Oral Mucositis (OM) is an inflammatory alteration of the mucosa primarily due to the damage resulting of cytotoxic effects of radiotherapy, chemotherapy, bone marrow transplantation and stem cell transplantation. The use of photobiomodulation (PBM) therapy for oral mucositis is intended to reduce or prevent lesions from manifesting. However, there is no consensus on the treatment dosimetry based on higher treatment success rates, and no exact cause of treatment success or failure has been found for large groups of patients. Therefore, optimizing treatment protocols and investigating causes affecting treatment outcomes is of paramount importance to decrease pain, hospitalization time, death rates of oncological patients while giving them improved quality of life via nutrition without pain. This case study shows a successful example of the treatment outcome of a new PBM therapy protocol for OM where we concluded that PBM therapy can be used as a potentially effective preventive and curative treatment of OM.
Trigeminal neuralgia (TN) is considered one of the most severe and most common facial pain. TN is characterized by a pain similar to an electric shock or sharp pain, restricted to one or more branches of the trigeminal nerve. TN can develop from idiopathic causes, and/or may be related to other conditions such as neoplasms, multiple sclerosis, nerve impairments. The most used TN treatments are drug or surgical therapies. However, both can cause side effects. A potential alternative or complementary TN treatment is low-level laser therapy (LLLT), which is known to control different types of pain. LLLT use in the treatment of trigeminal neuralgia as an adjunct to drug therapy has shown considerably positive results in previous studies. Our work evaluated the results achieved in the drug treatment associated with LLLT at red (660 nm) and infrared (808 nm) wavelengths based on a clinical case report of a TN patient. The Recover® and Vacumlaser® (MMOptics, São Carlos, SP, Brazil) devices were used, with applications in the region of the trigeminal nerve branches, three times a week, according to the protocol developed by researchers at the Physics Institute of São Carlos (IFSC-USP). The treatment outcome was assessed at every session regarding the patient’s progression. The clinical outcome observed was outstanding, resulting in a reduction of between 50-100% of the dosage of every medicine prescribed. We hypothesize that such result occurred due to photobiomodulation effects providing neuroprotection through anti-inflammatory, analgesic and antioxidant pathways, which can promote the metabolic homeostasis necessary for the reestablishment of tissue function.
Tooth whitening has grown as one of the most requested dental procedures as the public continuously demands whiter smiles for appearance enhancement. This demand resulted in many options of home-based products (toothpastes, films, gels) and in-office-based products based on concentrated bleaching agents (typically hydrogen peroxide and carbamide peroxide) to be applied under professional supervision. However, protocols involving bleaching agents may increase tooth demineralization, tooth-surface roughening/softening, as well as degradation of dental restorations. Violet illumination alone has been proposed as an alternative to reduce tooth sensitivity while keeping desired whitening effects. In this study, we assessed the effectiveness of whitening treatments using violet illumination (VI) alone or combined with 35% hydrogen peroxide (HP) gel, as well as cleaning teeth with and without mineral oil. This assessment was performed by calculating whiteness and yellowness indexes based on the color change for the experimental groups: control, VI alone (VI group), VI with 35% HP gel (VI + HP group), violet illumination without 35% HP gel and cleaned with mineral oil before washing (VI + HP + oil group). All procedures were performed in 16 bovine teeth (1) stored in 5% thymol solution immediately after extraction, (2) subsequently cleaned and (3) stained with instant coffee solution for 24 hours (except by the control group). Our results suggested that the VI + gel whitening treatment was able to completely restore the teeth whiteness while lowering its yellowness by 31.2% compared to the control group. The VI + oil treatment was 3.7 times more effective in increasing whiteness and decrease yellowness compared to VI treatment. The performance of whitening treatments could potentially be increased by cleaning the tooth surface with mineral oil. The VI + gel treatment should be recommended against coffee stains and potentially investigated for stain types in future research.
