Although in clinical dentistry the major method used for pain relief is oral administration of analgesics, alternative methods are available, such as transcutaneous electrical nerve stimulation (TENS), acupuncture, vibration and conditioned pain modulation (CPM), formerly termed diffuse noxious inhibitory control. The aim of the present study was to investigate the combined effects of non-noxious (TENS) and noxious (CPM) stimuli on postoperative pain after extraction of an impacted wisdom tooth. The study involved 44 patients who were scheduled to undergo impacted wisdom tooth extraction. The patients were randomly allocated into four groups: noxious stimuli, non-noxious stimuli, combined noxious and non-noxious stimuli, and a sham group. On the day after tooth extraction, stimulation procedures for pain relief were performed and changes in the level of perceived pain were scored using a visual analog scale (VAS). The combination of non-noxious and noxious stimuli decreased the VAS scores by 63.7%, indicating a more potent analgesic effect than that in the non-noxious, noxious, and sham groups. This method of analgesia using a combination of nonnoxious and noxious stimuli can be applied to patients who are unable to tolerate analgesics, such as those with allergy, hypersensitivity or digestive disorders, and those who are pregnant.
Delayed postoperative infection is known as a major complication after bone surgeries using osteosynthetic biomaterial such as titanium (Ti) and bioresorbable organic materials. However, the precise cause of this type of infection is still unclear and no effective prevention has been established. The purpose of this study is to investigate the effect of irradiation with a 405 nm blue-violet laser on the bacteria adhered on the Ti and hydroxyapatite-poly-L-lactic acid- (HA-PLLA) based material surfaces and to verify the possibility of its clinical application to prevent the delayed postoperative infection after bone surgeries using osteosynthetic biomaterial. The suspension of Staphylococcus aureus FDA 209P was delivered onto the surface of disks composed of Ti or HA-PLLA. Bacterial adhesion on each disk was observed using a scanning electron microscope (SEM). After thorough washing with distilled water, the growth of bacteria attached to the material surfaces was examined with an alamar blue-based redox indicator. Moreover, a bactericidal effect of 405 nm blue-violet laser irradiation on residual bacteria on both materials was investigated using colony-forming assay. As a result, there was no significant difference in the bacterial adhesion between Ti and HA-PLLA materials. In contrast, 45 J/cm2 of irradiation with 405 nm blue-violet laser inhibited the bacterial growth at approximately 93% on Ti disks and at approximately 99% on HA-PLLA disks. This study clearly demonstrated the possibility that the irradiation with a 405 nm blue-violet laser is useful as an alternative management strategy for the prevention of delayed postoperative infection after bone surgeries using osteosynthetic biomaterials.
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