A UTILIZAÇÃO DO LASER DE BAIXA INTENSIDADE NA MOVIMENTAÇÃO DENTÁRIA E NA SENSIBILIDADE DOLOROSA APÓS APLICAÇÃO DE FORÇA ORTODÔNTICA

O presente estudo objetivou avaliar a eficácia do Laser de Baixa Intensidade (LBI) na aceleração da movimentação dentária e na diminuição da dor frente à aplicação de força ortodôntica. A amostra foi composta por 19 pacientes, sendo doze do sexo feminino e sete do sexo masculino, com idade inicial média de 14,69 anos, todos com indicação para extrações de primeiros pré-molares. Destes, 66 caninos foram submetidos à retração inicial, sendo que 33 receberam aplicação de laser e 33 foram considerados controle. Utilizou-se o Laser de Baixa Intensidade de arseneto de gálio e alumínio, com comprimento de onda de 780nm, na dosimetria de 40mW;10J/cm2;10s/ponto, aplicado apenas uma vez ao mês em dez pontos, sendo cinco por vestibular e cinco por lingual/palatino. Modelos de gesso foram confeccionados durante todos os meses de retração dos caninos, que teve duração de quatro meses, sendo, posteriormente, digitalizados para se mensurar a quantidade de movimentação de um lado em relação ao outro, utilizando-se como referência as papilas incisivas. Para a avaliação da dor experimentada pelos pacientes, os mesmos foram orientados a preencher uma escala analógica visual (VAS) que variava de 0 a 10 , em que zero significava nenhuma dor e dez significava dor insuportável, nos intervalos de 12, 24, 48 e 72 horas após a aplicação da força ortodôntica. Foi mensurado o apinhamento de todas as hemiarcadas dos pacientes na fase inicial, medindo-se a distância entre os pontos de contato de cada dente. Para a verificação do padrão de normalidade, empregou-se o teste de Kolmogorov-Smirnov, sendo que para comparar o lado irradiado com o lado não irradiado foi utilizado o teste t pareado, exceto para a variável razão caninos/molares , analisada pelo teste não paramétrico de Wilcoxon (p<0,05). Os resultados mostraram que em relação ao apinhamento dentário, os lados irradiado e não irradiado apresentaram-se compatíveis. Além disso, não houve diferença estatisticamente significante entre a quantidade de retração dos caninos irradiados comparados aos não irradiados, o mesmo acontecendo com a sensibilidade dolorosa experimentada pelos pacientes. Concluiu-se assim que o LBI na dosimetria e forma como foi utilizado não foi eficiente na aceleração da movimentação dentária nem na redução da dor experimentada pelos pacientes frente às forças ortodônticas.

Efeitos da terapia laser de baixa intensidade associada ao exercício aeróbio no reparo de tenotomia do tendão de aquiles de ratos diabéticos

Diabetes Mellitus (DM ) is a complex disease that requires continuous medical care for the reduction of risk factors in addition to glycemic control. The typical hyperglycemia of this disease produces glycosylation of proteins and so the consequence is the accumulation of glycosylation final products in various human tissues, among them, the tendon. The aerobic exercise (AE) and the low level laser therapy (LLLT) have been used to treat tendinopathies in individuals with or without DM. Objective: The aim of this study was to watch the effect of the LLLT and the AE, in association, in partial tenotomy of the tissue repair of the Achilles tendon (AT) of diabetic rats. Methods: 91 animals were utilized and divided in to the following groups: control group (GC), injured control group (GCL), diabetic group (GD), diabetic group LLLT (GD – TLBI), diabetic group trained (GD - EX) and diabetic group trained laser (GD-EX+TLBI). The animals were submitted to intervention with AE, using a protocol with a progressive increase of time (12 to 60 min) and speed of (4 to 9 m/min), and the LLLT (660 nm laser, 10mW, 4 J/cm², single point for 16 seconds, three times for week). It was analyzed morphological, biomechanical and molecular characteristics. For data showing normal distribution was used one-way ANOVA test and post hoc Tukey and data without normal distribution was used Mann Whitney test and post hoc Dunn's. It was accepted p <0.05 for statistical significance Results: The biomechanical tests indicated major improvement in the GC and GD-EX+TLBI groups when compared with the diabetic groups in the following variables: maximum load, strain, absorbed energy, stress, cross section area, elastic modulus and energy density (p<0.05). The analysis through molecular biology indicated that the association of aerobic exercise and LLLT generated an increase of the collagen I gene expression and modulated the expression of the MMP2 and MMP9 (p<0.05). No observed any major improvement in the morphological variable studied. Conclusion: the LLLT associated with aerobic exercise promotes and increase of the mechanical properties, in the control of collagen I gene expression and of the MMP2 and MMP9 of the diabetic rats.

