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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
91

Risk indicators for mucositis and peri-implantitis: results from a practice-based cross-sectional study

Nordlohne, Marc 10 August 2021 (has links)
Purpose: This practice-based cross-sectional study aimed to investigate whether common risk indicators for peri-implant diseases were associated with peri-implant mucositis and peri-implantitis in patients undergoing supportive implant therapy (SIT) at least 5 years after implant restoration. Methods: Patients exclusively restored with a single implant type were included. Probing pocket depth (PPD), bleeding on probing (BOP), suppuration, and radiographic bone loss (RBL) were assessed around implants. The case definitions were as follows: peri-implant mucositis: PPD ≥4 mm, BOP, no RBL; and peri-implantitis: PPD ≥5 mm, BOP, RBL ≥3.5 mm. Possible risk indicators were compared between patients with and without mucositis and peri-implantitis using the Fisher exact test and the Wilcoxon rank-sum test, as well as a multiple logistic regression model for variables showing significance (P<0.05). Results: Eighty-four patients with 169 implants (observational period: 5.8±0.86 years) were included. A patient-based prevalence of 52% for peri-implant mucositis and 18% for peri-implantitis was detected. The presence of 3 or more implants (odds ratio [OR], 4.43; 95 confidence interval [CI], 1.36–15.05; P=0.0136) was significantly associated with an increased risk for mucositis. Smoking was significantly associated with an increased risk for peri-implantitis (OR, 5.89; 95% CI, 1.27–24.58; P=0.0231), while the presence of keratinized mucosa around implants was associated with a lower risk for peri-implantitis (OR, 0.05; 95% CI, 0.01–0.25; P<0.001). Conclusions: The number of implants should be considered in strategies to prevent mucositis. Furthermore, smoking and the absence of keratinized mucosa were the strongest risk indicators for peri-implantitis in patients undergoing SIT in the present study.:1. Einführung 1.1 Definition und Erkrankungen peri-implantärer Gewebe 1.2 Prävalenz peri-implantärer Entzündungen 1.3 Einfluss- bzw. Risikofaktoren 1.4 Prävention peri-implantärer Erkrankungen 1.5 Zielsetzung und Fragestellung 2. Publikationsmanuskript 3. Zusammenfassung der Arbeit 4. Literatur 5. Wissenschaftliche Präsentationen 6. Darstellung des eigenen Beitrags 7. Erklärung über die eigenständige Abfassung der Arbeit 8. Danksagung
92

La protéine de couche de surface SlpB assure la médiation de l’immunomodulation et de l’adhésion chez le probiotique Propionibacterium freudenreichii CIRM-BIA 129. / Surface layer protein SlpB mediates immunodulation and adhesion in the probiotic Propionibacterium freudenreichii CIRM-BIA 129.

