Myelomeningocele is a severe type of spina bifida, resulting from improper closure of the neural tube. This condition drastically affects the structures of the spinal cord resulting in deficiencies. ...The combination of these deficiencies results in an overall decrease in mobility and functional participation amongst this population. Physiotherapy plays an essential role in rehabilitating people with MMC. The current literature shows that resources such as photobiomodulation (PBM) may support the rehabilitation of neurological conditions. The aim of the proposed study is to evaluate the effects of photobiomodulation (PBM) combined with physical therapy on functional performance in children with low lumbosacral myelomeningocele.
This is a protocol randomized clinical blind study, that will include 30 individuals of both sexes, aged between 5 to 8 years, diagnosed with low and sacral lumbar myelomeningocele and capable of performing the sit-to-stand task. The participants will be randomly assigned into two treatment groups: PBM + physiotherapeutic exercises and sham PBM + physiotherapeutic exercises. Irradiation will be carried out with light emitting diode (LED) at a wavelength of 850 nm, energy of 25 J per point, 50 seconds per point and a power of 200 mW. The same device will be used in the placebo group but will not emit light. Muscle activity will be assessed using a portable electromyograph (BTS Engineering) and the sit-to-stand task will be performed as a measure of functioning. Electrodes will be positioned on the lateral gastrocnemius, tibialis anterior and rectus femoris muscles. The Pediatric Evaluation of Disability Inventory will be used to assess functional independence. Quality of life will be assessed using the Child Health Questionnaire-Parent Form 50. Changes in participation will be assessed using the Participation and Environment Measure for Children and Youth. The data will be analyzed with the aid of GraphPad PRISM.
The results of this study can contribute to a better understanding of the effectiveness of PBM on functioning and quality of life in children with myelomeningocele.
ClinicalTrials.gov Identifier: NCT04425330.
We conducted a systematic review to evaluate the efficacy of PDT in the management of recurrent herpes labialis (RHL). Study design: systematic review.
This study was reported according to the PRISMA ...checklist and we performed a literature search on five databases.
The search revealed that there are no published clinical trials addressing PDT on RHL, therefore we conducted a review of case reports and five studies were included for qualitative review. The number of treated patients varied from 2 to 6 in each article. Most studies used methylene blue as a photosensitizer, while one used 5-aminolevulinic acid. For light irradiation, most studies used laser and one used a red light from halogen lamp. Patients’ follow-up varied from 24 h to 12 months. All articles reported good outcomes with resolution of disease and no recurrences. Only one study reported adverse effects during treatment (burning and pain).
The results of this review suggest that PDT could be an effective treatment for herpes labialis. However, due to very few case reports and heterogeneity among protocols, there is a call for well-designed randomized clinical trials to confirm the efficacy of this therapy and to establish standardized protocols.
The review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD CRD42018108973.
The aim of this study was to compare the anesthetic efficacy of two volumes of articaine in conventional inferior alveolar nerve block (IANB) of mandibular molars with irreversible pulpitis, and in ...cases of anesthetic failure, its complementation with periodontal ligament injection (PDL).
Ninety patients with irreversible pulpitis in mandibular molars received conventional IANB with 1.8 mL or 3.6 mL of 4% articaine with 1:100,000 epinephrine. In cases of IANB failure, the same volumes were administered in the PDL. Presence of pulpal anesthesia and absence/presence of pain during pulpectomy were evaluated by electric pulp stimulation and verbal analogue scale, respectively. Relative risks (RR) with corresponding 95% confidence intervals (95% CI) were calculated for each outcome.
27% and 42% of the patients achieved pulpal anesthesia following IANB with 1.8 mL and 3.6 mL, respectively (RR = 0.63, CI 95% 0.35 to 1.14, p = 0.12). Analgesia during pulpectomy was present in 64% and 73% of the patients, respectively, for 1.8 mL and 3.6 mL (RR = 0.87, CI 95% 0.66 to 1.16, p = 0.36). In cases of IANB failure, 75% and 42% of the patients that received 1.8 mL and 3.6 mL of PDL injection, respectively, achieved pulpal anesthesia (RR = 1.80, CI 95% 0.87 to 3.72, p = 0.11). During a new attempt at the pulpectomy procedure, analgesia was present in 69% and 75% of the patients, respectively, for 1.8 mL and 3.6 mL (RR = 0.91, CI 95% 0.57 to 1.45, p = 0.71).
Increasing the volume from 1.8 mL to 3.6 mL of the 4% articaine with 1:100,000 epinephrine in the IANB and in the PDL, did not significantly increase the success rate of pulpal anesthesia and clinical analgesia during the pulpectomy procedure. Therefore, both volumes presented a similar efficacy, though neither resulted in effective pain control during irreversible pulpitis treatment.