Mast Cell Curve-Response in Partial Achilles Tendon Rupture After 830 nm Phototherapy

Objective: the aim of this study was to quantify mast cells at different time intervals after partial Achilles tendon rupture in rats treated with low-level laser therapy (LLLT). Background data: There is a high incidence of lesions and ruptures in the Achilles tendon that can take weeks and even months to heal completely. As the mast cells help in the healing repair phase, and LLLT has favorable effects on this tissue repair process, study of this modality on the quantity of mastocytes in the ruptured tendon is relevant. Methods: Sixty Wistar rats were subjected to partial Achilles' tendon rupture by direct trauma, randomized into 10 groups, and then divided into the group treated with 80mW aluminum gallium arsenide infrared laser diode, continuous wave, 2.8W/cm(2) power density, 40J/cm(2) energy density, and 1.12J total energy, and the simulation group. Both the groups were subdivided according to the histological assessment period of the sample, either 6h, 12h, 24h, 2 days, or 3 days after the rupture, to quantify the mastocytes in the Achilles' tendon. Results: the group subjected to LLLT presented a greater quantity of mastocytes in the periods of 6h, 12h, 24h, 2 days, and 3 days after rupture, compared with the simulation groups, but differences were detected between the sample assessment periods only in the simulation group. Conclusions: LLLT was shown to increase the quantity of mastocytes in the assessment periods compared with the simulation groups.

Los diferentes tipos de láser y sus aplicaciones en podología

Los diferentes tipos de láseres, sobre todo el láser de diodo, irrumpen en la terapéutica podológica para proporcionar una alternativa más de tratamiento en muchas patologías que son el día a día de las consultas. El buen manejo y el conocimiento de sus características son requisitos imprescindibles para no tener efectos secundarios indeseados y poder llevar a cabo tratamientos poco dolorosos, minimizando el tiempo total, y muchas veces proporcionando una solución a diversas patologías.

Efeitos da laserterapia de baixa potência sobre a fadiga do músculo quadríceps de indivíduos jovens

The objective of this study was to evaluate the effect of low laser power on the performance of anaerobic endurance of the quadriceps muscle in young subjects. Low-level laser therapy (LLLT) appears to decrease some indices of muscle fatigue. Most of these effects may be due to the influence of the laser on the muscles predominantly aerobic. Animal studies and clinical trials have already shown that the laser can improve the efficiency of mitochondrial metabolism for the resynthesis of adenosine triphosphate and thus slow down - or minimize, the deleterious effects of muscle fatigue. This research was characterized as an experimental study of the controlled clinical trial, randomized, blinded, attended by 93 volunteers, military, with ages between 18 and 19 years. The subjects were randomly allocated into three groups: Control (G1), Placebo (G2) and Laser (G3). All volunteers underwent an anthropometric assessment and a protocol Fatigue. This protocol was applied to an initial assessment (AV-1) for the collection of baseline data, and a final evaluation (AV-2). As the study variables, we used the blood lactate concentrations and indices of muscle power, as average power and peak velocity. The fatigue protocol consisted of a test of speed with twenty repetitions, performed on an exercise machine leg press 45º . In conclusion, it was found that, in this study, LLLT caused a significant increase in the Average of the Averages Powers, phase eccentric exercise in leg press 45º performed by young individuals

Efeitos da laserterapia na atividade biológica de células de carcinoma epidermóide de língua humano

The low level laser therapy (LLLT) has shown to be effective in promoting the proliferation of different cells in vitro, including keratinocytes, osteoblasts, endothelial cells and stem cells. It has been speculated that the biostimulatory effect of LLLT could cause undesirable enhancement of tumor growth in neoplastic diseases, since the malignant cells are more susceptible to proliferative stimuli. Within this context, this study evaluated the effect of LLLT on epidermoid carcinoma of the tongue cell line (SCC25) proliferation and invasion. Cultured cells were irradiated with an InGaAIP diode laser, 660nm, 30mW using two energy densities (0.5J/cm2 and 1.0J/cm2). Proliferative activity was assessed through trypan blue staining method and through cell cycle analysis using flow cytometry. The invasive potential was measured through cell invasion assay using matrigel. Cyclin D1, E-cadherin, -catenin and MMP-9 expressions were analyzed by immunofluorescence and flow cytometry and related to the investigated biological activities. Proliferation curve demonstrated that SCC25 irradiated with 1.0J/cm2 had the highest proliferative rate when compared to the control group and the group irradiated with 0.5J/cm2 (p<0.05). LLLT affected cell cycle distribution and energy density of 1.0 J/cm2 promoted a higher percentage of cells in S/G2/M phases, with statistically significant differences at 24h interval (p<0.05). LLLT, mainly with 1.0J/cm2, revealed significantly higher potential for invasion and influenced the expression of cyclin D1, E-cadherin, -catenin and MMP-9, promoting the malignant phenotype. In conclusion, our results indicate that LLLT has an important stimulatory effect on proliferation and invasion of SCC25 cells, likely due to altered expression of proteins associated with these processes

