quicker healing.
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Regeneração Óssea/efeitos da radiação , Terapia com Luz de Baixa Intensidade , Cicatrização/efeitos da radiação , Animais , Fêmur/cirurgia , Raios Infravermelhos , Lasers , Masculino , Distribuição Aleatória , Ratos , Ratos WistarRESUMO
Technological advances have increased the rate of success of dental procedures. In periradicular surgery, the use of ultrasonic tips ensures high-quality root-end cavity preparations, enables the performance of a 90-degree apicoectomy, and removes larger amounts of contaminated material. The authors reviewed in vitro and in vivo studies in the literature and evaluated root-end cavities prepared with burs or ultrasonic tips using scanning electron microscopy.
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Terapia por Ultrassom , Apicectomia , Endodontia , Técnicas In VitroRESUMO
Portland cement has been analyzed and compared to mineral trioxide aggregate (MTA) because of their chemical similarity. The possibility of using this material as a less expensive alternative to MTA in dental practice should be considered. In view of this, the present study compared the components of a Portland cement (Votoran) to two commercial brands of MTA (Pro-Root and MTA-Angelus). Twelve specimens of each material were fabricated and examined by scanning electron microscopy (SEM) with energy dispersive spectroscopy (EDS) to obtain their percentage of chemical elements. The means of the chemical elements found in each material was compared by descriptive statistics. Bismuth was present only in MTA cements to provide radiopacity. In conclusion, the tested cements have similar components, which supports, as far as composition is concerned, the possible clinical use of Portland as an option to MTA.
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Compostos de Alumínio/química , Compostos de Cálcio/química , Cimentos Dentários/química , Óxidos/química , Materiais Restauradores do Canal Radicular/química , Silicatos/química , Compostos de Alumínio/economia , Bismuto/análise , Bismuto/química , Bismuto/economia , Compostos de Cálcio/economia , Cimentos Dentários/economia , Combinação de Medicamentos , Microscopia Eletrônica de Varredura/métodos , Óxidos/economia , Materiais Restauradores do Canal Radicular/economia , Silicatos/economia , Espectroscopia de Perda de Energia de Elétrons/métodosRESUMO
OBJECTIVE: The present study aimed to assess the effect of the use of the CO(2) laser on the treatment of gingival hyperplasia in orthodontic patients wearing fixed appliances. BACKGROUND DATA: Gingival hyperplasia is a condition very frequent in patients undergoing fixed orthodontic treatment. Amongst the treatments available for this is the use of surgical lasers. METHODS: Ten patients entered this study and signed an informed consent. Seventy-five anterior teeth with gingival hyperplasia were selected for laser surgery. Prior to surgery, the length of the crowns were measured using a digital caliper, and depth of the pocket was probed. The hyperplasic gingival was removed with a CO(2) laser under local anesthesia. Immediately after surgery, measurement of the length of the crowns and probing were carried out and were repeated. RESULTS: The results were statistically analyzed and significant differences were detected regarding the length of the crown (p = 0.000) and depth of the gingival sulcus (p = 0.000). CONCLUSION: It is concluded that the use of the CO(2) laser was effective in the treatment of gingival hyperplasia.
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Hiperplasia Gengival/cirurgia , Terapia a Laser , Aparelhos Ortodônticos , Humanos , Aparelhos Ortodônticos/efeitos adversos , Resultado do TratamentoRESUMO
O objetivo desta pesquisa foi avaliar, através do uso de um torquímetro digital, se implantes de titânio, instalados com liberdade rotaciona em tíbias de coelhos e irradiados com laser de Arseneto de Gálio e Alumínio, na dose de 86 J/cm2, com comprimento de onda de 830 nm, potência de 12 mW e tempo de aplicação de 51 segundos, apresentam um valor de torque de remoção estatisticamente maior que os valores obtidos nos grupos não irradiados (grupo controle). Para tanto, trabalhou-se com trinta coelhos, da raça Nova Zelândia, machos, os quais foram divididos em dois grupos, Laser e Controle, e subdivididos de acordo com o dia de sua morte. Os grupos L1 e C1, L2 e C2, L3 e C3 foram mortos 15, 30 e 45 dias após a inserção do implante, respectivamente. Um torquímetro digital mensurou o torque necessário para o afrouxamento do implante, rompendo sua união com o osso. Os resultados foram, então, submetidos ao Teste t de Student e ao Teste ANOVA, a fim de validar esses achados. Observou-se, para um p=0,05, um aumento nos valores dos torques de remoção dos implantes irradiados com laser e controle (L1 e L2), tanto aos quinze quanto aos trinta dias após as cirurgias, em relação aos respectivos grupos controle (C1 e C2). Aos 45 dias, não mais foi observada diferença estatisticamente significante entre os valores encontrados nos grupos laser e controle (L1 e C1). Concluiu-se, nesse modelo animal e com o protocolo de irradiação utilizado neste estudo, que o laser, por ser a única variável entre os grupos, foi responsável pelo aumento do embricamento do implante ao osso, no mês inicial e mais critico da osseointegração.
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Implantes Dentários , Lasers , OsseointegraçãoRESUMO
Portland cement has been analyzed and compared to mineral trioxide aggregate (MTA) because of their chemical similarity. The possibility of using this material as a less expensive alternative to MTA in dental practice should be considered. In view of this, the present study compared the components of a Portland cement (Votoran®) to two commercial brands of MTA (Pro-Root and MTA-Angelus®). Twelve specimens of each material were fabricated and examined by scanning electron microscopy (SEM) with energy dispersive spectroscopy (EDS) to obtain their percentage of chemical elements. The means of the chemical elements found in each material was compared by descriptive statistics. Bismuth was present only in MTA cements to provide radiopacity. In conclusion, the tested cements have similar components, which supports, as far as composition is concerned, the possible clinical use of Portland as an option to MTA.
O cimento Portland tem sido analisado e comparado com o agregado trióxido mineral (MTA) devido a sua similaridade química. Dada à possibilidade de uso na Odontologia como uma alternativa menos onerosa ao MTA, realizou-se uma análise comparativa dos componentes do cimento Portland (Votoran®) com os constituintes de dois cimentos MTA (Pro-Root-MTA e Angelus®-MTA). Para tanto, foram confeccionados 12 corpos-de-prova de cada um dos materiais (n=36), e estes foram analisados em microscopia eletrônica de varredura (MEV) pela técnica de espectroscopia por dispersão de energia (EDS), que fornece o percentual dos componentes químicos encontrados nos corpos-de-prova. As médias dos elementos químicos encontrados nos três cimentos foram comparadas por meio de análise estatística descritiva. O bismuto estava presente somente nos cimentos MTA. Concluiu-se que os cimentos testados apresentaram similaridade em seus constituintes, o que indica, considerando-se a composição, a possibilidade de futura utilização clínica do cimento Portland como alternativa ao MTA.