El traumatismo dental trae consigo afecciones pulpares irreversibles que pueden desencadenar una necrosis del tejido pulpar. Debido a la ausencia de sintomatología en algunos casos, el proceso necrótico puede generar una lesión apical que a largo plazo puede alcanzar grandes extensiones. Para tratar este tipo de lesiones apicales de gran tamaño, es necesario un adecuado diagnóstico clínico, complementado con la evaluación tomográfica, para la localización los dientes afectados. Es posible tratar estas afecciones con un abordaje no quirúrgico, obteniendo resultados favorables. El presente reporte de caso tiene como objetivo presentar la resolución no quirúrgica de una lesión periapical extensa de origen endodóntico. / Dental trauma brings irreversible pulpal conditions that can trigger pulp tissue necrosis. Due to the absence of symptomatology in some cases, the necrotic process can generate an apical lesion that in the long term can reach large extensions. To treat this type of large apical lesions, an adequate clinical diagnosis, complemented with tomographic evaluation, are necessary to locate the affected teeth. Is possible to treat these conditions with a non-surgical approach, obtaining favorable results. This case report aims to present the non-surgical resolution of an extensive periapical lesion of endodontic origin. / Trabajo académico

Significant cost and debilitation results from connective tissue injury and disease every year. Prolotherapy is an effective medical treatment used to increase joint stability. However, most associated studies are retrospective or case studies, rather than comprehensive laboratory investigation originating with the cellular response to exposure to the proliferant solutions. As a parallel consideration, nanoparticles are being investigated for use in drug delivery and heat shock treatment of cancerous tissue due to their unique structural and thermal properties. The phenomenal strength and stiffness of carbon nanoparticles have been used for commercial purposes in composite materials, but investigation of biomedical applications is still fairly nascent. In an attempt to develop a non-surgical approach to supporting and healing damaged ligaments and tendons resulting from injury or disease by combining prolotherapy and the use of nanoparticles, the author presents studies investigating the cellular response to proliferative therapy solution as well as tendon and ligament tissue's mechanical and cellular response to exposure to nanoparticles. In the prolotherapy solution cell studies, the results suggested that there is an optimal dosage of the proliferant for in vitro studies, different responses between cell types, and a dosage-dependent response in cell viability and collagen production to the solution P2G in preosteoblasts. In the nanoparticle studies, cell populations tolerated nanoparticles at the levels tested, tendon mechanical properties were increased (stiffness significantly so), and bright field and transmission electron microscopic histological images were taken of connective tissue and carbon nanohorn interactions. / Master of Science

Introdução: Estiramento muscular e outras desordens músculoesqueléticas são as principais causas que desabilitam atletas e praticantes de atividades físicas. Seu tratamento inclui AINES que desencadeiam vários efeitos adversos. O objetivo do estudo foi investigar os efeitos da Terapia Laser de Baixa Intensidade (810nm) sobre absorção do diclofenaco aplicado topicamente, além de investigar uma sinergia entre ambos. Métodos: Foram quantificadas concentrações plasmáticas de diclofenaco em diferentes tempos, com e sem irradiação do laser, em ratos Wistar fêmeas. Ratos foram submetidos à indução do estiramento muscular. Os grupos tratados receberam irradiação do Laser, antes da droga, 1 hora após a indução da lesão, para analisar índice funcional, estudo eletrofisiológico, expressão gênica RT-PCR de COX-1 e COX-2, PGE2 por espectrofotometria e histologia. Resultados/Discussão: A utilização do Laser de Baixa Potência aumentou a biodisponibilidade da droga e reduziu a inflamação e a lesão após estiramento experimental, conduzindo a uma melhora da atividade de caminhar. / Introduction: Stretch muscle and other musculoskeletal disorders are the main causes that disable the athlete and physically active practitioner. It´s treatment includes NSAIDs that trigger adverse effects. The aim of the study was to investigate the effect of Low Level Laser Therapy (810nm) on the absorption of topically applied diclofenac, and investigate a synergy between them. Methods: quantify the plasma concentrations of diclofenac in different times, with and without laser irradiation in Wistar female rats. Female Wistar rats were subjected to induction of muscle stretch. The groups received laser irradiation, prior to application of the drug, one hour after induction of the injury, to analyze the sciatic index functional, electrophysiological studies, gene expression by RT-PCR of COX-1 and COX-2, PGE2 by spectrophotometry and histology. Results/Discussion: The use of Low Level Laser Therapy increased the bioavailability of the drug and reduced inflammation and muscle damage after stretch experiment, leading to a significant improvement in walking activity.

Introdução: Estiramento muscular e outras desordens músculoesqueléticas são as principais causas que desabilitam atletas e praticantes de atividades físicas. Seu tratamento inclui AINES que desencadeiam vários efeitos adversos. O objetivo do estudo foi investigar os efeitos da Terapia Laser de Baixa Intensidade (810nm) sobre absorção do diclofenaco aplicado topicamente, além de investigar uma sinergia entre ambos. Métodos: Foram quantificadas concentrações plasmáticas de diclofenaco em diferentes tempos, com e sem irradiação do laser, em ratos Wistar fêmeas. Ratos foram submetidos à indução do estiramento muscular. Os grupos tratados receberam irradiação do Laser, antes da droga, 1 hora após a indução da lesão, para analisar índice funcional, estudo eletrofisiológico, expressão gênica RT-PCR de COX-1 e COX-2, PGE2 por espectrofotometria e histologia. Resultados/Discussão: A utilização do Laser de Baixa Potência aumentou a biodisponibilidade da droga e reduziu a inflamação e a lesão após estiramento experimental, conduzindo a uma melhora da atividade de caminhar. / Introduction: Stretch muscle and other musculoskeletal disorders are the main causes that disable the athlete and physically active practitioner. It´s treatment includes NSAIDs that trigger adverse effects. The aim of the study was to investigate the effect of Low Level Laser Therapy (810nm) on the absorption of topically applied diclofenac, and investigate a synergy between them. Methods: quantify the plasma concentrations of diclofenac in different times, with and without laser irradiation in Wistar female rats. Female Wistar rats were subjected to induction of muscle stretch. The groups received laser irradiation, prior to application of the drug, one hour after induction of the injury, to analyze the sciatic index functional, electrophysiological studies, gene expression by RT-PCR of COX-1 and COX-2, PGE2 by spectrophotometry and histology. Results/Discussion: The use of Low Level Laser Therapy increased the bioavailability of the drug and reduced inflammation and muscle damage after stretch experiment, leading to a significant improvement in walking activity.