Rosa do carmo, Fillipe Luiz 06 September 2018 (has links)
Propionibacterium freudenreichii est une bactérie Gram-positive bénéfique, traditionnellement utilisée comme levain d’affinage fromager, qui bénéficie du statut GRAS (Generally Recognized As Safe). P. freudenreichii a révélé un effet immunomodulateur qui a été confirmé in vivo par la capacité à protéger des souris d’une colite aigüe induite. L’effet anti-inflammatoire est cependant hautement souche-dépendant. Il est dû, au moins en partie, à des composés de surface clés qui favorisent ces effets probiotiques. Les bactéries Gram-positives, y compris P. freudenreichii, peuvent être recouvertes d’une couche extérieure protéique, appelée « surface-layer », paracristalline, et formée par l’autoassemblage de protéines dites de S-layer (Slps). Les Slps, dans différentes bactéries, sont impliquées dans plusieurs caractéristiques probiotiques, telles que l’adhésion aux cellules de l’hôte et au mucus, la persistance dans l’intestin, ou encore l’immunomodulation. Le but de cette étude est d’étudil’immunomodulation. Le but de cette étude est d’étudier, chez une souche probiotique de P. freudenreichii, la protéine de surface qui joue le principal rôle dans les interactions probiotiques avec l’hôte. La souche P. freudenreichii CIRM-BIA 129, récemment reconnue comme immunomodulatrice prometteuse, possède plusieurs protéines de surface Slps, y compris SlpB. Dans la présente étude, l’inactivation du gène correspondant, dans la souche mutante CB129¿slpB, a provoqué une baisse drastique de l’adhésion aux cellules intestinales épithéliales HT-29, confirmant le rôle clé des Slps dans l’adhési / Propionibacterium freudenreichii is a beneficial Gram-positive bacterium, traditionally used as a cheese ripening starter, with the GRAS status (Generally Recognized As Safe). P. freudenreichii has revealed an immunomodulatory effect confirmed in vivo by the ability to protect mice from induced acute colitis. The anti-inflammatory effect is however highly strain-dependent and due, at least in part, to key surface compounds favouring probiotic effects. Gram-positive bacteria, including P. freudenreichii, can be covered with an external proteinaceous layer called a surface-layer paracrystalin layer and formed by the self-assembly of surface-layer-proteins (Slps). Slps were shown, in different bacteria, to be involved in several probiotics traits, such as adhesion to host cells and mucus, persistence within the gut, or immunomodulation. The aim of this study is to investigate, in a P. freudenreichii probiotic strain, the surface protein that plays the main role in the probioticinteraction with the host. The P. freudenreichii CIRM-BIA 129 strain recently revealed promising immunomodulatory properties and possesses several Slps, including SlpB. In the presented work, inactivation of the corresponding gene, CB129¿slpBa mutant strain, caused a drastic decrease in adhesion to intestinal epithelial HT-29 cells, further evidencing the key role of Slps in cell adhesion. we investigated immune response of HT-29 cells towards P. freudenreichii CIRM-BIA 129 and CB129¿slpB. The wild type strain mainly induced expression of the immunomodulatory IL-10 by the cells. Interestingly, th
93

Interaktion einer Blockade des Rezeptors für den Epidermalen Wachstumsfaktor (EGFR) mit der Gabe von Keratinozyten-Wachstumsfaktor (KGF) bei der Strahlenreaktion der Mundschleimhaut – tierexperimentelle Untersuchungen an Mäusen

Fehrmann, Astrid 03 February 2010 (has links)
Bei der Strahlentherapie fortgeschrittener Tumoren im Kopf-Hals-Bereich gilt die radiogene Mucositis enoralis als schwerwiegende und dosislimitierende frühe Nebenwirkung. Sehr häufig führt sie zu einer Unterbrechung der Behandlung, mit der Folge einer Reduktion der Tumorheilungschancen. Während einer fraktionierten Strahlenexposition kommt es in der Mundschleimhaut zu einer erhöhten Expression des Epidermalen Wachstumsfaktors (Epidermal Growth Factor, EGF) und dessen Rezeptors (EGFR). Durch eine Blockade des EGFR, als anerkannte Strategie zur Verbesserung der Tumorheilung, besteht deshalb die Gefahr, dass es zu einer Verschlimmerung der Schleimhaut-Nebenwirkungen kommt. Der Einsatz von Keratinozyten-Wachstumsfaktor (KGF) zeigt positive Ergebnisse bezüglich einer Reduktion der Schleimhautveränderungen. In dieser Arbeit wird deshalb im Tiermodell einerseits die Auswirkung einer Blockade des EGFR auf die Schleimhautreaktion, und andererseits eine mögliche Interaktion der Blockade mit der schleimhautschützenden Wirkung von KGF untersucht. Insgesamt kann keine signifikante Veränderung der Schleimhauttoleranz durch die EGFR-Inhibition mittels BIBX1382BF innerhalb der ersten beiden Wochen einer fraktionierten Bestrahlung festgestellt werden; lediglich das Auftreten ulzerativer Läsionen nach der zweiten Woche ist vorverlagert
94

Investigations on the microbial community associated with peri-implantitis in smokers and non-smokers.

