Evaluation of photobiomodulation in the salivary production of patients with hyposalivation induced by antihypertensive drugs - A blind, randomized, controlled clinical trial.

BACKGROUND: Arterial hypertension is a systemic condition that affects about 35% of the world population. The drugs that are used for its control can produce hyposalivation. This work evaluated the effect of photobiomodulation on salivary flow rate, salivary pH, total protein concentration, and calcium concentration in individuals using antihypertensive medications. MATERIAL AND METHODS: 41 subjects were randomly allocated in one of two groups: control (placebo) and photobiomodulation. The subjects had their salivary glands (20 sites) irradiated with a laser emitting at 808 nm, 4J/site once a week for 4 weeks and had their salivary flow measured before and after the whole treatment. RESULTS: The intragroup analysis (before and after treatment) shows a significant difference for both non-stimulated and stimulated salivary flow in the photobiomodulation group (p = 0.0007 and p = 0.0001, respectively). Comparing the placebo with the photobiomodulation group, significant differences were found for both non-stimulated (p = 0.0441) and stimulated salivary flow (p = 0.0441) after the treatment. No significant differences were found in pH, total protein concentration, calcium concentration. CONCLUSION: Despite the usage of drugs that influence the nervous system and typically result in a reduction of saliva production, photobiomodulation demonstrated a remarkable ability to enhance saliva production by a significant 75%.

Effects of photobiomodulation in salivary glands of chronic kidney disease patients on hemodialysis.

This randomized placebo-controlled trial evaluates the impact of photobiomodulation (PBMT) on the salivary flow and biochemistry of patients with chronic kidney disease (CKD) on hemodialysis. Forty-four patients on hemodialysis self-responded two questionnaires for oral health and salivary gland function perception. The subjects were evaluated for function of salivary glands and randomly allocated to two groups: PBMT group (three irradiations at 808 nm, 100 mW, 142 J/cm2, and 4 J per site); and placebo group. Patients were submitted to non-stimulated and stimulated sialometry and after the treatment at baseline and 14 days. Salivary volume and biochemical of the saliva were analyzed. At baseline, most subjects had self-perception of poor oral health (52.6%) and salivary dysfunction (63.1%). Clinical exam revealed that 47.3% of subjects presented dry mucosa. PBMT promoted increase of the non-stimulated (p = 0.027) and stimulated saliva (p = 0.014) and decrease of urea levels in both non-stimulated (p = 0.0001) and stimulated saliva (p = 0.0001). No alteration was detected in total proteins and calcium analysis. Patients with kidney disease can present alteration in flow, concentrations, and composition of saliva, affecting oral health, but our findings suggest that PBMT is effective to improve hyposalivation and urea levels in saliva of patients with CKD.

Evaluation of photobiomodulation in salivary production of patients with xerostomy induced by anti-hypertensive drugs: Study protocol clinical trial (SPIRIT compliant).

INTRODUCTION: Hypertension (systemic arterial hypertension [SAH]) is a systemic condition that affects about 30% of the world population, according to data from the World Health Organization (WHO). Drugs used to control this disease have the potential to induce xerostomia, an oral condition in which the decrease of the salivary flow is observed and whose presence leads to the increase of the index of caries, periodontal disease, loss of the teeth, dysgeusia, difficulty of mastication, dysphagia, bad breath and oral burning and impairment of prothesis installed in the buccal cavity, including retention of removable and total dentures. METHODS: This is a randomized, placebo-controlled, blind clinical protocol that aims to analyze the impact of phobiomodulation (PBM) on salivary glands of patients with antihypertensive drug induced xerostomia. Patients will be divided into 2 groups: G1: older adults with xerostomia induced by antihypertensive drugs and treatment with PBM (n = 30); G2: placebo PBM (n = 30). The irradiation will be made using a diode laser emitting at 808 nm with 100 mW and 40 seconds of exposure per site at the salivary glands. Twenty sites will be irradiated weekly for 4 weeks. Non-stimulated and stimulated salivary flow will be analyzed before and after the treatment. RESULTS: This protocol will determine the effectiveness of photodynamic therapy regarding the reduction of xerostomia in older adults using antihypertensive drugs. CONCLUSION: This protocol will determine the effectiveness of photodynamic therapy regarding the reduction of xerostomia in older adults using antihypertensive drugs. TRIAL REGISTRATION: Clinicaltrials.gov - NCT03632096.