Los avances tecnológicos para mejorar la calidad del tratamiento endodóntico en todos los aspectos son insuficientes si no se complementa con un adecuado tratamiento protésico. La filtración bacteriana causada por tratamientos protésicos desadaptados puede promover la migración bacteriana hacia el canal radicular y el material de obturación, en caso presente un tratamiento endodóntico. Si esta situación no es controlada, la infección podría continuar hacia los tejidos periapicales, causando un quiste periapical. Para tratar el quiste periapical será necesario identificar el diente donde se originó la infección, retratar los canales radiculares y realizar el retiro quirúrgico del quiste. Sin embargo, es posible realizar un abordaje no quirúrgico con resultados favorables. / Technological advances to improve the quality of endodontic treatment in all aspects are insufficient if they are not complemented by adequate prosthetic treatment. The bacterial cause caused by the maladaptive prosthetic treatments can promote bacterial migration towards the root canal and the filling material, in case of endodontic treatment. If this situation is not controlled, the infection could continue into the periapical tissues, causing a periapical cyst. To treat the periapical cyst, identify with the tooth where the infection originated, portray the root canals and perform the surgical removal of the cyst. However, it is possible to perform a non-surgical approach with favorable results. / Trabajo académico

O objetivo do presente estudo foi avaliar, em ratos, a eficácia da aplicação conjunta do Ultrassom e do Laser na nocicepção e recuperação funcional do nervo isquiático submetido à lesão por pinçamento. Neste estudo, os ratos foram submetidos ao pinçamento do nervo isquiático (pinça regulável á 5000g durante 5 minutos). Este pinçamento acarretou hiperalgesia mecânica e térmica, alodinia mecânica, além de disfunção motora. O Ultrassom, na dosagem de 1.0 W/cm2 e o Laser, na dosagem de 6 J, causaram antinocicepção e induziram recuperação funcional parcial. A aplicação conjunta de ambos os recursos físicos, além de antinocicepção, acarretou melhor recuperação funcional. Em conclusão, a aplicação conjunta do Ultrassom e Laser é eficaz no controle da nocicepção resultante do pinçamento do nervo isquiático, além de acelerar o processo de regeneração nervosa, favorecendo o restabelecimento da função motora. / The aim of this study was to evaluate, in rats, the effectiveness of the application of the Ultrasound and Laser in nociception and functional recovery of rat sciatic nerve injury. In this study, the sciatic nerve was submitted to crush injury by a forceps especially constructed for this purpose and calibrated for a static load of 5000 g, for 5 minutes. The nerve crushing causes the development of mechanical and thermal hyperalgesia, mechanical allodynia, and motor dysfunction. The Ultrasound, at a dosage of 1.0 W/cm2, and the Laser, at a dose of 6 J, induced antinociception and partial functional recovery. The combined application of both physical resources, in addition to antinociception, resulted in a faster histopathological changes recovery. In conclusion, the application of Ultrasound and Laser is effective in the control of nociception resulting from sciatic nerve crushing, and in accelerating the process of nerve regeneration, favoring the restoration of motor function.

O objetivo do presente estudo foi avaliar, em ratos, a eficácia da aplicação conjunta do Ultrassom e do Laser na nocicepção e recuperação funcional do nervo isquiático submetido à lesão por pinçamento. Neste estudo, os ratos foram submetidos ao pinçamento do nervo isquiático (pinça regulável á 5000g durante 5 minutos). Este pinçamento acarretou hiperalgesia mecânica e térmica, alodinia mecânica, além de disfunção motora. O Ultrassom, na dosagem de 1.0 W/cm2 e o Laser, na dosagem de 6 J, causaram antinocicepção e induziram recuperação funcional parcial. A aplicação conjunta de ambos os recursos físicos, além de antinocicepção, acarretou melhor recuperação funcional. Em conclusão, a aplicação conjunta do Ultrassom e Laser é eficaz no controle da nocicepção resultante do pinçamento do nervo isquiático, além de acelerar o processo de regeneração nervosa, favorecendo o restabelecimento da função motora. / The aim of this study was to evaluate, in rats, the effectiveness of the application of the Ultrasound and Laser in nociception and functional recovery of rat sciatic nerve injury. In this study, the sciatic nerve was submitted to crush injury by a forceps especially constructed for this purpose and calibrated for a static load of 5000 g, for 5 minutes. The nerve crushing causes the development of mechanical and thermal hyperalgesia, mechanical allodynia, and motor dysfunction. The Ultrasound, at a dosage of 1.0 W/cm2, and the Laser, at a dose of 6 J, induced antinociception and partial functional recovery. The combined application of both physical resources, in addition to antinociception, resulted in a faster histopathological changes recovery. In conclusion, the application of Ultrasound and Laser is effective in the control of nociception resulting from sciatic nerve crushing, and in accelerating the process of nerve regeneration, favoring the restoration of motor function.

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