ABSTRACT
Use of low level laser therapy (LLLT) in bone healing has been studied for years, and its application in implant dentistry is still a controversial topic due to the difficult assessment of its clinical efficacy. We report the application of LLLT as aid in the osseointegration in two patients undergone to implant surgery in the upper jaw. In one hemi-arch the LLLT was applied and the other one was used as control. The assessment of the bone area surrounding the fixtures was performed by means of cone beam compute tomography and the area of bone-implants contact was measured by means of InVesalius® software. The radiological findings support the idea of considering the laser biostimulation as an adjunctive aid in implant surgery.
El uso de la terapia con láser de baja potencia (LLLT) en la reparación ósea se ha estudiado durante años y su aplicación en la implantología sigue siendo un tema controvertido, debido a la difícil evaluación de su eficacia clínica. Reportamos la aplicación de LLLT como ayuda en la osteointegración en dos pacientes sometidos a cirugía de implantes en el maxilar superior. En un hemi-arco se aplicó la LLLT y en el otro se utilizó como control. La evaluación del área ósea que rodea a las fijaciones se realizó mediante tomografía computarizada Cone Beam y el área de contacto hueso-implantes se midió mediante el software InVesalius®. Los hallazgos radiológicos apoyan la idea de considerar la bioestimulación con láser como un coadyuvante en la cirugía de implantes.
Subject(s)
Humans , Periodontitis/radiotherapy , Dental Implants , Low-Level Light Therapy , Periodontitis/diagnostic imaging , Cone-Beam Computed TomographyABSTRACT
Photodynamic therapy (PDT) uses a photoactive dye (photosensitizer [PS])that activates by exposure to light of a specific wavelength in the presence of oxygen. The energy transfer from the activated PS to available oxygen leads to the formation of reactive oxygen species, such as singlet oxygen and free radicals. These chemical species are extremely reactive and can damage proteins, lipids, nucleic acids, and other components of the bacterial cell wall. Bacterial biofilms are widely implicated in their role in the causation of gingivitis and periodontitis. Prophylactic and therapeutic regimens for dental plaque related diseases include the usage of various chemotherapeutic agents. Since it is difficult to maintain therapeutic concentrations of these agents in the oral cavity and they run the risk of being rendered ineffective by bacterial resistance mechanisms, the need for an alternative antimicrobial approach in the treatment and prevention of dental plaque related diseases was felt. Many studies have reported the killing of bacteria via lethal photosensitization including both Gram-positive and Gram-negative bacteria. Photosensitization leads to bacterial elimination, with minimal chances of microbial resistance and with no adverse effects on host tissues and resident microflora. In dentistry, PDT has found use in the treatment of oral cancers, bacterial and fungal infections, and also in the detection of malignancies. PDT is free from genotoxic and mutagenic effects; another important factor for long-term safety. The ease of accessibility of the oral cavity to illumination makes it a suitable target for PDT.
Subject(s)
Humans , Laser Therapy/instrumentation , Laser Therapy/methods , Laser Therapy/therapeutic use , Laser Therapy/statistics & numerical data , Periodontitis/radiotherapy , Periodontitis/therapy , Photochemotherapy/instrumentation , Photochemotherapy/methods , Photochemotherapy/trends , Photochemotherapy/statistics & numerical dataABSTRACT
Periodontitis is a one of the commonly occurring disease. Various therapies have been used and suggested for its treatment which includes nonsurgical, antimicrobial, and surgical therapy. In the recent years, lasers have been used frequently for periodontal therapy. Lasers have been applied for debridement, reshaping as well as the reduction of bacterial load in the pocket. This case series represent the use of lasers for exposure of impacted teeth, second stage surgery for dental implant, and vestibuloplasty. The surgical procedure with a 810 nm diode laser has been described. The laser-assisted procedures provided excellent results without complications as well as high patient and clinician satisfaction.