Treatment of herpes labialis by photodynamic therapy: Study protocol clinical trial (SPIRIT compliant).

BACKGROUND: Lesions of herpes labialis are caused by the herpes simplex virus type 1 and cause pain and aesthetic compromise. It is characterized by the formation of small vesicles that coalesce and rupture forming extremely painful ulcers, that evolve to crusts, dry desquamations until their complete remission. Currently the treatment of these lesions is done with acyclovir. Although it diminishes the symptomatology, it causes viral resistance and does not prevent the recurrence of the lesions. It is known that antimicrobial photodynamic therapy (aPDT) has numerous advantages, among them: the reduction of the time of remission, and does not cause resistance. This protocol will determine the effectiveness of PDT in lesions of herpes labialis. MATERIALS AND METHODS: A total of 30 patients with herpes labialis in the prodromal stage of vesicles, ulcers, and crusts will be selected to participate in the study and randomized into 2 groups: G1 control and G2 experimental. After signing Research Ethics Committee and TA, patients in group G1 will undergo the standard gold treatment for herpes labialis with acyclovir and simulated PDT treatment. Patients in the experimental G2 group will be treated simulating the gold standard treatment of herpes labialis (placebo) and PDT. In all patients, saliva samples will be collected for analysis of cytokines, and will be performed exfoliative cytology in the lesions. The pain will be assessed through a pain scale and a questionnaire of quality of life related to oral health (OHIP-14) will be given to them. Patients will continue to be followed up after 7 days, 1 month, 3 months, and 6 months; if there is a recurrence of the lesion, they will contact the researchers.Clinical registration: clinicaltrials.gov - NCT04037475. Registered on July 2019.

Use of low-level laser therapy on children aged 1 to 5 years with energy-protein malnutrition: A clinical trial.

BACKGROUND: Episodes of malnutrition in early childhood can produces alterations in the salivary glands. The investigation of mechanisms that can reduce the impact of malnutrition on the defenses of the organism is of the utmost important and interest to public health. The aim of this study is to evaluate the effect of low-level laser on the saliva of children aged 1 to 5 years with energy-protein malnutrition. METHODS: Mandatory inclusion criteria are diagnosis of malnutrition. The sample will consist of 50 men and women malnourished children aged 12 to 71 months. Saliva will be collected and the volume of saliva will be measured and the salivary flow rate will be determined (mL/min). Concentrations of salivary IgA in all samples will be measured using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit. Low-level laser (laser diode) will be administered in the region of the parotid glands bilaterally as well as in the regions of the submandibular and sublingual glands. DISCUSSION: This study will be the first that investigate the effects of local laser therapy on the salivary glands of malnourished children. TRIAL REGISTRATION: Clinical.trials.gov as NCT03355313, first received in 21 November 2017.

Multiple metastases of malignant melanoma in the head and neck: a case report and literature review.

Malignant melanoma (MM) with multiple metastases (including the oral mucosa) is an extremely rare condition that is difficult to manage due to its complexity. This article presents the case of a 27-year-old man who first developed MM on the scalp, which subsequently metastasized to the mandible, parotid gland, infratemporal fossa, and the cervical regions of the larynx, kidneys, liver, and lungs. The findings of the present case report are compared with 31 other cases published in the English literature. Multiple metastases of MMs in the head and neck region are rare and generally are associated with a poor prognosis. In such cases, dentists play a role in the diagnosis, prevention, and treatment of sequelae stemming from oncologic treatment, with the aim of improving the patient's quality of life.

