Root Curvature in Non-Syndromic Oral Clefts: A Case-Control Study in a Brazilian Population.

OBJECTIVE: This study assesses the degree of root curvature in patients with non-syndromic cleft lip and/or palate (NSCL/P). DESIGN: Retrospective. Case-control study. SETTING: Root curvature was assessed in lower premolars and molars in 800 panoramic radiographs: 400 from patients with cleft and 400 from healthy control individuals. Root curvature was classified according to its angulation, as well as its apical, medial, or coronal localization. RESULTS: The frequency of mild curvature in the NSCL/P group compared to the control group was higher in premolars especially in the left second premolar in cleft palate (OR: 6.91; 95% CI: 3.23-14.77; P < .0001). The frequency of moderate curvature in molars was significantly higher in the cleft group, with the highest risk in the right first molar in the cleft lip group (OR: 2.74; 95% CI: 1.67-4.52; P < .0001). Inclination was more frequently observed in the apical third of the root in the group with cleft, whereas for the control group, the curvature was more frequent in the medial third. In patients with cleft, the OR of curvature in the apical third was significant in premolars (left lower second premolar: Cleft lip, OR: 1.91; 95% CI: 1.04-3.52; P = .03; right lower second premolar: Cleft lip, OR: 1.91, 95% CI: 1.04-3.50; P = .03, cleft lip and palate, OR: 1.75; 95% CI: 1.12-2.73; P = .01). CONCLUSION: The results of the current study indicate differences in root curvature in patients with non-syndromic cleft lip and/or palate, which should be considered during the dental treatment planning of patients.

Comparative thermographic analysis at pre- and postcryolipolysis treatment: Clinical case report.

INTRODUCTION: Although the exact cryolipolysis mechanisms on adipose tissue remain unknown, the current literature indicates that it may occur a crystallization followed by an ischemic reaction which generates an inflammatory process. OBJECTIVE: To evaluate thermographically, the tissue's circulatory pattern of a patient submitted to the cryolipolysis technique and the beginning of the inflammatory process, through variations of temperature gradients and the evaluation of the pains degree of the patient in these same moments. METHODS: A descriptive study, of an interventional case report, performed in an 18-year-old patient who had clearly visible fat in the lower abdomen area, with a skin fold greater than 2 centimeters and body mass index ≤ 30 kg/m2 . RESULTS: Comparing the maximum temperatures showed on the last thermography with the pre-application image, an increase of 0.4°C was observed, which is suggestive of abnormality. Regarding the minimum temperatures verified, there was a significative decrease in the temperature with the procedure, which was observed on the last 5 minutes (ΔT = 9.8°C). However, in 48 hour, the minimum temperature began to recover (ΔT = 0.3°C). CONCLUSION: The observed data indicate that there was a significant decrease in the temperature during the cooling phase, whereas in the recovery phase, the inverse was found.

Thermographic and clinical evaluation of 808-nm laser photobiomodulation effects after third molar extraction.

BACKGROUND: A randomized, blind, controlled clinical study was conducted with a convenience sample of 24 patients to evaluate the effectiveness of an aluminum gallium arsenide (AlGaAs) infrared laser 808 nm after third molar extraction by the use of infrared thermography technique. METHODS: Patients were divided into four groups: erupted third molars were extracted from the patients in Group I and Group II, and impacted third molars were extracted from the patients in Group III and Group IV. Group I and Group III received mock laser therapy in which the device was powered off, and Group II and Group IV were exposed to laser light. Postoperative clinical parameters related to the third molar extraction were evaluated; these parameters included pain, trismus and edema. Circulatory patterns were also evaluated by infrared thermography that exhibited local temperature coefficient at different postoperative periods. RESULTS: A slight improvement was observed for swelling, pain and trismus in patients who received laser irradiation, although the differences were not statistically significant (P>0.05). Laser therapy had a significant influence on the local circulation in the area near the temporomandibular joint, as determined by infrared thermography (P<0.05). CONCLUSIONS: Laser therapy was able to change the local circulation, although it did not significantly influence swelling, pain or trismus during the postoperative period.

Influence of laser (λ670 nm) and dexamethasone on the chronology of cutaneous repair.

OBJECTIVE: This study aimed to assess the effect of LLLT associated with and without dexamethasone on inflammation and wound healing in cutaneous surgical wounds. BACKGROUND: Limited studies are directed at the possible interference of laser photobiomodulation on the formation of myofibroblasts, associated with an antiinflammatory drug. METHODS AND MATERIALS: Standard skin wounds were performed on 80 Wistar rats, distributed into four groups: no treatment (sham group), laser only (λ670 nm, 9 mW, 0.031 W/cm(2), 4 J/cm(2), single dose after surgery), dexamethasone only (2 mg/kg 1 h before surgery), and laser with dexamethasone. Tissue was examined histologically to evaluate edema, presence of polymorphonuclear, mononuclear cells, and collagen. The analysis of myofibroblasts was assessed by immunohistochemistry and transmission electron microscopy. The intensity was rated semiquantitatively. RESULTS: The results showed that laser and dexamethasone acted in a similar pattern to reduce acute inflammation. Collagen synthesis and myofibroblasts were more intense in the laser group (p = 0.048), whereas animals treated with dexamethasone showed lower results for these variables. In a combination of therapies, the synthesis of collagen and actin and desmin-positive cells was less than laser group. CONCLUSIONS: Laser was effective in reducing swelling and polymorphonuclear cells and accelerated tissue repair, even in the presence of dexamethasone.