Subject(s)
Adult , Dental Implantation/methods , Dental Implants , Female , Humans , Laser Therapy/instrumentation , Laser Therapy/methods , Male , Middle Aged , Periodontitis/surgery , Periodontitis/radiotherapy , Tooth, Impacted/surgery , Tooth, Impacted/therapy , Vestibuloplasty , Young AdultABSTRACT
Objetivo: Este estudo avaliou a influência de múltiplas sessões da Terapia com Laser em Baixa Intensidade (LLLT) coadjuvante a raspagem e alisamento radicular (RAR), e da terapia fotodinâmica antimicrobiana (aPDT) associada ou não ao tratamento mecânico de RAR, no tratamento da periodontite experimental (PE) em ratos submetidos à quimioterapia com 5-Fluorouracil. Materiais e Métodos: Duzentos e dezesseis ratos foram submetidos à indução da PE por meio de ligadura no primeiro molar inferior direito e esquerdo. Após 7 dias a ligadura foi removida e os animais separados aleatoriamente em 9 grupos: PE (n=24) - sem tratamento; 5FU-PE (n=24) - tratados sistemicamente com 5FU (60mg/kg e 40mg/kg); 5FU-PE-RAR (n=24) - tratados sistemicamente com 5-FU e com RAR; 5FU-PE-RAR-1LLLT (n=24) - tratados sistemicamente com 5-FU, com RAR seguida da LLLT (sessão única) (660 nm; 0,035 W; 4,2 J, 120 segundos; 1,23 W/cm2); 5FU-PE-RAR-4LLLT (n=24) - tratados sistemicamente com 5-FU, com RAR seguida da LLLT (0, 24, 48 e 72 horas); 5FU-PE-RAR-1aPDT (n=24) - tratados sistemicamente com 5-FU, com RAR e 1 episódio de aPDT (LLLT + azul de metileno); 5FU-PE-RAR-4aPDT (n=24) - tratados sistemicamente com 5-FU, com RAR e aPDT (0, 24, 48, 72 horas); 5FU-PE-1aPDT (n=24) - tratados sistemicamente com 5-FU seguida da aPDT; 5FU-PE-4aPDT (n=24) - tratados sistemicamente com 5-FU, seguida da aPDT (0, 24, 48, 72 horas). Oito animais de cada grupo foram eutanasiados aos 7, 15 e 30 dias após tratamento local. A área de perda óssea (PO) na região de furca foi analisada histometricamente, histologicamente e análise dos padrões de imunomarcação para TRAP, PCNA RANKL, OPG e CASP-3-AT foram realizadas. A quantificação da citocina PGE2 foi avaliada pelo ELISA e TNF-α e IL-6 foram avaliadas pelos Kits de ensaio Multiplex. A prevalência de periodontopatógenos, Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella nigrescens (Pn), Prevotella intermedia (Pi) e Fusobacterium...
Objective: This study evaluated the influence of multiple sessions of Low Level Laser Therapy (LLLT), adjuvant to the scaling and root planing (SRP), and antimicrobial photodynamic therapy (aPDT), with or without the mechanical treatment of SRP, in the treatment of experimental periodontitis (EP) in rats treated with chemotherapy 5- fluorouracil (5-FU). Materials and methods: Two hundred and sixteen animals were subjected to induction of EP by ligature in mandibular first molar right and left. 7 days after the ligature was removed, the animals were randomly divided into 9 groups: EP (n=24) - no treatment; 5FU-EP (n=24) - systemically treated with 5-FU (60mg/kg and 40mg/kg); 5FU-EP-SRP (n=24) - systemically treated with 5-FU, with SRP; 5FU-EP-SRP-1LLLT (n= 24) - systemically treated with 5-FU, with SRP, followed by LLLT (single session) (660 nm, 0.035 W; 4.2 J, 120 seconds; 1.23 W/cm2); 5FU-EP-SRP-4LLLT (n= 24) - systemically treated with 5-FU, with SRP, followed by LLLT (0, 24, 48 and 72 hours); 5FU-EP-SRP-1aPDT (n=24) - systemically treated with 5-FU, with SRP, followed by one application of antimicrobial photodynamic therapy (aPDT) (LLLT + methylene blue); 5FU-EP-SRP-4aPDT (n=24) - systemically treated with 5-FU, with SRP followed by aPDT (0, 24, 48, 72 hours); 5FU-EP-1aPDT (n=24) - systemically treated with 5-FU followed by aPDT; 5FU-EP-4aPDT (n=24) - treated systemically with 5-FU, followed by treatment with aPDT (0, 24, 48, 72 hours). Eight animals in each group were euthanized at 7, 15 and 30 days after local treatment. The area of bone loss (BL) in the furcation region was analyzed histometrically, histologically and analysis of immunostaining patterns for RANKL, OPG, TRAP, PCNA and CASP-3-AT were performed. Quantity of cytokine was measured by ELISA for PGE2 and TNF-α and IL-6 were evaluated by kits multiplex assays. The prevalence of periodontopathogens Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella nigrescens...