Effect of laser phototherapy in the prevention and treatment of chemo-induced mucositis in hamsters

The aim of this study was to investigate the effect of laser phototherapy (LPT) in the prevention and/or treatment of oral mucositis induced by 5-fluorouracil (5-FU; Eurofarma, São Paulo, Brazil) in hamsters. Ninety-six hamsters were divided into four groups (n = 24): Control (no treatment); Preventive [LPT from day (D) D-5 to D+5]; Therapeutic (LPT from D+5 to D+15); and Combined (preventive plus therapeutic LPT from D-5 to D+15). The animals received an intraperitoneal injection of 5-FU on Days 0 and 2. The pouch mucosa was scratched on Days 3 and 4. The irradiation parameters were: indium-gallium-aluminum-phosphide (InGaAlP) diode laser (MM Optics, São Carlos, Brazil) (660 nm), beam area of 0.036 cm2, 40 mW, 1.11 W/cm2, 6.6 J/cm2, power density applied daily of 39.6 J/cm2, in punctual mode (six points and six seconds per point) and contact mode, one application per day. The animals were sacrificed on Days 0, 5, 10 and 15 (n = 6) and weighed, and the pouch mucosa was removed for histopathological analysis. Clinical and corresponding histological scores were compared using ANOVA and Tukey's test (p ≤0.05). Similar weight losses ranging from 5% to 10% occurred in all groups. The therapeutic group had significantly lower clinical and histological scores than the other groups at Day 10. This study showed that positive effects on oral mucositis management were obtained only when LPT was applied in the therapeutic protocol (from D+5 to D+15 after chemotherapy).

Effect of laser phototherapy in the prevention and treatment of chemo-induced mucositis in hamsters.

The aim of this study was to investigate the effect of laser phototherapy (LPT) in the prevention and/or treatment of oral mucositis induced by 5-fluorouracil (5-FU; Eurofarma, São Paulo, Brazil) in hamsters. Ninety-six hamsters were divided into four groups (n=24): Control (no treatment); Preventive [LPT from day (D) D-5 to D+5]; Therapeutic (LPT from D+5 to D+15); and Combined (preventive plus therapeutic LPT from D-5 to D+15). The animals received an intraperitoneal injection of 5-FU on Days 0 and 2. The pouch mucosa was scratched on Days 3 and 4. The irradiation parameters were: indium-gallium-aluminum-phosphide (InGaAlP) diode laser (MM Optics, São Carlos, Brazil) (660 nm), beam area of 0.036 cm2, 40 mW, 1.11 W/cm2, 6.6 J/cm2, power density applied daily of 39.6 J/cm2, in punctual mode (six points and six seconds per point) and contact mode, one application per day. The animals were sacrificed on Days 0, 5, 10 and 15 (n=6) and weighed, and the pouch mucosa was removed for histopathological analysis. Clinical and corresponding histological scores were compared using ANOVA and Tukey's test (p≤0.05). Similar weight losses ranging from 5% to 10% occurred in all groups. The therapeutic group had significantly lower clinical and histological scores than the other groups at Day 10. This study showed that positive effects on oral mucositis management were obtained only when LPT was applied in the therapeutic protocol (from D+5 to D+15 after chemotherapy).

Influence of laser photobiomodulation on collagen IV during skeletal muscle tissue remodeling after injury in rats.

OBJECTIVE: The aim of the present study was to determine the effect of GaAlAs low-level laser therapy (LLLT) on collagen IV remodeling of the tibialis anterior (TA) muscle in rats after cryolesion. BACKGROUND: Considerable interest exists in skeletal muscle regeneration in situations such as repair after exercise-induced muscle injury, after muscle transplantation, in muscular dystrophy, exercise-induced muscle injury, and the recovery of strength after atrophy due to disuse. A number of studies have demonstrated the potential of LLLT in facilitating the muscle-healing process; however, no consensus is found in the literature regarding the best laser-irradiation parameters. METHODS: Adult male Wistar rats (n = 45) were used and randomly divided into three groups: control (n = 5); nontreated cryolesioned group (n = 20), and LLLT-cryolesioned group (n = 20). The cryolesioned groups were analyzed at 1, 7, 14, and 21 days after the injury procedure. Laser irradiation was performed 3 times per week on the injured region by using the GaAlAs laser (660 nm; beam spot of 0.04 cm(2), output power of 20 mW, power density of 500 mW/cm(2), and energy density of 5 J/cm(2), for 10 sec). The muscles were removed, frozen, cryosectioned, and then stained with hematoxylin-eosin for the visualization of general morphology or used for immunohistochemical analysis of collagen IV. RESULTS: It was demonstrated that LLLT promotes an increase in collagen IV immunolabeling in skeletal muscle in the first 7 days after acute trauma caused by cryoinjury, but does not modify the duration of the tissue-repair process. Even with LLLT, the injured muscle tissue needs ∼21 days to achieve the same state of organization as that in the noninjured muscle. CONCLUSION: The collagen IV content is modulated in regenerating skeletal muscle under LLLT, which might be associated with better tissue outcome, although the histologic analysis did not detect tissue improvement in the LLLT group.

