This study conducted a randomized clinical trial in 15 patients, who sought care at the Dental Clinic of the University of Passo Fundo, in order to compare the use of low-level laser and botulinum toxin in the treatment of myofascial pain and whether they alter the mouth opening of patients with temporomandibular disorder. The patients were divided into two groups: the Laser group received low-level GaAlAs laser, 100mW of power at a wavelength of 830nm in continuous light emission; and the Toxin group received 30U of botulinum toxin type A (BTX-A) in the first session, and 15U after fifteen days. The assessments were performed by measuring pain with Visual Analogue Scale (VAS), and mouth opening with a digital caliper. Data were submitted to Student's t test at 5% significance level. Regarding pain symptoms, the results indicate that groups treated with laser and toxin registered 7U in VAS, at day 5 the scores were 4.75 and 4.86U, respectively. The laser worked faster (day 12) at 2.75U, and the group treated with BTX-A registered 2.86U at day 30. Both therapies investigated were effective in reducing pain, but the effect of low-level laser was faster than the use of BTX-A. Both treatments showed no statistically significant improvement in mouth opening.
Postsurgical changes of the airways have become a great point of interest because it has been reported that maxillomandibular advancement surgery can improve or eliminate obstructive sleep apnea; however, its treatment effectiveness is still controversial. The purpose of this systematic review and meta-analysis was to assess the effectiveness of maxillomandibular advancement surgery to increase upper airway volume in adults, comparing before and after treatment. Bibliographic searches of observational studies with no restriction of year or language were performed in the electronic databases PubMed, Scopus, ScienceDirect and SciELO for articles published up to April 2015. After verification of duplicate records, 1860 articles were examined. Of these, ten met the eligibility criteria, of which three were excluded for having poor methodological quality. The other seven articles were included in the systematic review and six in the meta-analysis, representing 83 patients. One study whose data were not given in absolute values was excluded from the meta-analysis. The meta-analysis showed a statistically significant difference between the averages of upper airway volume before and after surgery {7.86 cm [95 % CI (6.22, 9.49), p = 1.00)}. Clinical evidence suggests that the upper airway volume is increased after maxillomandibular advancement surgery.
This study aimed to compare the effect of conventional irrigation (CI) and passive ultrasonic irrigation (PUI) with 17% EDTA and QMiX on the maximum depth and percentage of sealer penetration into the dentinal tubules by confocal laser scanning microscopy (CLSM) and to describe the cleaning of root canal walls by scanning electron microscopy (SEM). Eighty single-rooted human mandibular premolars were instrumented and randomly assigned to four groups (n = 20): EDTA + CI, QMiX + CI, EDTA + PUI, and QMiX + PUI. Ten samples from each group were examined by SEM (2,000×) and the remaining 40 roots were filled with a single gutta-percha cone and AH Plus sealer mixed with 0.1% rhodamine B for analysis by CLSM (10×). Images were assessed at distances of 2 mm (apical), 5 mm (middle), and 8 mm (coronal) from the apex with the Leica Application Suite V4.10 software. The EDTA + PUI and QMiX + PUI protocols presented higher rates of debris/smear layer removal in the apical and middle thirds. The PUI was superior to CI in the maximum depth of sealer penetration at the middle third. The QMiX + PUI group had a higher percentage of sealer penetration at the apical third. The PUI and QMiX protocol improved debris/smear layer removal and tubular dentin sealer penetration.
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