Subject(s)
Animals , Rats , Low-Level Light Therapy , Periodontitis , Photochemotherapy , Periodontitis/drug therapy , Periodontitis/radiotherapy , Rats, WistarABSTRACT
Objetivo: Este estudo avaliou a influência de múltiplas sessões da Terapia com Laser em Baixa Intensidade (LLLT) coadjuvante a raspagem e alisamento radicular (RAR), e da terapia fotodinâmica antimicrobiana (aPDT) associada ou não ao tratamento mecânico de RAR, no tratamento da periodontite experimental (PE) em ratos submetidos à quimioterapia com 5-Fluorouracil. Materiais e Métodos: Duzentos e dezesseis ratos foram submetidos à indução da PE por meio de ligadura no primeiro molar inferior direito e esquerdo. Após 7 dias a ligadura foi removida e os animais separados aleatoriamente em 9 grupos: PE (n=24) - sem tratamento; 5FU-PE (n=24) - tratados sistemicamente com 5FU (60mg/kg e 40mg/kg); 5FU-PE-RAR (n=24) - tratados sistemicamente com 5-FU e com RAR; 5FU-PE-RAR-1LLLT (n=24) - tratados sistemicamente com 5-FU, com RAR seguida da LLLT (sessão única) (660 nm; 0,035 W; 4,2 J, 120 segundos; 1,23 W/cm2); 5FU-PE-RAR-4LLLT (n=24) - tratados sistemicamente com 5-FU, com RAR seguida da LLLT (0, 24, 48 e 72 horas); 5FU-PE-RAR-1aPDT (n=24) - tratados sistemicamente com 5-FU, com RAR e 1 episódio de aPDT (LLLT + azul de metileno); 5FU-PE-RAR-4aPDT (n=24) - tratados sistemicamente com 5-FU, com RAR e aPDT (0, 24, 48, 72 horas); 5FU-PE-1aPDT (n=24) - tratados sistemicamente com 5-FU seguida da aPDT; 5FU-PE-4aPDT (n=24) - tratados sistemicamente com 5-FU, seguida da aPDT (0, 24, 48, 72 horas). Oito animais de cada grupo foram eutanasiados aos 7, 15 e 30 dias após tratamento local. A área de perda óssea (PO) na região de furca foi analisada histometricamente, histologicamente e análise dos padrões de imunomarcação para TRAP, PCNA RANKL, OPG e CASP-3-AT foram realizadas. A quantificação da citocina PGE2 foi avaliada pelo ELISA e TNF-α e IL-6 foram avaliadas pelos Kits de ensaio Multiplex. A prevalência de periodontopatógenos, Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella nigrescens (Pn), Prevotella intermedia (Pi) e Fusobacterium...
Objective: This study evaluated the influence of multiple sessions of Low Level Laser Therapy (LLLT), adjuvant to the scaling and root planing (SRP), and antimicrobial photodynamic therapy (aPDT), with or without the mechanical treatment of SRP, in the treatment of experimental periodontitis (EP) in rats treated with chemotherapy 5- fluorouracil (5-FU). Materials and methods: Two hundred and sixteen animals were subjected to induction of EP by ligature in mandibular first molar right and left. 7 days after the ligature was removed, the animals were randomly divided into 9 groups: EP (n=24) - no treatment; 5FU-EP (n=24) - systemically treated with 5-FU (60mg/kg and 40mg/kg); 5FU-EP-SRP (n=24) - systemically treated with 5-FU, with SRP; 5FU-EP-SRP-1LLLT (n= 24) - systemically treated with 5-FU, with SRP, followed by LLLT (single session) (660 nm, 0.035 W; 4.2 J, 120 seconds; 1.23 W/cm2); 5FU-EP-SRP-4LLLT (n= 24) - systemically treated with 5-FU, with SRP, followed by LLLT (0, 24, 48 and 72 hours); 5FU-EP-SRP-1aPDT (n=24) - systemically treated with 5-FU, with SRP, followed by one application of antimicrobial photodynamic therapy (aPDT) (LLLT + methylene blue); 5FU-EP-SRP-4aPDT (n=24) - systemically treated with 5-FU, with SRP followed by aPDT (0, 24, 48, 72 hours); 5FU-EP-1aPDT (n=24) - systemically treated with 5-FU followed by aPDT; 5FU-EP-4aPDT (n=24) - treated systemically with 5-FU, followed by treatment with aPDT (0, 24, 48, 72 hours). Eight animals in each group were euthanized at 7, 15 and 30 days after local treatment. The area of bone loss (BL) in the furcation region was analyzed histometrically, histologically and analysis of immunostaining patterns for RANKL, OPG, TRAP, PCNA and CASP-3-AT were performed. Quantity of cytokine was measured by ELISA for PGE2 and TNF-α and IL-6 were evaluated by kits multiplex assays. The prevalence of periodontopathogens Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella nigrescens...
Subject(s)
Animals , Rats , Low-Level Light Therapy , Periodontitis , Photochemotherapy , Periodontitis/drug therapy , Periodontitis/radiotherapy , Rats, WistarABSTRACT
Se realizó un estudio clínico fase II con 60 pacientes para conocer la eficacia del tratamiento con láser helio-neón en las pérdidas óseas horizontales. Los pacientes se dividieron en 2 grupos de 30: un grupo de estudio, en el que se realizó colgajo Kirkland e irradiación con láser helio-neón en una sola dosis de 3 J/cm² en el acto quirúrgico, y un grupo control al que solamente se le realizó colgajo Kirkland. En las mediciones se utilizaron pie de rey y radiografías periapicales. Se utilizó el equipo Lasermed 101 M de fabricación cubana con potencia de salida de 2MW y fibra óptica. Se aplicó el índice de Love para medir la eficiencia del cepillado. El 100 por ciento de los pacientes con periodontitis simple incipiente tuvieron ganancia ósea parcial, mientras que de los que presentaban periodontitis simple moderada, el 83 por ciento mostró ganancia ósea total en el 10 por ciento del grupo tratado; sin embargo, el grupo control se mantuvo sin cambios en el 100 por ciento. En el índice de Love los pacientes que se mantuvieron estables del grupo que había recibido tratamiento con láser presentaron valores superiores al 20 por ciento. Se concluyó que el tratamiento con láser helio-neón en el acto quirúrgico resultó eficaz