The effectiveness of photobiomodulation (PBM) and manual therapy (MT), alone or combined (CT), were evaluated in pain intensity, mandibular movements, psychosocial aspects, and anxiety symptoms of temporomandibular disorder (TMD) patients. Fifty-one TMD patients were randomly assigned to three groups: the PBM group (n = 18), which received PBM with 808 nm, 100 mW, 13.3 J/cm2, and 4 J per point; the MT group (n=16) for 21 minutes each session on masticatory muscles and temporomandibular joint TMJ; and the CT group (n = 17), applied during twelve sessions. Seven evaluations were performed in different moments using visual analogue scale (VAS), Research Diagnosis Criteria for Temporomandibular Disorders (RDC/TMD) Axis I and II, and Beck anxiety inventory (BAI). All groups demonstrated reductions in pain and improvement in jaw movements during treatment and at follow-up (< 0.001). The assessment of psychosocial aspects of TMD, comparing baseline and follow-up in all treatment groups, revealed that treatment did not promote modification in the intensity of chronic pain (p > 0.05). However, depression symptoms showed a reduction in PBM and CT groups (p≤0.05). All treatments promoted reduction in physical symptoms with and without pain and enhancement of jaw disabilities (p ≤ 0.05). MT promotes improvement in 5 functions, PBM in 2, and CT in 1 (p < 0.001). BAI analysis revealed that all treatments lead to a reduction in anxiety symptoms (p≤0.05). All protocols tested were able to promote pain relief, improve mandibular function, and reduce the negative psychosocial aspects and levels of anxiety in TMD patients. However, the combination of PBM and MT did not promote an increase in the effectiveness of both therapies alone.
This study evaluated the use of red and infrared lasers on tissue surrounding the femurs of 60 rats randomly divided into three groups after implantation of bioabsorbable plates. The control group were not subjected to laser irradiation; group A was treated with red laser [indium-gallium-aluminum-phosphide (InGaAlP) laser, wavelength 685 nm, 35 mW, continuous wave (CW), Ø = 0.06 cm, 2.23 min], and group B was subjected to infrared laser [gallium-aluminum-arsenium (GaAlAs) laser, wavelength 830 nm, 50 mw, CW, Ø = 0.06 cm, 1.41 min], both at 10 J/cm(2). Samples were stained with hematoxylin and eosin (H&E) and examined microscopically. Results showed that the laser irradiation had had a positive photobiomodulation effect on inflammation, confirmed by a better histologic pattern than that of the control group at 3 days and 7 days. Semiquantitative analysis revealed that groups A and B had a histologic score significantly greater than that of the control group at 3 days. At 21 days, histomorphometric analysis revealed a more intense inflammation in the red laser group than in the other groups. We concluded that low-level laser therapy (LLLT) has positive effects on the photobiomodulation of inflammation in the tissues surrounding the poly-L-lactic/polyglycolic acid (PLLA/PGA) bioabsorbable plate. It stimulated vascularization, fibroblast proliferation, and collagen deposition.
IntroduçãoEm toda atividade odontológica, tão importante quanto o aprimoramento técnico e científico é a conscientização dos riscos de contaminação e infecção durante o atendimento. Com a finalidade de reduzir o número de microrganismos presentes em instrumento ou superfície, um dos procedimentos comumente utilizados na odontologia é a desinfecção. Segundo Block 1 (2001) a desinfecção é a destruição de patógenos e outros tipos de microrganismos por mecanismos térmicos e químicos, mas não em todas as formas, como os esporos bacterianos.Diversos agentes podem ser utilizados para a desinfecção de instrumentos. Dentre os existentes, os que serão analisados no estudo são: solução aquosa de digluconato de clorexidina 0,12%, solução alcoólica de digluconato de clorexidina 0,12%, solução aquosa de digluconato de clorexidina 2%, solução alcoólica de digluconato de clorexidina 2%, álcool 70% e compostos de iodo. Almejando o sucesso da desinfecção, deve-se conhecer do agente o mecanismo de ação sobre os microrganismos, toxicidade para o manipulador e ação deletéria para o equipamento a ser desinfetado 2 . As soluções de digluconato de clorexidina, tanto alcoólica quanto aquosa, são anti-sépticos químicos, com ação antifúngica, bactericida e bacteriostática. O mecanismo de ação decorre da diminuição da tensão superficial e da estrutura proteica, através de desnaturação das membranas celulares 3 .
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