RESUMO
This study aimed to evaluate the role of photobiomodulation (PBM) in apexification and apexogenesis of necrotic rat molars with an open apex. Rat molars were exposed to the oral environment for 3 weeks. Canals were rinsed with 2.5% NaOCl and 17% EDTA, filled with antibiotic paste and sealed. After 7 days, canals were rinsed and divided into six groups (n=6): mineral trioxide aggregate (MTA); blood clot (BC); human dental pulp stem cells (hDPSC); MTA+PBM; BC+PBM; and hDPSC+PBM. In hDPSC groups, a 1% agarose gel scaffold was used. Two groups were not exposed: healthy tooth+PBM (n = 6), healthy tooth (n = 3); and one was exposed throughout the experiment: necrotic tooth (n = 3). In PBM groups, irradiation was performed with aluminum gallium indium phosphide (InGaAlP) diode laser for 30 days within 24-h intervals. After that, the specimens were processed for histological and immunohistochemical analyses. Necrotic tooth showed greater neutrophil infiltrate (p < 0.05). Necrotic tooth, healthy tooth, and healthy tooth+PBM groups showed absence of a thin layer of fibrous condensation in the periapical area. All the other groups stimulated the formation of a thicker layer of fibers (p < 0.05). All groups formed more mineralized tissue than necrotic tooth (p < 0.05). PBM associated with MTA, BC, or hDPSC formed more mineralized tissue (p < 0.05). MTA+PBM induced apexification (p < 0.05). Rabbit polyclonal anti-bone sialoprotein (BSP) antibody confirmed the histological findings of mineralized tissue formation, and hDPSC groups exhibited higher percentage of BSP-positive cells. It can be concluded that PBM improved apexification and favored apexogenesis in necrotic rat molars with an open apex.
Assuntos
Apexificação/métodos , Cavidade Pulpar/efeitos da radiação , Necrose da Polpa Dentária/radioterapia , Lasers Semicondutores/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Ápice Dentário/efeitos da radiação , Doenças Dentárias/radioterapia , Compostos de Alumínio/uso terapêutico , Animais , Compostos de Cálcio/uso terapêutico , Polpa Dentária/citologia , Cavidade Pulpar/patologia , Necrose da Polpa Dentária/patologia , Combinação de Medicamentos , Imuno-Histoquímica , Sialoproteína de Ligação à Integrina/análise , Óxidos/uso terapêutico , Distribuição Aleatória , Ratos Wistar , Reprodutibilidade dos Testes , Silicatos/uso terapêutico , Células-Tronco , Ápice Dentário/patologia , Doenças Dentárias/patologia , Resultado do TratamentoRESUMO
Abstract This study aimed to evaluate the role of photobiomodulation (PBM) in apexification and apexogenesis of necrotic rat molars with an open apex. Rat molars were exposed to the oral environment for 3 weeks. Canals were rinsed with 2.5% NaOCl and 17% EDTA, filled with antibiotic paste and sealed. After 7 days, canals were rinsed and divided into six groups (n=6): mineral trioxide aggregate (MTA); blood clot (BC); human dental pulp stem cells (hDPSC); MTA+PBM; BC+PBM; and hDPSC+PBM. In hDPSC groups, a 1% agarose gel scaffold was used. Two groups were not exposed: healthy tooth+PBM (n = 6), healthy tooth (n = 3); and one was exposed throughout the experiment: necrotic tooth (n = 3). In PBM groups, irradiation was performed with aluminum gallium indium phosphide (InGaAlP) diode laser for 30 days within 24-h intervals. After that, the specimens were processed for histological and immunohistochemical analyses. Necrotic tooth showed greater neutrophil infiltrate (p < 0.05). Necrotic tooth, healthy tooth, and healthy tooth+PBM groups showed absence of a thin layer of fibrous condensation in the periapical area. All the other groups stimulated the formation of a thicker layer of fibers (p < 0.05). All groups formed more mineralized tissue than necrotic tooth (p < 0.05). PBM associated with MTA, BC, or hDPSC formed more mineralized tissue (p < 0.05). MTA+PBM induced apexification (p < 0.05). Rabbit polyclonal anti-bone sialoprotein (BSP) antibody confirmed the histological findings of mineralized tissue formation, and hDPSC groups exhibited higher percentage of BSP-positive cells. It can be concluded that PBM improved apexification and favored apexogenesis in necrotic rat molars with an open apex.
