Maria Alves Garcia Santos Silva

THE PREVENTION OF INDUCED ORAL MUCOSITIS WITH LOW-LEVEL LASER THERAPY IN BONE MARROW TRANSPLANTATION PATIENTS: A RANDOMIZED CLINICAL TRIAL

BACKGROUND DATA AND OBJECTIVE Patients who have received high doses of chemotherapy, either alone or in combination with total body irradiation often cite oral mucositis (OM) as the most debilitating side effect. The aim of this study was to investigate the clinical effects of low-level laser therapy (LLLT) on the prevention of conditioning-induced OM in hematopoietic stem cell transplantation (HSCT). METHODS We randomized 42 patients who underwent autologous or allogeneic HSCT. A low-level InGaAlP diode laser was used, emitting light at 660 nm, 40 mW, and 4 J/cm(2). An evaluation of OM was carried out using the World Health Organization scale. RESULTS AND CONCLUSION In the LLLT group, 57.1% of patients had an OM grade 0, 9.6% had grade 1, and 33.3% had grade 2, whereas in the control group, only 4.8% of patients were free of OM (grade 0). Our results indicate that the preventive use of LLLT in patients who have undergone HSCT is a powerful instrument in reducing OM incidence.

Dehiscence and fenestration in patients with Class I and Class II Division 1 malocclusion assessed with cone-beam computed tomography

INTRODUCTION The aim of this study was to compare the presence of alveolar defects (dehiscence and fenestration) in patients with Class I and Class II Division 1 malocclusions and different facial types. METHODS Seventy-nine Class I and 80 Class II patients with no previous orthodontic treatment were evaluated using cone-beam computed tomography. The sample included 4319 teeth. All teeth were analyzed by 2 examiners who evaluated sectional images in axial and cross-sectional views to check for the presence or absence of dehiscence and fenestration on the buccal and lingual surfaces. RESULTS Dehiscence was associated with 51.09% of all teeth, and fenestration with 36.51%. The Class I malocclusion patients had a greater prevalence of dehiscence: 35% higher than those with Class II Division 1 malocclusion (P <0.01). There was no statistically significant difference between the facial types. CONCLUSIONS Alveolar defects are a common finding before orthodontic treatment, especially in Class I patients, but they are not related to the facial types.

Effective dosages for recording Veraviewepocs dental panoramic images: analog film, digital, and panoramic scout for CBCT

OBJECTIVE The aim of this study was to evaluate the effective doses from analog film, panoramic digital, and panoramic scout for cone-beam computerized tomography (CT). STUDY DESIGN Three different types of Veraviewepocs machines were investigated: Veraviewepocs Conventional, Veraviewepocs Digital, and Veraviewepocs 3D (Morita, Kyoto, Japan). Organ absorbed doses were measured using an anthropomorphic phantom loaded with thermoluminescent dosimeters (TLD 100H) at 16 sites located in sensitive organs. The resulting effective organ doses (muSv) were compared by descriptive statistics. RESULTS The highest value (5.2 muSv) was for Veraviewepocs Conventional. The Veraviewepocs Digital (2.7 muSv) and Veraviewepocs 3D (2.95 muSv) presented low effective doses in the same range. CONCLUSIONS The panoramic digital system delivered the least radiation dose. The use of the panoramic scout for cone-beam CT was marginally higher in dose than its 2D counterpart.

Effect of low level laser therapy in the reduction of oral complications in patients with cancer of the head and neck submitted to radiotherapy.

The aim of this study was to assess the effect of low level laser therapy on reducing the occurrence and severity of oral complications in patients with head and neck cancer undergoing radiotherapy. Sixty head and neck cancer outpatients from a cancer hospital receiving radiotherapy were selected and randomly assigned into two groups. The laser group was irradiated with an InGaAlP laser and the control received sham laser. The assessment of complications (oral mucositis, pain) was carried out one week after starting radiotherapy, and at the fifteenth and thirtieth sessions of radiotherapy. All patients from both groups showed some degree of oral mucositis. Better outcomes were observed in the laser group when compared with the control in the follow-up sessions, indicating lower degrees of oral mucositis, pain and higher salivary flow (p < .05). These findings support the use of laser therapy as an adjuvant treatment for the control of oral complications.