Tsigarida, Alexandra 28 August 2013 (has links)
No description available.
95

Head and Neck Radiotherapy Induces a Transcriptional Profile Associated with Inflammation and Damage

Dillon, John T. January 2021 (has links)
No description available.
96

METAGENOMIC ANALYSIS OF THE DEVELOPING PERI-IMPLANT SULCUS

Robitaille, Nicolas 08 October 2015 (has links)
No description available.
97

Assessment of students knowledge regarding patients suffering from microbial induced peri-implant diseases. Survey Study at the Faculty of Odontology, Malmö University

Johansson, Johanna, Stolic, Nicole January 2017 (has links)
SyfteSyftet med studien var att undersöka vilken kunskap sistaårs tandläkarstudenter och sista-termins tandhygieniststudenter vid Odontologiska Fakulteten, Malmö Högskola har gällande diagnos, behandling och prognos av periimplantära sjukdomar.Material och MetodEn pappersenkät sammanställdes och delades ut till sistaårs tandläkar- och tandhygieniststudenter vid Odontologiska Fakulteten, Malmö Högskola.I enkäten inkluderades bakgrundsfrågor gällande erfarenhet av implantatinstallation samt implantatprotetik, kunskap om hur vävnaderna kring ett implantat undersöks, diagnostiska kriterier för periimplantär sjukdom, och prognos. Enkäten inkluderade även fyra unika fall.Resultat97 av 119 enkäter delades ut, 83 av 97 enkäter returnerades. Studien visade att studenterna i hög grad föreslår korrekt diagnos, behandlingsplan, och prognos. Resultaten visar även osäkerhet vid självutvärdering av den ställda prognosen.SlutsatsStudenterna angav i hög grad korrekt behandling, men att de träffar få patienter med periimplantär sjukdom under utbildningen. Studenterna är osäkra vilket resulterar i variationer mellan studenter gällande diagnos, behandling, och prognosbedömning vid periimplantär sjukdom.Majoriteten av studenterna föreslog att det är patientens nuvarande tandläkare som är ansvarig för uppföljning/utvärdering av implantatet. Detta är det mest lämpliga förslaget tack vare regelbundna kontroller till samma tandläkare (nuvarande).Då implantat används mer frekvent som ersättning för förlorade tänder finns ett behov av mer utbildning och färdighetsträning inom området vid Odontologiska Fakulteten, Malmö Högskola. / AimThe aim of this study is to examine the knowledge of last-year dental students and last semester dental hygienist students at the Faculty of Odontology, Malmö University regarding diagnosis, treatment, and prognosis of peri-implant diseases. Material and MethodA paper case based survey study was conducted and handed out among last-year dental and dental hygienist students at the Faculty of Odontology, Malmö University.The survey included background questions regarding experience of implant installation and implant prosthetics, and knowledge about how an examination is conducted, diagnostic criteria for peri-implant diseases, and prognosis. The survey also included four unique cases.Results97 of 119 surveys were handed out, 83 of 97 surveys were returned. The study showed that students to a high degree suggests a correct diagnosis, treatment plan and prognosis. The results also shows insecurities when self-evaluating the prognosis.ConclusionThe students planned the correct treatment, to a high degree, but they encounter few patients with peri-implant diseases during their education. The students are insecure, resulting in inter-student disagreement regarding diagnosis, treatment and assessment of prognosis of peri-implant diseases.The majority suggested the patients current dentist as responsible for follow-ups/evaluation, which also is the most appropriate suggestion because of regular check-ups to the same (current) dentist.Because implants are used more frequently as a replacement for lost teeth there is a need for more education and training in this area at the Faculty of Odontology, Malmö University.
98

Modulation von Differenzierungsprozessen in der Mundschleimhaut (Maus) durch Inhibition des epidermalen Wachstumsfaktor-Rezeptors (EGFR): Immunhistochemische Untersuchungen

