RESUMO
Temporomandibular disorders (TMDs) are common painful multifactorial conditions affecting the temporomandibular joint (TMJ) and whose treatment depends on the type and symptoms. Initially, it requires pain control, and, for this, drugs, biting plates, occlusal adjustment, physiotherapy or their association are used. Lately, laser phototherapy (LPT) has been used in the treatment of pain of several origins, including TMDs. This study reports the treatment of a selected group of 74 patients treated at the Laser Center of the Federal University of Bahia between 2003 and 2008. Following standard anamneses, clinical and imaging examination and with the diagnosis of any type of TMD, the patients were prepared for LPT. No other intervention was carried out during the treatment. Treatment consisted of three sessions a week for 6 weeks. Prior to irradiation, the patients were asked to score their pain using a visual analog scale (VAS). Lasers of wavelength (lambda)780 nm, lambda790 nm or lambda830 nm and/or lambda660 nm were used at each session (30/40 mW; spot (varphi) approximately 3 mm; mean dose per session 14.2 +/- 6.8 J/cm(2); mean treatment dose of 170 +/- 79.8 J/cm(2)). Of the patients, 80% were female ( approximately 46 years old). At the end of the 12 sessions the patients were again examined, and they scored their pain using the VAS. The results were statistically analyzed and showed that 64% of the patients were asymptomatic or had improved after treatment and that the association of both wavelengths was statistically significant (P = 0.02) in the asymptomatic group. It was concluded that the association of red and infrared (IR) laser light was effective in pain reduction on TMJ disorders of several origins.
Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Transtornos da Articulação Temporomandibular/radioterapia , Adulto , Brasil , Feminino , Humanos , Lasers Semicondutores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Dor/fisiopatologia , Dor/radioterapia , Medição da Dor , Fototerapia/métodos , Estudos Retrospectivos , Transtornos da Articulação Temporomandibular/fisiopatologiaRESUMO
OBJECTIVE: The aim of this study was to assess and compare the effects of laser phototherapy (LPT) on cutaneous flaps on diabetic rats. BACKGROUND: Diabetes mellitus is characterized by high blood glucose levels. Its main complications are delayed wound healing, an impaired blood supply, and a decrease in collagen production. Cutaneous flaps are routinely used in several surgical procedures, and most failures are related to poor blood supply. LPT has been studied using several healing models. ANIMALS AND METHODS: Twelve Wistar rats were randomized into three groups: group 1 (G1; diabetic animals without treatment), group 2 (G2; diabetic animals irradiated with lambda680 nm), and group 3 (G3; diabetic animals irradiated with lambda790 nm). Diabetes was induced with streptozotocin. A 2- x 8-cm cutaneous flap was raised on the dorsum of each animal, and a plastic sheet was introduced between the flap and the bed to cause poor blood supply. Nonirradiated animals acted as controls. The dose per session was 40 J/cm(2). Laser light was applied transcutaneously and fractioned on 16 contact points at the wound margins (16 x 2.5 J/cm(2)). Animal death occurred on day 8 after surgery. Specimens were taken, processed, cut, stained with eosin (HE) and sirius red, and underwent histological analysis. RESULTS: It is shown that accute inflammation was mostly discrete for G3. Chronic inflammation was more evident for G2. Fibroblast number was higher for G3. Angiogenesis was more evident for G3. Necrosis was more evident for G2. Statistical analysis among all groups showed significant differences (p = 0.04) on the level of acute inflammation between G1 and G3, tissue necrosis between G1 and G2 (p = 0.03), chronic inflammation between (p = 0.04), fibroblastic proliferation between G2 and G3 (p = 0.05), and neovascularization between G2 and G3 (p = 0.04). CONCLUSION: LPT was effective in increasing angiogenesis as seen on irradiated subjects and was more pronounced when IR laser light was used.
Assuntos
Diabetes Mellitus Experimental , Sobrevivência de Enxerto/efeitos da radiação , Terapia com Luz de Baixa Intensidade , Retalhos Cirúrgicos , Animais , Masculino , Distribuição Aleatória , Ratos , Ratos WistarRESUMO
The aim of the investigation was to assess histologically the effect of laser photobiomodulation (LPBM) on a repair of defects surgically created in the femurs of rats. Forty-five Wistar rats were divided into four groups: group I (control); group II (LPBM); group III (hydroxyapatite guided bone regeneration; HA GBR); group IV (HA GBR LPBM). The animals in the irradiated groups were subjected to the first irradiation immediately after surgery, and it was repeated every day for 2 weeks. The animals were killed 15 days, 21 days and 30 days after surgery. When the groups irradiated with implant and membrane were compared, it was observed that the repair of the defects submitted to LPBM was also processed faster, starting from the 15th day. At the 30th day, the level of repair of the defects was similar in the irradiated groups and those not irradiated. New bone formation was seen inside the cavity, probably by the osteoconduction of the implant, and, in the irradiated groups, this new bone formation was incremental. The present preliminary data seem to suggest that LPMB therapy might have a positive effect upon early wound healing of bone defects treated with a combination of HA and GBR.