Influence of laser photobiomodulation upon connective tissue remodeling during wound healing.

The modulation of collagen fibers during experimental skin wound healing was studied in 112 Wistar rats submitted to laser photobiomodulation treatment. A standardized 8mm-diameter wound was made on the dorsal skin of all animals. In half of them, 0.2ml of a silica suspension was injected along the border of the wound in order to enhance collagen deposition and facilitate observation. The others received saline as vehicle. The treatment was carried out by means of laser rays from an aluminum-gallium arsenide diode semiconductor with 9mW applied every other day (total dose=4J/cm2) on the borders of the wound. Tissue sections obtained from four experimental groups representing sham-irradiated animals, laser, silica and the association of both, were studied after 3, 7, 10, 15, 20, 30 and 60 days from the laser application. The wounded skin area was surgically removed and submitted to histological, immunohistochemical, ultrastructural, and immunofluorescent studies. Besides the degree and arrangement of collagen fibers and of their isotypes, the degree of edema, the presence of several cell types especially pericytes and myofibroblasts, were described and measured. The observation of Sirius-red stained slides under polarized microscopy revealed to be of great help during the morphological analysis of the collagen tissue dynamic changes. It was demonstrated that laser application was responsible for edema regression and a diminution in the number of inflammatory cells (p<0.05). An evident increase in the number of actin-positive cells was observed in the laser-treated wounds. Collagen deposition was less than expected in silica-treated wounds, and laser treatment contributed to its better differentiation and modulation in all irradiated groups. Thus, laser photobiomodulation was able to induce several modifications during the cutaneous healing process, especially in favoring newly-formed collagen fibers to be better organized and compactedly disposed.

Effect of 670-nm laser therapy and dexamethasone on tissue repair: a histological and ultrastructural study.

OBJECTIVE: In this study we investigated the role of extracellular matrix elements and cells during the wound healing phases following the use of low-level laser therapy (LLLT) and anti-inflammatory drugs. BACKGROUND DATA: There are few scientific studies that characterize the possible interactions of LLLT and anti-inflammatory medications. MATERIALS AND METHODS: Thirty-two rats submitted to a wound inflicted with a 6-mm-diameter punch. The animals were divided into four groups: sham treated, those treated with the GaAlAs laser (4 J/cm(2), 9 mW, lambda = 670 nm, spot size 28.27 x 10(2) cm(2)), those treated with dexamethasone (2 mg/kg), and those treated with both LLLT and dexamethasone. After 3 and 5 d, the cutaneous wounds were assessed by histopathology using polarized light and ultrastructural assessment using transmission electron microscopy. Changes seen in polymorphonuclear inflammatory cells, edema, mononuclear cells, and collagen fiber deposition were semi-quantitatively evaluated. RESULTS: The laser-treated group demonstrated increased collagen content and better arrangement of the extracellular matrix (p < 0.05). Fibroblasts in these tissues were increased in number and were more synthetically active. In the dexamethasone group, the collagen was shown to be non-homogenous and disorganized, with a scarcity of fibroblasts. In the group treated with both types of therapy, fibroblasts were more common and they exhibited vigorous rough endoplasmic reticulum, but they had less collagen production compared to those seen in the laser group. CONCLUSION: LLLT alone accelerates post-surgical tissue repair and reduces edema and the polymorphonuclear infiltrate even in the presence of dexamethasone.

Action of low-level laser therapy on living fatty tissue of rats.

Little is known about the action of laser rays on normal adipose cells. The present study attempts to observe the behavior of fatty cells submitted to laser therapy. Dorsal fat pads of normal adult rats were submitted to low-level laser irradiation applied locally through intact skin, with four different dose schedules (4, 8, 12, and 16 J/cm(2)), with a further group being sham-irradiated. Histology, morphometry, immunofluorescence, and electron microscopy were all used to analyze irradiated tissues. Changes were restricted to the brown fatty tissue, in which a tendency was shown for multivacuolar cells to be transformed into the unilocular type. The number of cells which exhibited enlargement and fusion of small vacuoles was greater in the 4- and 16-J/cm(2) groups (p<0.05). Increased vascular proliferation and congestion was another more evident finding in laser-treated animals compared to nontreated animals. Low-level laser rays cause brown adipose fat droplets to coalesce and fuse. Additionally, they stimulated proliferation and congestion of capillaries in the extracellular matrix.