Straube, Kathleen 09 November 2017 (has links)
Die strahleninduzierte Mucositis enoralis ist eine der bedeutendsten und häufig dosislimitierenden frühen Nebenwirkungen der Strahlentherapie fortgeschrittener Kopf Hals Tumoren. Bis heute hat sich noch kein allgemein gültiges Konzept zur Therapie und Prophylaxe der Mundschleimhautentzündung durchsetzen können. Ein Ansatz zur selektiven, auf der Tumorbiologie beruhenden Beeinflussung der Strahlenempfindlichkeit von Tumoren ist die Blockade des epidermalen Wachstumsfaktor-Rezeptors (EGFR). In Kombination mit Strahlentherapie sollen so die lokale Tumorkontrolle und die Heilungschancen verbessert werden. Die Wirkung der Tyrosinkinase-Inhibitoren BIBX1382BF und Erlotinib auf histomorphologische Parameter in der Mundschleimhaut sowie auf die Expression der als Stammzellmarker diskutierten Proteine p63, Integrin β1 und CD44 wurde in der vorliegenden Arbeit im Vergleich zur alleinigen fraktionierten Bestrahlung untersucht. Für die histologischen Studien erfolgte die zweiwöchige fraktionierte Bestrahlung der Schnauzen von Mäusen des Inzuchtstammes C3H/Neu mit zehn Fraktionen zu je 3 Gy (Tag 0-4, Tag 7-11). Die Versuche gliederten sich in vier Gruppen: • I/A (54 Tiere) und II/A (40 Tiere): fraktionierte Bestrahlung, keine weitere Behandlung • I/B (51 Tiere): fraktionierte Bestrahlung, zusätzlich orale Gabe von BIBX1382BF, 50 mg/kg KG per os, von Tag 0-14 je 30 min nach der Bestrahlung • II/B (35 Tiere): fraktionierte Bestrahlung, zusätzlich orale Gabe von Erlotinib, 50 mg/kg KG per os, von Tag 0-11 je 30 min nach der Bestrahlung. Die Entnahme der Zungen erfolgte im Versuch I bei jeweils drei Tieren pro Tag von Tag 0 bis Tag 17. Im Versuch II wurden an den Tagen 0, 2, 4, 6, 8, 10, 12 und 14 jeweils die Zungen von fünf Tieren entnommen. Anschließend folgten die Fixierung der Zungen in Formalin, die Einbettung in Paraffin und die Anfertigung 3 µm dicker Gewebeschnitte. Die Zungenpräparate wurden für die histologischen Untersuchungen mit Hämatoxylin-Eosin gefärbt. Für die immunhistochemischen Färbungen wurde die ABC-Methode eingesetzt. Das Epithel der Zungenunterseite wurde lichtmikroskopisch hinsichtlich Zellzahl, Schichtdicke und Expression der potentiellen Stammzellmarker p63, Integrin β1 und CD44 ausgewertet. Aufgrund der geringen Gruppengröße (Versuch I: drei Tiere pro Datenpunkt; Versuch II: fünf Tiere pro Datenpunkt) wurde auf eine eingehende statistische Testung verzichtet. Die vorliegende Arbeit beschränkt sich auf eine beschreibende Darstellung des Verlaufs der Einzelparameter über den Gesamtzeitraum. Die Zellzahlen verringerten sich während der ersten Bestrahlungswoche auf 60-70 % der Ausgangswerte, stagnierten in der zweiten Woche und stiegen schließlich bis zum Ende der Nachbeobachtung wieder an. Zwischen den nur bestrahlten und den zusätzlich mit BIBX1382BF behandelten Tieren war kein Unterschied feststellbar. Ein gleichsinniger Verlauf war auch in Versuch II zu beobachten, wobei die Zellzahlen der mit Erlotinib behandelten Tiere in der Funktionsschicht durchgängig höher ausfielen als in Versuchsreihe A. Die Dicke des Gesamtepithels bzw. der einzelnen Epithelschichten zeigte im Versuch I unter Bestrahlung große individuelle Schwankungen. Unter zusätzlicher BIBX1382BF-Gabe wurden oft niedrigere Werte gemessen. Im Versuch II blieb die Dicke des Gesamtepithels