ClinicalTrials.gov NCT02422823.
A peripheral nerve injury (PNI) can result in motor or sensory disorders. Low‐level laser therapy (LLLT) has demonstrated positive results as a treatment option for PNI. Wistar rats were divided into ...five groups: Control, Injury, Injury + LLLTn (nerve), Injury + LLLTm (muscle) and Injury + LLLTn + m (nerve and muscle irradiation). The groups were analyzed after one, two, three and four weeks. PNI was achieved by crushing the sciatic nerve. Laser treatment (780 nm, 3.2 J) was realized over the nerve and/or tibialis anterior muscle. In gait analyses, the groups irradiated over the nerve demonstrated an improvement after two weeks. In the analysis of mechanical sensitivity, the Injury + LLLTn demonstrated a reduction after one week in comparison with Injury group; the Injury + LLLTn + m and Injury + LLLTm demonstrated an increase after two weeks in comparison with Injury group; and the irradiated groups demonstrated a reduction in nociception after four weeks in comparison with Injury group. In the analysis of muscle atrophy, the Injury + LLLTn demonstrated more muscle mass after two weeks. LLLT improves functional aspects related to gait, mechanical sensitivity and muscle mass, with better results regarding motor aspects and muscle mass when administered over the injured nerve and better results regarding sensory aspects when administered over the muscle.
A peripheral nerve injury (PNI) can result in motor or sensory disorders. Methods: Wistar rats were divided into five groups: Control, Injury, Injury + LLLTn (nerve), Injury + LLLTm (muscle) and Injury + LLLTn + m (nerve and muscle irradiation). PNI was achieved by crushing the sciatic nerve and the animals were irradiated with low‐level laser therapy (LLLT) (780 nm, 3.2 J). Conclusion: LLLT improve functional aspects related to gait, mechanical sensitivity and muscle mass, with better results regarding motor aspects and muscle mass when administered over the injured nerve and better results regarding sensory aspects when administered over the muscle.
Lung fibrosis (LF) is a chronic and progressive lung disease characterized by pulmonary parenchyma progressive lesion, inflammatory infiltration, and interstitial fibrosis. It is developed by ...excessive collagen deposition and other cellular matrix components, resulting in severe changes in the alveolar architecture. Considering the absence of effective treatment, the aim of this study was to investigate the effect of photobiomodulation therapy (PBMT) on the development of PF. For this purpose, we used C57BL6 mice subjected to induction of LF by bleomycin administration (1.5 U/kg) by orotracheal route and, after 14 days of the induction, mice were treated with PBMT applied to the thorax 1×/day for 8 days (wavelength 660 ± 20 nm, power 100 mW, radiant exposure 5 J/cm
2
, irradiance 33.3 mW/cm
2
, spot size 2.8cm
2
, total energy 15 J, time of irradiation: 150 s) and inflammatory and fibrotic parameters were evaluated with or without PBMT. Our results showed that PBMT significantly reduced the number of inflammatory cells in the alveolar space, collagen production, interstitial thickening, and static and dynamic pulmonary elastance. In addition, we observed reduced levels of IL-6 e CXCL1/KC released by pneumocytes in culture as well as reduced level of CXCL1/KC released by fibroblasts in culture. We can conclude that the PBMT improves both inflammatory and fibrotic parameters showing a promising therapy which is economical and has no side effects.
The benefits of photobiomodulation (PBM) applied to wounds are well-described in the literature; however, its effects in skin graft donor sites have been poorly studied. The aim of this study is to ...evaluate the effects of LED PBM on re-epithelialization and wound quality of the skin donor site and on pain during repair process. This is a case series study that part of the patients received standard treatment and the others received standard treatment combined with PBM. Data collection was performed at the Burn Unit at a Public Hospital, Brazil. The study had 21 participants and 25 donor sites, 13 in the control group (conventional treatment with Membracel® bandage) and 12 in the experimental group (Membracel® + LED). Irradiation parameters were 1.53 J/cm
2
, 2.55 mW/cm
2
, 660 nm, 600 s in the immediate postoperative period as well as on the 1st, 3rd, 5th, and 7th days postoperatively. Pain was measured using the visual analog scale. The Bates-Jensen scale was used to monitor the re-epithelialization process and measurements were performed of donor skin sites in the postoperative period. Quantitative variables were expressed as mean ± standard deviation or median and interquartile range p25; p75. The comparison of the distribution of these variables between groups was performed using the Mann–Whitney test. No differences between groups were found for re-epithelialization time, area or quality of the wound. Regarding pain, a significant reduction was found on the 5
th
postoperative day in the experimental group compared to the control group. PBM did not induce changes in the re-epithelialization period, wound area or wound quality scores of the Bates-Jensen Scale but did induce a reduction in pain compared to the group treated with Membracel® alone.