Assuntos
Materiais Biocompatíveis/uso terapêutico , Regeneração Óssea/efeitos da radiação , Durapatita/uso terapêutico , Fêmur/patologia , Regeneração Tecidual Guiada/métodos , Terapia com Luz de Baixa Intensidade , Animais , Terapia Combinada , Feminino , Fêmur/fisiopatologia , Fêmur/efeitos da radiação , Masculino , Ratos , Ratos WistarRESUMO
OBJECTIVE: This study assessed histologically the effect of laser photobiomodulation on the repair of surgical defects created in the femurs of Wistar rats treated or not treated with bone morphogenetic proteins (BMPs) and organic bovine bone graft. BACKGROUND DATA: This paper is part of an ongoing series of works in which biomaterials and/or guided bone regeneration (GBR) are used in association with laser photobiomodulation. Several previous reports from our group have shown that the use of laser photobiomodulation improves the treatment of bone defects. MATERIALS AND METHODS: Forty-eight adult male Wistar rats were divided into four randomized groups: group 1 (controls, n = 12); group 2 (laser photobiomodulation, n = 12); group 3 (BMPs + organic bovine bone graft + GBR, n = 12); and group 4 (BMPs + organic bovine bone graft + GBR + laser photobiomodulation, n = 12). The irradiated groups received seven irradiations every 48 h, the first immediately after the surgical procedure. Laser photobiomodulation (830 nm, 40 mW, CW, phi approximately 0.6 mm) consisted of a total of 16 J/cm2 per session at four points (4 J/cm2 each) equally spaced around the periphery of the defect. The animals were sacrificed after 15, 21, and 30 d, and the specimens were routinely embedded in wax and stained with hematoxylin and eosin and Sirius red stains and analyzed under light microscopy. RESULTS: The results showed histological evidence of increased deposition of collagen fibers (at 15 and 21 d), as well as an increased amount of well-organized bone trabeculi at the end of the experimental period (30 d) in irradiated animals compared to non-irradiated controls. CONCLUSION: We concluded that the use of laser photobiomodulation in association with BMPs, organic bovine bone grafts, and GBR increases the positive biomodulating effects of laser energy.
Assuntos
Proteínas Morfogenéticas Ósseas/uso terapêutico , Regeneração Óssea/efeitos da radiação , Fêmur/fisiopatologia , Fêmur/efeitos da radiação , Regeneração Tecidual Guiada/métodos , Terapia a Laser , Animais , Materiais Biocompatíveis/uso terapêutico , Regeneração Óssea/efeitos dos fármacos , Feminino , Fêmur/lesões , Masculino , Ratos , Ratos WistarRESUMO
OBJECTIVE: This study assessed histologically the effect of laser photobiomodulation (LPBM) on the repair of surgical defects created in the femurs of Wistar rats treated or not treated with bone morphogenic proteins (BMPs) and organic bovine bone graft. BACKGROUND DATA: This paper is part of an ongoing series of works in which biomaterials are used in association with LPBM. Several previous reports by our group have shown that the use of laser photobiomodulation improves the treatment of bone defects. MATERIALS AND METHODS: Forty-eight adult male Wistar rats were divided into four randomized groups: group I (control, n = 12); group II (LPBM, n = 12); group III (BMPs + organic bovine bone graft, n = 12); and group IV (BMPs + organic bovine bone graft + LPBM, n = 12). The irradiated groups received seven irradiations every 48 h, beginning immediately after the surgical procedure. The laser therapy (lambda = 830 nm, 40 mW CW, varphi = 0.6 mm) consisted of 16 J/cm(2) per session divided equally over four points (4 J/cm(2) each) around the defect. The subjects were sacrificed after 15, 21, and 30 d, and the specimens were routinely embedded in wax, stained with hematoxylin and eosin and sirius red, and analyzed under light microscopy. RESULTS: The results showed histological evidence of increased deposition of collagen fibers (at 15 and 21 d), as well as an increased amount of well-organized bone trabeculae at the end of the experimental period (30 d) in the irradiated animals versus the non-irradiated controls. CONCLUSION: The use of LPBM with BMPs and organic bovine bone grafts increases the positive biomodulating effects of laser light.