Assistência Odontológica em Crianças com Paralisia Cerebral e Perspectivas Tecnológicas de Reabilitação

The improvement of oral health and quality of life is closely related to transdisciplinary dialogue, technological development and social responsibility. In patients with cerebral palsy, the lesion of motor areas of the brain compromises the development and function of the craniofacial complex. Considering all the ethiopathogenic conditions, the treatment of such patients involves great difficulties. The dentist and other professionals related to their rehabilitation need to deal with difficulty in chewing, respiration, phonation, besides the poor oral hygiene resulted from abnormal involuntary movements of facial and masticatory musculature, tongue, and upper limb. It is also relevant the lack of understanding about the importance of oral health care due to mental deficits of these individuals. This study aims to review some aspects of oral health in patients with cerebral palsy proposing rehabilitation associated to technology. Few studies concerned about the effectiveness of therapies for oral rehabilitation in patients with cerebral palsy. Laser therapy, electromyography, electrostimulation and LED therapy should be analyzed as options for treatment of patients with cerebral palsy. Following research projects should focus more attention on the dynamic and oral function of these patients to achieve positive repercussions in their overall health. © ArquiMed, 2010.

Effects of LLLT in combination with bisphosphonate on bone healing in critical size defects: A histological and histometric study in rat calvaria

The purpose of this study was to analyze histologically the effect of low-level laser therapy (LLLT) in combination with bisphosphonate on bone healing in surgically created critical size defects (CSD) in rat calvaria. One hundred Wistar female rats sham operated (sham) and ovariectomized (Ovx) were maintained untreated for 1 month to allow for the development of osteopenia in the Ovx animals. A CSD was made in the calvarium of each rat, and the animals were divided into five groups according to following treatments: (1) sham rats (control), (2) Ovx rats, (3) Ovx rats treated with LLLT, (4) Ovx rats treated with bisphosphonate, and (5) Ovx rats treated with bisphosphonate and LLLT. Groups 4 and 5 were irrigated with 1 ml of bisphosphonate, and groups 3 and 5 were submitted to LLLT (GaAlAs), 660 nm, 24 J, and 0.4285 W/cm2 on the CSD. Ten animals of each treatment were killed at 30 and 60 days. Histomorphometric assessments, using image analysis software, and histological analyses were performed. No defect was completely regenerated with the bone. Histometrically, it can be observed that groups 3 (37.49 ± 1.94%, 43.11 ± 2.39%) and 5 (35.05 ± 1.57%, 41.07 ± 1.89%) showed a significant bone neoformation when compared to groups 1 (16.81 ± 1.57%, 27.54 ± 1.49%), 2 (11.68 ± 0.98%, 22.51 ± 1.05%), and 4 (14.62 ± 1.70%, 25.67 ± 1.41%) in all experimental periods (P < 0.05). It was possible to conclude that the LLLT associated or not with bisphosphonate treatment was effective for stimulating bone formation in CSD in the calvaria of rats submitted to ovariectomy. © 2012 Springer-Verlag London Ltd.

Adjunctive antimicrobial photodynamic treatment of experimentally induced periodontitis in rats with ovariectomy

Background: The aim of this study is to compare antimicrobial photodynamic therapy (aPDT) as an adjunctive therapy to scaling and root planing (SRP) for the treatment of experimentally induced periodontitis in rats with ovariectomy (OVX) that are or are not treated with estrogen replacement. Methods: A total of 270 female rats were divided into three groups: 1) normal rats; 2) rats with OVX; and 3) rats with OVX with estrogen replacement. Periodontal disease was induced through the introduction of a cotton thread around the mandibular left first molar. After 7 days, the ligature was removed, and the rats were randomly divided into the following treatment groups: 1) SRP plus saline solution; 2) SRP plus low-level laser therapy (LLLT); and 3) SRP plus toluidine blue O irrigation followed by LLLT. Ten rats from each group were euthanized at days 7, 15, and 30 after dental treatment. Bone loss (BL) in the furcation region was evaluated using histometric and immunohistochemical analyses. Results: aPDT treatment resulted in reduced BL compared with SRP treatment at all time points. Additionally, rats treated with aPDT exhibited reduced numbers of tartrate-resistant acid-phosphatase-positive cells and more proliferating cell nuclear antigen-positive cells in all treatment groups regardless of estrogen status. Whereas rats treated with aPDT showed weak immunoreactivity to the receptor activator of nuclear factor-k B ligand at day 7 post-treatment, strong osteoprotegerin immunoreactivity was observed at day 15 post-treatment. Conclusion: aPDT is an effective adjunctive therapy for the treatment of periodontitis in rats with OVX that are or are not given estrogen replacement therapy.