Changes in the pre-surgical treatment planning using conventional spiral tomography

OBJECTIVE To investigate variation in the pre-surgical treatment planning after using conventional spiral tomography in addition to conventional radiographic exams. MATERIAL AND METHODS Twenty-nine partial or fully edentulous patients referred to implant therapy were selected and submitted to periapical, panoramic and conventional cross-sectional tomography exams. Pre-surgical treatment planning of 120 potential implant sites in 69 edentulous areas was performed by two independent experienced dental implant surgeons. After clinical examination, pre-surgical planning was made using only periapical and panoramic exams. Examiners were requested to reformulated initial planning after assessing tomographic images. Four treatment parameters were evaluated: length and width of implants, need of bone grafting and need of other surgical procedures. RESULTS Implant length and width remained unchanged in 60.2% and 87.2% of cases, respectively. No difference in length (P=0.576) and width (P=1) scores was observed in treatment planning with and without tomography. Variation in implant dimension was not affected by location of edentulous areas. Bone grafting and other surgical procedures significantly changed after tomograms (P<0.001), independent of the location of edentulous areas. In 15.8% and 5.3% of cases bone grafting and other procedures were planned only after tomograms, respectively. Significant differences were observed in all maxillary and mandibular regions. CONCLUSION Conventional spiral tomography plays an important role in pre-surgical treatment planning, increasing clinicians certainty of the need of additional surgical procedures (bone grafting, sinus lifting, and others) in pre-surgical treatment stage.

Melanotic Neuroectodermal Tumor of Infancy: Report of 2 Cases

6. Gallego L, Junquera L, Villarreal P, et al: Spontaneous fracture of the mandibular genial tubercles: A case report. Med Oral Patol Oral Cir Bucal 12:E599, 2007 7. Yassutaka F, Yaedú R, Regina F, et al: Spontaneous fracture of genial tubercles: Case report. Quintessence Int 37:737, 2006 8. Shohat I, Shoshani Y, Taicher S: Fracture of the genial tubercles associated with a mandibular denture: A clinical report. J Prosthet Dent 89:232, 2003 9. Burnett CA, Clifford TJ: A case of fractured genial tubercles. Dent Update 20:219, 1993, 1993 0. Santos-Oller JM, Junquera Gutierrez LM, De Vicente Rodriguez JC, et al: Spontaneous fracture of hypertrophied genial tubercles. S Oral Surg Oral Med J Oral Pathol 74:28, 1992 1. Youngs R, Albert D: Fractured genial tubercles. J Laryngol Otol 98:1047, 1984

Influence of voxel size on cone-beam computed tomography-based detection of vertical root fractures in the presence of intracanal metallic posts

Purpose This study was performed to evaluate the influence of voxel size and the accuracy of 2 cone-beam computed tomography (CBCT) systems in the detection of vertical root fracture (VRF) in the presence of intracanal metallic posts. Materials and Methods Thirty uniradicular extracted human teeth were selected and randomly divided into 2 groups (VRF group, n=15; and control group, n=15). The VRFs were induced by an Instron machine, and metallic posts were placed in both groups. The scans were acquired by CBCT with 4 different voxel sizes: 0.1 mm and 0.16 mm (for the Eagle 3D V-Beam system) and 0.125 mm and 0.2 mm (for the i-CAT system) (protocols 1, 2, 3, and 4, respectively). Interobserver and intraobserver agreement was assessed using the Cohen kappa test. Sensitivity and specificity were evaluated and receiver operating characteristic analysis was performed. Results The intraobserver coefficients indicated good (0.71) to very good (0.83) agreement, and the interobserver coefficients indicated moderate (0.57) to very good (0.80) agreement. In respect to the relationship between sensitivity and specificity, a statistically significant difference was found between protocols 1 (positive predictive value: 0.710, negative predictive value: 0.724) and 3 (positive predictive value: 0.727, negative predictive value: 0.632) (P<.05). The least interference due to artifact formation was observed using protocol 2. Conclusion Protocols with a smaller voxel size and field of view seemed to favor the detection of VRF in teeth with intracanal metallic posts.