Effects of low-level laser therapy on expression of TNF-α and TGF-ß in skeletal muscle during the repair process.

The aim of the present study was to determine the effect of low-level laser therapy (LLLT) on the expression of TNF-α and TGF-ß in the tibialis anterior muscle of rats following cryoinjury. Muscle regeneration involves cell proliferation, migration and differentiation and is regulated by growth factors and cytokines. A growing body of evidence suggests that LLLT promotes skeletal muscle regeneration by reducing the duration of acute inflammation and accelerating tissue repair. Adult male Wistar rats (n = 35) were randomly divided into three groups: control group (no lesion, untreated, n = 5), cryoinjury without LLLT group (n = 15), and cryoinjury with LLLT group (n = 15). The injured region was irradiated three times a week using an AlGaInP laser (660 nm; beam spot 0.04 cm(2), output power 20 mW, power density 500 mW/cm(2), energy density 5 J/cm(2), exposure time 10 s). Muscle remodeling was evaluated at 1, 7 and 14 days (long-term) following injury. The muscles were removed and total RNA was isolated using TRIzol reagent and cDNA synthesis. Real-time polymerase chain reactions were performed using TNF-α and TGF-ß primers; GAPDH was used to normalize the data. LLLT caused a decrease in TNF-α mRNA expression at 1 and 7 days following injury and in TGF-ß mRNA expression at 7 days following cryoinjury in comparison to the control group. LLLT modulated cytokine expression during short-term muscle remodeling, inducing a decrease in TNF-α and TGF-ß.

Síndrome de Cushing como complicação do tratamento de líquen plano oral erosivo / Cushing´s Syndrome as a complication of treatment of oral lichen planus

O líquen plano oral (LPO) é uma doença mucocutânea inflamatória crônica relacionada com alterações na imunidade mediada por células T. Diversos medicamentos têm sido utilizados no tratamento desta doença, especialmente nas formas erosivas e ulcerativas, com resultados variados. O objetivo deste trabalho é descrever e discutir um caso clínico de líquen plano oral erosivo tratado com corticóide sistêmico que resultou em Síndrome de Cushing, que se manteve com o uso de corticóide tópico.

Oral lichen planus (OLP) is a chronic mucocutaneous inflammatory disease involving T cells-mediated immunity. Several drugs have been used to treat OLP, specially the erosive and ulcerative forms, with varying results. The aim of this paper was to describe and discuss one clinical case of erosive oral lichen planus treated with systemic corticosteroids that resulted in Cushing´s syndrome that maintained with topical corticosteroid.

Biocompatibility analysis of chemomechanical caries removal material Papacárie on cultured fibroblasts and subcutaneous tissue.

Chemomechanical caries removal allies an atraumatic technique with antimicrobiotic characteristics, minimizing painful stimuli and maximally preserving healthy dental structures. The purpose of this study was to compare the cytotoxic effects of papain-based gel (Papacarie) and another caries-removing substance, Carisolv, to a nontreatment control on cultured fibroblasts in vitro and the biocompatibility in subcutaneous tissue in vivo. The cytotoxicity analysis was performed on fibroblast cultures (NIH-3T3) after 0-, 4-, 8-, and 12-hour exposure (cell viability assay) and after 1-, 3-, 5-, and 7-day exposure (survival assay). In the in vivo study, the 2 compounds were introduced into polyethylene tubes that were implanted into subcutaneous tissues of rats. After 1, 7, 14, 30, and 60 days, tissue samples were examined histologically. Cell viability did not differ between the 2 experimental groups. The control group, however, showed significantly higher percentage viability. There were no differences in cell survival between the control and experimental groups. The histological analysis revealed a moderate inflammatory response at 2 and 7 days and a mild response at 15 days, becoming almost imperceptible by 30 and 60 days in both experimental groups. The 2 tested substances exhibited acceptable biocompatibilities and demonstrated similar responses in the in vitro cytotoxicity and in vivo implantation assay.