Influência da Superfície do implante e da laserterapia na osseointegração, em ratas osteopênicas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência do hidrocloreto de tetraciclina associado à terapia fotodinâmica no tratamento da doença periodontal induzida: estudo histomorfométrico e imunoistoquímico em ratos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Ação da terapia fotodinâmica no tratamento da doença periodontal induzida: estudo histológico em ratos

Pós-graduação em Odontologia - FOA

Análises macro e microscópica de enxertos cutâneos por semeadura após laserterapia de baixa intensidade

Pós-graduação em Cirurgia Veterinária - FCAV

Efeito da laserterapia de baixa intensidade sobre a cicatrização de úlceras hansênicas: ensaio clínico randomizado

Úlcera neuropática é uma das sequei as mais estigmatizantes da hanseníase. Sua presença é bastante incapacitante para o indivíduo, podendo levar a deformação e/ou amputação do membro afetado. Diversas técnicas de tratamento têm sido utilizadas no manejo destas úlceras, no entanto, os resultados nem sempre são satisfatórios, ocasionando a existência de pessoas que convivem há vários anos com ferimentos crônicos. A laserterapia de baixa intensidade (LBI) tem sido utilizada em diversos países no tratamento de úlceras de difícil cicatrização, entretanto seus resultados são inconclusivos e muitos dos trabalhos publicados apresentam falhas metodológicas. O objetivo deste estudo foi avaliar o efeito da LBI sobre o processo de cicatrização de úlceras em pacientes hansenianos, em um teste clínico controlado e randomizado. O estudo foi realizado no ambulatório de curativos da Unidade de Referência Estadual em Dermatologia Sanitária do Pará - Marcello Candia, a partir de um levantamento clínico-epidemiológico para caracterização da população estudada, por meio de anamnese, identificação da localização das úlceras, registro fotográfico digital, avaliação da área das lesões utilizando o programa ImageTool 3.0, e medida da profundidade das úlceras de 51 pacientes, totalizando 97 lesões. A comorbidade mais frequente nesta população foi a hipertensão arterial sistêmica (13 casos). Em seguida, 25 sujeitos foram distribuídos aleatoriamente em dois grupos de estudo. O grupo controle (GC), formado por 12 pacientes (14 Úlceras) permaneceu recebendo o tratamento de rotina, composto por curativos simples diários, uso de sulfadiazina de prata 1 %, e orientações para autocuidados e prevenção de incapacidades. O grupo experimental (GE), formado por 13 sujeitos (17 úlceras), permaneceu recebendo o mesmo tratamento de rotina do GC mais a aplicação de LBI três vezes por semana, durante um período de 12 semanas. A LBI foi aplicada com um equipamento de laser diodo A1GaInP (660 nm), na dose de 2 J/cm² com a técnica de varredura sem contato no leito da lesão, e 4 J/ponto nas bordas da lesão com aplicações pontuais com contato. A densidade de potência foi de 1 W/cm². As variáveis estudadas foram: área da lesão em cm², profundidade em milímetros e escore PUSH. No GC a média da área das úlceras foi de 5,3 (±9.2) antes e 4,4 (± 8,5) depois do tratamento, a profundidade foi de 6,3 (± 5,4) antes e 5,4 (± 5.7) depois, o escore PUSH foi 9,7 (± 3,4) antes e 8,4 (± 5.3) depois. No GE a média da área das Úlceras foi de 4,2 (± 5,9) antes e 3,8 (± 5,7) depois do tratamento, a profundidade foi de 6.2 (± 5.1) antes e 4,1 (± 3,9) depois, o escore PUSH foi 9,6 (± 3,3) antes e 7,9 (± 5,3) depois. A análise estatística não evidenciou diferença significativa (p > 0,05) em nenhuma das variáveis estudadas antes e depois do tratamento. A LBI, dentro dos parâmetros utilizados neste estudo, não demonstrou benefícios adicionais para a cicatrização de úlceras em hansenianos. A diminuição do peso exercido sobre a área da lesão e o controle da pressão arterial são medidas importantes no manejo destas úlceras.