Assuntos
Animais , Doenças Dentárias/radioterapia , Necrose da Polpa Dentária/radioterapia , Ápice Dentário/efeitos da radiação , Terapia com Luz de Baixa Intensidade/métodos , Cavidade Pulpar/efeitos da radiação , Lasers Semicondutores/uso terapêutico , Apexificação/métodos , Óxidos/uso terapêutico , Células-Tronco , Doenças Dentárias/patologia , Imuno-Histoquímica , Distribuição Aleatória , Reprodutibilidade dos Testes , Resultado do Tratamento , Ratos Wistar , Silicatos/uso terapêutico , Compostos de Cálcio/uso terapêutico , Compostos de Alumínio/uso terapêutico , Necrose da Polpa Dentária/patologia , Ápice Dentário/patologia , Polpa Dentária/citologia , Cavidade Pulpar/patologia , Combinação de Medicamentos , Sialoproteína de Ligação à Integrina/análiseRESUMO
OBJECTIVES: To assess the effectiveness of low-level laser therapy (LLLT) in reducing orthodontic pain after the application of orthodontic force (OF). METHODS: A systematic search was conducted in the MEDLINE, EMBASE, Scopus, Cochrane Library, Web of Science, and EBSCOhost databases. The study included randomized clinical trials (RCT) which analysed the effectiveness of LLLT in reducing orthodontic pain assessed at 24 and 72 hrs after the application of OF. The risk of bias of the eligible trials was assessed using the Cochrane Collaboration's risk of bias tool. Standard mean difference was calculated and pooled by meta-analysis using random effect models. RESULTS: Of 467 identified articles, 20 RCT were finally included. In the risk of bias assessments, 13 studies presented a high risk, 5 an unclear risk, and 2 a low risk. The meta-analysis showed that in patients treated with laser versus placebo there was a difference in favour of LLLT in spontaneous pain 24 and 72 hrs after the installation of light archwires and spontaneous pain and chewing pain 24 and 72 hrs after the installation of elastomeric separators. CONCLUSIONS: LLLT proved to be effective in promoting a reduction in spontaneous and chewing pain after the application of OF; however, the poor quality of the evidence requires these results to be treated with caution.
Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Dor/radioterapia , Doenças Dentárias/radioterapia , Bases de Dados Factuais , Humanos , Manejo da DorRESUMO
The application of laser as a therapeutic measure in nervous regeneration in dentistry has not been a discussed subject, even though the knowledge about the response of the peripheral nervous system is very important inpractice as well as in the recovery of the patient. It has been proposed that low-level laser (LLL) therapy has beneficial effects on tissues; LLL therapy acts as an analgesic, anti-inflammatory, anti-edematous, anti-cellulitic tool, and it stimulates cellular trofism. In the present study, we conducted a meta-analysis of available literature regarding the response of the injured nerveto low-power laser using search engines EBSCO and PUBMED. The literature refers to the stimulant effect of the low-level laser in the neoformation of vessels and to the existing bibliographic evidence to propose that this mechanism is important in nervous regeneration. There is limited bibliographic evidence on the effects of LLL therapy in dentistry.
La aplicación de láser como medio terapéutico en la regeneración nerviosa en odontología, no ha sido un tema muy discutido, aún cuando el conocimiento de la respuesta del sistema nervioso periférico es muy importante tanto en la práctica como en la recuperación del paciente. Se ha propuesto que el láser de baja potencia (LBP) tiene efectos benéficos en los tejidos, entre ellos antiálgico, antiinflamatorio, antiedematoso, anticelulítico y bioestimulante del trofismo celular. En el presente estudio se realizó un metaanálisis de la literatura disponible en relación con la respuesta del nervio lesionado ante la aplicación de láser de baja potencia utilizando los buscadores EBSCO y PUBMED. La literatura se refiere al efecto estimulante del LBP en la neoformación de vasos y existiendo evidencia bibliográfica para proponer a este mecanismo como importante en la regeneración nerviosa. Los efectos del láser de baja potencia en Odontología presentaron una escasa evidencia bibliográfica.