Photobiomodulation therapy reduces postoperative pain after third molar extractions: A randomized clinical trial.

BACKGROUND: To assess the efficacy of PBMT on reducing postoperative pain scores in patients submitted to third molar extractions. MATERIAL AND METHODS: A randomized controlled trial (ReBEC:RBR-94BCKZ) was designed according to the SPIRIT and followed the CONSORT. Patients were randomly allocated according to control or PBMT groups. PBMT consisted of the application of GaAlAs laser (808nm;50mW) applied in six points (1.23 min;11 J/cm2) after extraction. Pain scores were assessed using the Visual Analogue Scale (VAS) in millimeters evaluated after 6 (T6), 24 (T24), and 48 (T48) hours. The Wilcoxon Mann-Whitney test was used to check for possible associations between VAS scores and treatment groups. RESULTS: A total of 101 third molar extractions were performed in 44 patients. The mean age was 28 years old(SD±11.54). Comparing control and intervention, PBMT group showed a significant effect on the reduction of postoperative pain at T6(mean VAS=0.9; C.I:0.63-1.16) compared to control (mean VAS=2.5;C.I:2.1-2.88)(p<0.001). The same statistically significant effect on the reduction of postoperative pain was observed at T24 (PBMT mean VAS=0.72;C.I:0.51-0.93; control mean VAS=2.86;C.I:2.40-3.31;p<0.001) and T48 (PBMT mean VAS=0.64;C.I:0.36-0.92; control mean VAS=2.86;C.I:2.37-3.34;p<0.001). CONCLUSIONS: PBMT significantly reduce the postoperative pain scores when assessed 6, 24, and 48 hours after third molar extractions.

Complications associated with the treatment of fractures of the dentate portion of the mandible in paediatric patients: a systematic review.

This study aimed to answer the following question: What is the best treatment option for fractures of the dentate portion of the mandible in paediatric patients when considering the occurrence of postoperative complications? A systematic literature review was done using the PubMed, Scopus, and Cochrane Library databases, and 1186 articles on the topic were found. Twelve of these articles were included in the final review after the full texts had been read. A sample of 178 paediatric patients was obtained. In the six cases in which treatment was surgery with titanium plate fixation, there were no postoperative complications, whereas in the 141 cases in which treatment was surgery with biodegradable plates, there were 12 postoperative complications, and in the 31 cases in which treatment was non-surgical, there were three postoperative complications. A connection between the best treatment and the number of postoperative complications in fractures of the dentate portion of the mandible in paediatric patients could not be established; however, the occurrence of postoperative complications was low for both surgical and non-surgical treatments.

Autogenous non-vascularized bone graft in segmental mandibular reconstruction: a systematic review.

The restoration of mandibular bone defects with non-vascularized bone grafts depends on the diagnosis, anatomical site, extent of the defect, and the patient's age, as well as the surgeon's experience. The aim of this study was to perform a systematic literature review on mandibular reconstruction for segmental mandibular bone defects using non-vascularized bone grafts to answer the following question: Is there scientific evidence to support the use of this technique? The initial literature search in PubMed, Scopus, and Cochrane databases identified 862 articles. Of these, 25 were included in the final review. These articles encompassed 926 procedures with non-vascularized bone grafts; 76.1% were from the iliac crest. Benign tumours were the major cause of these defects (56.8%), and 44.7% of defects were located in the lateral mandibular area. Although this technique showed a high occurrence of complications (290 in 873 patients, some with more than one complication), these did not account for treatment failure. The restoration of bone defects due to malignant tumours treated with radiation therapy had lower success rates, and these appear to be a contraindication for the technique. Although standardized randomized controlled clinical studies are needed to obtain better clinical evidence for treatment choices in general, the use of non-vascularized bone grafts for mandibular reconstruction showed an 87.6% success rate in this review.

Marginal adaptation and microleakage of five root-end filling materials: an in vitro study.

AIM: Endodontic surgery consists of several procedures which involve the endodontic space or the root canal and is performed as an alternative to unsuccessful outcomes or complications following endodontic treatments. The aim of the study was to evaluate the sealing ability of five root-end filling materials. METHODS: Fifty human single rooted teeth were treated endodontically; roots were resected at 3 mm from the apex, and root end cavities were prepared with ultrasonic tips. Root ends were filled with one of the following materials: silver amalgam (control group); mineral trioxide aggregate; white Portland cement; Vitremer; and Fuji Ortho. Apical sealing was evaluated by evaluating microleakage of 50% silver nitrate solution. The apical portion of the roots was sectioned to obtain 1-mm thick transversal slices, and epoxy resin replicas of these apical slices were produced. A scanning electron microscope (SEM) was used for analyses. The Kruskal-Wallis test and a multiple comparisons test were used for statistical data analysis. RESULTS: Results showed microleakage and variable adaptation gaps on the interface between dentin and root-end filling material in all specimens. CONCLUSION: All the studied materials exhibited some degree of apical microleakage and marginal gaps. No correlation was found between data obtained from analyses of apical sealing and marginal adaptation.