unter Fraktionierung konstant. Von Tag 0-12 wurden bei zusätzlicher Erlotinib-Applikation geringere Werte der Gesamtdicke gemessen als unter alleiniger Bestrahlung, ansonsten fielen die Veränderungen der Epitheldicke unabhängig von der Erlotinib-Gabe gering aus. Der kurzzeitigen, mit dem allgemeinen Zellverlust einhergehenden Verringerung der p63-Expression zu Beginn der Bestrahlung folgt bis zum Ende des Beobachtungszeitraumes die Normalisierung der p63-positiven Zellen. Mit EGFR-Blockade sind gegenüber der alleinigen Bestrahlung keine Unterschiede in der p63-Expression festzustellen. Die Integrin β1-Expression nahm im Verlauf der Bestrahlung ab. Unter EGFR-Blockade mit BIBX1382BF zeigte sich an den Tagen 2-9 und 12-16 ein schwächeres Färbesignal als im fraktioniert bestrahlten Epithel, was für eine mögliche Interaktion des EGF-Rezeptors mit Integrin β1 spricht. Im Versuch II waren unabhängig von der Erlotinib-Gabe keine Unterschiede in der Expression von Integrin β1 feststellbar. Die CD44-Expression im Epithel wurde durch Bestrahlung gefördert. Übereinstimmend konnte in der vorliegenden Arbeit in beiden Versuchen eine Steigerung der CD44-Färbeintensität über den jeweiligen Referenzbereich festgestellt werden. Eine Blockade der EGFR-Aktivität durch Erlotinib reduzierte die Expression von CD44, wie in Versuch II/B im initialen Abfall der CD44-Färbeintensität deutlich wurde. Doch schon ab Tag 4 wurden im Versuch II/A und II/B gleich starke Färbesignale für CD44 erfasst. Insgesamt ergaben sich unter EGFR-Inhibition mittels BIBX1382BF oder Erlotinib keine Hinweise auf Veränderungen der untersuchten Parameter während einer zweiwöchigen fraktionierten Bestrahlung. Ob diese Ergebnisse auch auf andere Tyrosinkinase-Inhibitoren bzw. unterschiedliche Wirkstoffklassen (z. B. Anti-EGFR-Antikörper) übertragbar sind, muss in weiteren Studien untersucht werden. / Radiation-induced oral mucositis is one of the most important and often dose limiting early side effects of radiotherapy of advanced tumours in the head-and-neck region. To this day, no general concept for therapy and prophylaxis of the oral mucositis has been established. The inhibition of the epidermal growth factor receptor (EGFR) is one approach to a selective increase of the radiosensitivity of tumours based on the tumour biology. In combination with radiotherapy, application of EGFR-inhibitors is supposed to increase the local tumour control and the chances of cure. The aim of the present study was to investigate the effect of the tyrosine kinase inhibitors BIBX1382BF and Erlotinib on the radiation response of the oral mucosa and on the expression of different proteins that are discussed to be markers of epithelial stem cells. For the histological studies, the snouts of C3H/Neu mice were irradiated with ten daily fractions of 3 Gy over two weeks (on days 0-4, 7-11). The experiments comprised four treatment groups: • I/A (54 animals) and II/A (40 animals): fractionated irradiation, no further treatment • I/B (51 animals): fractionated irradiation, administration of BIBX1382BF, 50 mg/kg per os, once daily (days 0-14) 30 min after the radiation treatment • II/B (35 animals): fractionated irradiation, administration of Erlotinib, 50 mg/kg per os, once daily (days 0-11) 30 min after the radiation treatment. Between day 0 and 17, three animals of the groups I/A