Remodelamento do músculo esquelético: papel da matriz extracelular / Skeletal muscle remodeling: role of extracellular matrix

A plasticidade ou remodelamento do músculo esquelético em resposta a estímulos diferentes, tanto em situações fisiológicas como patológicas, tem sido demonstrada em vários modelos experimentais e estudos clínicos. Este processo depende de uma ação coordenada entre a degradação e síntese da matriz extracelular (MEC) e, portanto, as alterações nos componentes da matriz vêm sendo alvo de inúmeros trabalhos nos últimos anos. O objetivo do presente estudo foi revisar a literatura sobre o papel dos diversos tipos de colágeno, que são os principais componentes da MEC, das metaloproteinases (MMPs) e dos inibidores de metaloproteinases (TIMPs) no processo de remodelamentomuscular esquelético.

The skeletal muscle remodeling in response to several stimuli in physiological and pathological conditionshave been demonstrated by different experimental and clinical studies. This process depends on an interaction between the degradation and synthesis of extracellular matrix. Therefore, the modifi cations in the extracellular matrixcomponents have been studied in last years. The aim of this study was to revise the literature about collagen typesthat are the main components of the MEC, metallopeptidases (MMPs) and metallopeptidases inhibitors (TIMPs) during the skeletal muscle healing process.

Comparative analysis between Chamomilla recutita and corticosteroids on wound healing. An in vitro and in vivo study.

The comparison of chamomile and corticosteroids for treating ulcers was done in vitro and in vivo. The experimental groups were: control; chamomile recutita; triamcinolone acetonide and clobetasol propionate. For the in vitro study the cell viability of fibroblasts cultured for 24 h in media conditioned by the substances was obtained by the MTT reduction analysis. For the in vivo study, 125 male rats were submitted to experimental ulcers treated or not (control) by the substances tested. At 1, 3, 5, 7 and 14 days later 5 animals of each group were sacrificed. The lesions were analyzed by means of clinical observation and histological wound-healing grading. Data were compared by ANOVA (p

Avaliação do conhecimento sobre o câncer bucal entre universitários / Evaluation of knowledge of oral cancer among students

Introdução: O câncer oral é uma doença de alta incidência no mundo e que vem sendo considerada como problema de saúde pública. A prevenção e o diagnóstico precoce constituem as melhores formas de reverter essa situação. Objetivo: Avaliar o nível de conhecimento de uma população de universitários de Odontologia sobre o câncer de boca. Métodos: Foi aplicado um questionário contendo 37 questões para 148 alunos de Odontologia. Após a coleta, foi confeccionada uma planilha no programa de computador Excel (Microsoft). Foram comparadas as porcentagens de acerto entre os anos (teste qui-quadrado de tendência) e verificada a consistência e coerência (coeficiente de Cronbach) com nível de significância de 5% ou calculado o p-valor correspondente. As análises foram feitas utilizando-se o programa SAS for Windows, v.9.1.3. Resultados: O valor do de Cronbach para o questionário foi de 0,7681, considerado o instrumento consistente e coerente, tornando-o um método adequado para avaliação do nível de conhecimento sobre o câncer bucal. Na análise individual das questões, notou-se que, mesmo havendo diferença significativa entre algumas respostas corretas entre os anos, isso não significa que, com o passar do tempo, a porcentagem de acertos aumente. Quanto ao conhecimento sobre o câncer bucal, notou-se maior nível de acerto nos alunos de 3º e 4º ano. Os alunos demonstram alto índice de acertos quanto ao conhecimento sobre os fatores de risco do câncer bucal. Conclusão: Para melhorar o nível do conhecimento dos alunos sobre o câncer bucal, faz-se necessário um programa universitário de prevenção de câncer bucal envolvendo os alunos de todos os anos do curso.