Accurate color assessment is still a challenge for food-industrial applications and dental aesthetics. Even though current tooth color determination relies mostly on visual shade matching with shade guides, the technological advancements move towards objective tooth color assessment by using instruments such as colorimeters, spectrophotometers and digital cameras. Objective assessment of tooth color improves the communication between the professionals including clinicians, dentists, laboratory technicians and equipment designers. Tooth color can be evaluated by calculation of whiteness and yellowness indexes. Precise determination of these indexes is particularly important in dentistry, where monitoring the quality of dental restoration and the tooth appearance during whitening treatments is essential for improving the patient outcome. In this study, we evaluated the effect of tooth staining and a whitening treatment using violet illumination alone on yellowness and whiteness indexes. These indexes were quantified by colorimetry and digital photography, which were compared in terms of absolute values of the indexes and variation due to staining and whitening procedures. The violet illumination was capable of generating (36 ± 2) % of W* whiteness index recovery and (41 ± 2) % decrease on the YIE313 yellowness index. Even though the absolute W* and YIE313 values are relatively close for photographic and colorimetric methods, the indexes contrast were (37.3 ± 0.01) % and (12.8 ± 0.1) % lower for digital photography compared to colorimetry. We believe our study can be used as a guide for the evaluation of the color contrast generated on whitening monitoring devices in future studies.
The assessment of tooth color is typically performed by subjective comparison with a visual shade guide or by using objective optical techniques such as quantitative light-induced fluorescence (QLF). QLF measurements rely on the precise wavelength calibration of fluorescence excitation and emission for enhancing the contrast between the white sound tooth and stained areas. These areas may change the fluorescence emission differently depending on the color that is most absorbed by the stain on the tooth surface. Although previous studies have monitored the staining contrast generated by the consumption of beverages on teeth, the information provided is based on total intensity. However, this intensity varies from each QLF device configuration and comparison across studies may not be possible. Few studies report the wavelength-dependent characterization of the staining process, which allow the comparison on the light attenuation on specific wavelengths and can be used to design fluorescence equipment with improved contrast for the tooth color assessment. In this study, we quantified the fluorescence spectral features (fluorescence intensity, wavelength shift of the maximum intensity, full width at half maximum, and wavelength-dependent intensity attenuation) of teeth in several degrees of coffee pigmentation by using 445 nm excitation. Most of the pigmentation effect was observed on the fluorescence intensity and a linear behavior was observed for the full width at half maximum (around 11.8% increase for each pigmentation level). We characterized the fluorescence properties of each degree of pigmentation level. Both spectral features and fluorescence properties can be used to design novel fluorescence equipment capable of increasing the contrast between white and stained teeth.
Tooth whitening treatment is a very common dentistry application for appearance enhancement. The importance of teeth appearance and color has attracted industrial interest in developing many products for consumers and professional users. However, standardizing a protocol for application of these products is difficult due to a high biological variability of the teeth color and structure. This creates a need for an objective method for monitoring of teeth shades. Current objective evaluation comprises colorimetric, spectroscopic, and imaging analysis, mostly based on reflectance and fluorescence techniques. Previous studies monitor total fluorescence intensity for this purpose, since it can take into account the effect of fluorescent agents in dental tissues. On the other hand, few spectroscopic studies investigate the processes that generate the variation in the fluorescence intensity due to staining or teeth whitening. These processes can be understood by using fluorescence spectroscopy, which has potential to be used with fluorescence imaging techniques to improve the assessment of teeth shade. This study aims to use fluorescence spectroscopy as a tool to assess tooth whitening, especially using a recently developed light-induced method using violet LED illumination. Our results show a decrease of 37.4% in the total fluorescence intensity between 450 nm and 750 nm after coffee staining. After the whitening treatment, this intensity increased 11% compared to the emission before staining. Observed spectral changes suggest the changes due to the whitening method used in this study. Also, this illustrates the potential of light-induced whitening for minimally or non-invasive whitening.
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