and I/B were euthanised per day. In the experimental arms II/A and II/B five mice were killed on day 0, 2, 4, 6, 8, 10, 12 and 14, respectively. The tongues were excised, fixed in formalin, embedded in paraffin and 3 µm thick sections were prepared. Subsequently, the tongue sections were stained with haematoxylin and eosin or with an ABC kit to visualise proteins of interest. The epithelium of the lower tongue was examined by light microscopy regarding the following parameters: cell numbers, thickness of epithelial layers and expression of the potential stem cell markers p63, integrin β1 and CD44. Due to the limited number of animals per data point (experiment I: three mice per data point; experiment II: five mice per data point), a detailed statistical analysis was not performed. The present study is determined to describe the parameter variations over the observation period. Cell numbers decreased to 60-70 % of the pre-treatment control values within the first week of irradiation alone, remained constant in the second week, and then slowly increased until the end of the observation period. There was no difference between radiotherapy alone or combined treatment with BIBX1382BF. In experiment II similar observations were made with higher cell numbers in the functional layer of the epithelium of the Erlotinib treated animals than in the irradiated group. The thickness of the epithelium and its individual layers showed high inter individual differences in experiment I. In treatment group I/B, lower values of thickness were often detected in comparison to group I/A. In experiment II the thickness of the epithelium remained constant under fractionated irradiation. Between day 0 and 12 the Erlotinib treatment slightly decreased the thickness of the whole epithelium in comparison to the irradiated group. Besides, there were only minor changes in the thickness of the different layers. Associated with the general loss of cells, radiation treatment led to a transient decrease in the expression of p63. The number of p63-positive cells recovered until the end of the observation period. A similar expression pattern of p63-positivity was found independent of EGFR inhibition. The expression of integrin β1 decreased during fractionated irradiation. On days 2-9 and 12-16, the changes were more pronounced in combination with BIBX1382BF treatment which indicates a potential interaction of the EGF receptor with integrin β1. In experiment II, no differences between the exclusively irradiated group and the combined treatment with Erlotinib were found for the expression patterns of integrin β1. Irradiation alone resulted in a higher epithelial expression of CD44. Accordingly, a general increase of CD44 staining intensity was observed in both experiments exceeding control values. Due to the EGFR inhibition with Erlotinib, the expression of CD44 initially decreased. However, by day 4 no persisting differences in staining intensity could be observed independent of EGFR inhibition. In summary, EGFR inhibition via BIBX1382BF or Erlotinib did not result in alterations of the analysed parameters during two weeks of fractionated irradiation. Further studies are required to demonstrate if the present findings are transferable to other tyrosine kinase inhibitors or different substance classes (e.g. inhibiting receptor antibodies).
99