Introduction: The oral cancer has a high incidence worldwide and it is considered a public health problem. Prevention and early diagnosis are the best solution to reverse this situation. Objective: To evaluate the level of knowledge about oral cancer in a group of Odontology students. Methods: A 37-question questionnaire was applied to 148 Odontology students. After collecting all the data, a worksheet using Microsoft Excel was created. The percentage of right answers was compared among university-level classes (Chi-square test of tendency), and the consistency and coherence were checked (Cronbach's coefficient) with 5% significance level or calculated the correspondent p-value. The analyses were conducted using the SAS system for windows 9.1.3. Results: The Cronbach's value in the questionnaire was 0.7681, considering the instrument consistent and coherent as an appropriate method to evaluate the students' level of knowledge about oral cancer. An individual analysis of the questions showed that, although there was an expressive difference in some of the right answers in different university-level classes, it does not mean that the percentage of accurate answers increases in the course of time. Regarding the level of knowledge about oral cancer, a larger number of right answers among students of the 3rd and 4th years was observed. Students had a large number of right answers concerning risk factors for oral cancer. Conclusion: It is essential to create a university program on oral cancer prevention for the students of all levels, in order to improve their knowledge about oral cancer.

Efeito de cogumelos medicinais na reabilitação da inflamação químio-induzida / Effect of medicinal mushrooms on rehabilitation of chemotherapy induced inflammation

Introdução: A inflamação químio-induzida é uma complicação dose limitante comum no tratamento citorredutor do câncer. Caracteriza-se por inflamação e ulceração da mucosa oral cuja severidade pode levar a alteração ou até interrupção do tratamento oncológico. Objetivo: comparar, por meio de análises clínicas e histopatológicas, a ação do Cogumelo do Sol® no processo inflamatório e reparador da mucosite quimionduzida. Métodos: Foram utilizados 30 Golden hamsters que receberam injeção intraperitoneal de quimioterápico 5-FU nos dias 0 e 2 do experimento. Nos dias 3 e 4, a mucosa jugal direita foi arranhada com a ponta de uma agulha estéril. A partir do 5º dia, foi iniciada a terapêutica com o fitoterápico. Nos dia 0, 2, 5, 10 e 12 foi feita avaliação clínica e três animais foram sacrificados e a mucosa jugal removida para análise histopatológica. Os dados obtidos foram submetidos à análise estatística pelo teste ANOVA complementado por Tukey. Resultados: após o quinto dia, houve o desenvolvimento de inflamação com o 5-FU e a maior severidade foi observada no décimo dia. Não houve redução clínica e histopatológica significativa do grau de inflamação com o tratamento tópico empregado. Conclusão: o extrato de cogumelo utilizado não foi efetivo na reabilitação da inflamação químio-induzida em hamsters.

Introduction: the chemotherapy induced inflammation is considered a significant complication of cancer treatment. This condition is characterized by inflammation and ulceration of the oral mucosa that can directly affect the clinical status of the patient and interfere with the patient oncological treatment. Objective: to compare the effect of medicinal mushrooms on the rehabilitation of chemoinduzed inflammation by clinical and histophatological evaluation. Methods: the inflammation was induced in 30 male Golden hamsters by two intraperitoneal administrations of 5-FU on the 0 and 2nd days of the experiment followed by mechanical trauma of the cheek pouch on the third and fourth day. Animals received the topical medicinal mushrooms daily since the 5th day until the end of the experiment on the 12th day. Macroscopic and histopathological analyses were evaluated and graded. The data were compared by Anova (p < 0.05) with Tukey's post hoc test. Results: after the 5th day the inflammation was observed and the most severe aspect was note after 10 days. The topical treatment with medicinal mushrooms do not improved clinically or histopathologically the recovery from 5-fluorouracil-induced damage. Conclusion: the medicinal mushrooms extract was not effective on the rehabilitation of chemotherapy induced inflammation.