The aim of this in vitro study, is to evaluate the penetration of a bioceramic root canal sealer into dentinal tubules at 3 mm and 5 mm from the apex after Nd:YAG laser irradiation.
Forty freshly ...extracted human mandibular premolars were prepared using Reciproc® and irrigated with 17% ethylenediaminetetraacetic acid (EDTA). Teeth were divided into 4 groups: group 1, obturated with control sealer (AH Plus®); group 2, obturated with bioceramic sealer (Endosequence BC Sealer®); group 3, Nd:YAG laser + control sealer (AH Plus®); and group 4, Nd:YAG laser + bioceramic sealer (Endosequence BC Sealer®). The samples were transversely sectioned 3 mm and 5 mm from the apex and examined using confocal laser scanning microscopy. Two parameters were measured: 1) sealer penetration into dentinal tubules of the root canal and 2) sealer penetration into the perimeter of the root canal walls.
Penetration analysis showed that bioceramic sealer had a higher penetration at depths of 3 and 5 mm than that of the control sealer, regardless of laser use (p <0.05). Perimeter analysis showed that there was no difference between both sealers at a depth of 3 mm (p <0.05), regardless of laser use. At a depth of 5 mm, bioceramic sealer and laser showed a greater perimeter of penetration (p <0.05) than the control sealer.
The use of Nd:YAG laser did not compromise the penetration of bioceramic sealer into dentinal tubules of root canals at 3 mm and 5 mm from the apex.
This study aimed to evaluate the effect of antimicrobial photodynamic therapy (aPDT) and the use of probiotics on the treatment of halitosis. Fifty-two participants, aged from 18 to 25 years, ...exhaling sulfhydride (H.sub.2 S) greater than or equal to 112 ppb were selected. They were allocated into 4 groups (n = 13): Group 1: tongue scraper; Group 2: treated once with aPDT; Group 3: probiotic capsule containing Lactobacillus salivarius WB21 (6.7 x 10.sup.8 CFU) and xylitol (280mg), 3 times a day after meals, for 14 days; Group 4: treated once with aPDT and with the probiotic capsule for 14 days. Halimetry with gas chromatography (clinical evaluation) and microbiological samples were collected from the dorsum of the tongue before and after aPDT, as well as after 7, 14, and 30 days. The clinical data failed to follow a normal distribution; therefore, comparisons were made using the Kruskal-Wallis test (independent measures) and Friedman ANOVA (dependent measures) followed by appropriate posthoc tests, when necessary. For the microbiological data, seeing as the data failed to follow a normal distribution, the Kruskal-Wallis rank sum test was performed with Dunn's post-test. The significance level was alpha = 0.05. Clinical results (halimetry) showed an immediate significant reduction in halitosis with aPDT (p = 0.0008) and/or tongue scraper (p = 0.0006). Probiotics showed no difference in relation to the initial levels (p = 0.7530). No significant differences were found in the control appointments. The amount of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola were not altered throughout the analysis (p = 0.1616, p = 0.2829 and p = 0.2882, respectively). There was an immediate clinical reduction of halitosis with aPDT and tongue scraping, but there was no reduction in the number of bacteria throughout the study, or differences in the control times, both in the clinical and microbiological results. New clinical trials are necessary to better assess the tested therapies.
Canine Alopecia X is a non-inflammatory hair loss disorder of unknown etiology that predominantly affects German Spitz dogs. Treatment modalities include hormone and/or melatonin supplementation and ...low trauma microneedling. Melatonin influences hair growth and pigmentation in several species and presents a low risk of adverse effects when used in dogs with Alopecia X. Photobiomodulation (PBM) is frequently used in human androgenetic alopecia and alopecia areata; despite this, PBM remains unexplored in canine Alopecia X. To address this knowledge gap, sixty dogs of both sexes will be randomly assigned to three groups: (i) melatonin only group (3 mg/Kg, n = 20); (ii) PBM only group (diode laser, wavelength 660nm, 100mw power, with 3 J/point, 2 sessions/week for 3 months, n = 20); (ii) PBM + melatonin group (n = 20). The objective is to determine the potential of PBM alone or in conjunction with melatonin supplementation in promoting hair regrowth (hair density and diameter) by means of dermatoscopy and planimetry over a period of 90 days.
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