Comparação dos efeitos da terapia laser de baixa intensidade (lambda = 660 nm ou lambda = 780 nm) no tratamento de mucosite oral induzida por radiação ionizante em ratos / Comparisson of the low level laser therapy effects (&lambda; = 660 nm ou &lambda; = 780 nm) in the threatment of ionizing radiation induced oral mucositis in rats

Andrade, Maira Franco de 15 August 2014 (has links)
A mucosite oral é um efeito colateral de quimioterapia e radioterapia de cabeça e pescoço e consiste de uma comorbidade severa com a presença de xerostomia, lesões ulcerativas, infecções secundárias e dor, passíveis de alterar e até interromper a terapia antineoplásica, diminuindo a possibilidade de controle da doença. A mucosite oral pode ser tratada com variados esquemas terapêuticos, incluindo a utilização de laser de baixa intensidade, que diferem em tipo de laser, densidade de energia, comprimento de onda utilizados, entre outros parâmetros de irradiação. Este trabalho utilizou mesmos parâmetros de irradiação laser (30 mW, 7,5 J/cm2, 0,04 mm diâmetro do feixe, 10 s por ponto, 3 pontos no dorso e 2 pontos no ventre da língua, com distância de 1 mm da superfície, 48/48 h por até 20 dias), diferindo apenas o comprimento de onda utilizado, &lambda; = 660 nm e &lambda; = 780 nm. Em seguida, os efeitos da irradiação foram comparados entre si e em relação ao grupo controle não tratado. Foi feita a padronização de modelo animal de mucosite oral em ratos utilizando radiação gama de fonte panorâmica, em dose única de 20 Gy, para avaliação uniforme dos grupos. Para tanto, foi elaborado escore clínico detalhado ponto a ponto, com correlação estatística, que se mostrou eficiente na avaliação clínica desta comorbidade. Após análise estatística dos dados coletados (p < 0,05), pode-se verificar que existem diferenças entre as terapias com laser, além de sua superioridade em relação ao grupo Controle. Os animais do grupo laser &lambda; = 660 nm apresentaram maior produção de colágeno em mucosa e fechamento de feridas mais rapidamente nos dias 14 e 20 quando comparados ao grupo laser &lambda; = 780 nm. Ambos os tratamentos foram superiores em relação ao grupo Controle. Os tratamentos laser também se mostraram superiores ao Controle na modulação da inflamação, formação de pseudomembrana e estimulação de angiogênese. Estes resultados indicam que os benefícios obtidos pelos dois comprimentos de onda, nas mesmas condições de irradiação, são diferentes, podendo ser utilizados de forma complementar em pacientes. / A well-known side effect of head and neck chemotherapy and radiotherapy is oral mucositis. This severe comorbidity presents xerostomya, ulcers, secondary infections and pain that can alter and even force to interrupt tumor-targeted therapies. Various treatments currently exist such as in particular low-level laser therapies (LLT) with different parameters including laser type, energy density, or wavelength. In the present study we propose to compare the effects of LLT at two different wavelengths, &lambda;= 660 nm and &lambda; = 780 nm, on an animal model. For this purpose we separated rats in three groups: one control group and one group for each wavelength. Apart from the wavelengths, the other laser irradiation parameters were identical: 30 mW, 7,5 J/cm2, 0,04 mm diameter, 10 s per point, 3 points on the upper side and 2 points on the lower side of the tongue , 1 mm away from the surface, 48/48 h until 20 days. An animal model of oral mucositis in rats was established by irradiation with a panoramic source of 60Co, single dose of 20 Gy, to ensure uniform evaluation of the groups. In addition, I elaborated a novel clinical point-to-point score scheme with statistical correlation that is proven to be efficient for clinical evaluation of this comorbidity. After statistical analysis using p < 0,05, we observed differences between each laser therapies and also in relation to the control group. The animals treated with &lambda; = 660 nm presented a higher amount of collagen in the mucosal region and faster wound healing when compared to the animals treated with &lambda; = 780 nm. Both laser treatments showed superior efficiency than the control group for collagen generation and wound healing speed, as well as in the inflammatory modulation, pseudomembrane production and angiogenesis stimulation. These results indicate that both laser treatments are beneficial in the wound healing process, with complementary effects depending on the wavelength. This suggests that laser therapies at various wavelengths could be simultaneously used for oral mucositis treatment.
100

Avaliação do uso do laser de baixa intensidade e do ligth-emitting diode (LED) no comportamento de fibroblastos e na redução da incidência da mucosite bucal em crianças sob tratamento quimioterápico / Evaluation of the use of low-intensity laser and Light-Emitting Diode (LED) on the behavior of fibroblasts and in reducing the incidence of oral mucositis in children under chemotherapy

Volpato, Luiz Evaristo Ricci 17 July 2009 (has links)
Avaliou-se o uso do laser de baixa intensidade e do Light-Emitting Diode (LED) no comportamento de fibroblastos e na redução da incidência da mucosite bucal em crianças sob tratamento quimioterápico. Para tanto, o estudo foi executado em dois períodos experimentais distintos. No primeiro período, foi realizada a análise da viabilidade de fibroblastos Balb/c 3T3 cultivados sob déficit nutricional irradiados com laser vermelho (660nm, 40mW), laser infravermelho (780nm, 50mW) e LED vermelho (637 ± 15nm, 40mW) por 4 e 8 segundos através dos ensaios de redução do MTT e captação do vermelho neutro. No segundo período experimental realizouse ensaio clínico randomizado duplo-cego para avaliar a eficácia do laser vermelho (660nm, 40mW) e do LED vermelho (637 ± 15nm, 40mW) na redução da incidência e da severidade da mucosite bucal e da dor relacionada em crianças portadoras de câncer submetidas a quimioterapia utilizando-se o sistema de graduação da mucosite bucal da Organização Mundial de Saúde e a Escala de Dor de Faces Revisada associada à escala analógica visual. A análise estatística foi realizada utilizando-se o teste não paramétrico de Kruskal-Wallis e analise de variância do modelo linear geral com nível de significância de 5% (p = 0,05). Observou-se com a redução do MTT uma tendência de aumento da proliferação celular relacionado diretamente com o tempo de irradiação, no entanto, não significante estatisticamente. Após 72 horas, os grupos que apresentaram maior proliferação celular foram: grupo irradiado com laser infravermelho, grupo irradiado com LED, grupo irradiado com laser vermelho, grupo controle positivo e grupo controle negativo. Já através da captação do vermelho neutro, após 72 horas o grupo que apresentou maior proliferação celular foi o grupo controle positivo (cultivado sob condições nutricionais ideais) seguido pelo grupo irradiado com laser infravermelho, grupo controle negativo e grupos irradiados com LED e laser vermelho. Através da análise dos resultados obtidos e considerando os parâmetros e protocolo de fototerapia utilizados, pode-se concluir que a fototerapia com laser de baixa intensidade e diodo emissor de luz (LED) não apresentaram toxicidade em nível celular, vindo mesmo a estimular a proliferação dos fibroblastos cultivados sob déficit nutricional, sobretudo no grupo irradiado com o laser infravermelho (780nm, 50mW). A incidência e a severidade da mucosite bucal, assim como a dor associada, foram muito baixas nos grupos irradiados com laser vermelho (660nm, 40mW) e LED (637 ± 15nm, 40mW). Não houve diferença estatisticamente significativa entre os grupos; A coerência da luz não interferiu no resultado da fototerapia in vitro e in vivo. / The use of low-intensity laser and Light-Emitting Diode (LED) on the behavior of fibroblasts and in reducing the incidence of oral mucositis in children under chemotherapy were evaluated. The study was performed in two separate experiments. In the first moment, the viability of fibroblasts Balb/c 3T3 cultured under nutritional stress irradiated with red laser (660nm, 40mW), infrared laser (780nm, 50mW) and red LED (637 ± 15nm, 40mW) for 4 and 8 seconds was analyzed through the MTT and neutral red assays. The second experiment carried out was a double-blind randomized clinical trial aiming to assess the effectiveness of red laser (660nm, 40mW) and red LED (637 ± 15nm, 40mW) in reducing the incidence and severity of oral mucositis and related pain in children with cancer undergoing chemotherapy using the World Health Organization oral mucositis grading system and the Faces Pain Scale - Revised associated with a visual analogue scale. Statistical analysis was performed using the Kruskal-Wallis nonparametric test and ANOVA with a significance level of 5% (p = 0.05). It was observed with the MTT assay a trend of cell proliferation increase directly related to the irradiation time, however, not statistically significant. After 72 hours, the groups that showed higher cell proliferation were: infrared laser irradiated group, LED irradiated group, red laser irradiated group, positive control group and negative control group. By the neutral red assay, though, after 72 hours the group that showed higher cell proliferation was the positive control (grown under ideal nutritional conditions) followed by the group irradiated with infrared laser, the negative control group and groups irradiated with red laser and LED. By analyzing the results and considering the used parameters and phototherapy protocol, it is plausible to conclude that phototherapy with lowintensity laser and light emitting diode (LED) showed no toxicity at cellular level, even stimulating the proliferation of fibroblasts cultured under nutritional stress, especially in the group irradiated with infrared laser (780nm, 50mW). The incidence and severity of oral mucositis and associated pain, were very low in the groups irradiated with red laser (660nm, 40mW) and LED (637 ± 15nm, 40mW). There was no statistically significant difference between these groups, the coherence of light did not affect the outcome of phototherapy in vitro and in vivo.

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