The use of local anesthetics associated to vasoconstrictor agents in dentistry is thoroughly justified and is widely extended, but we cannot ignore the fact that anesthetic infiltration poses risk of complications throughout the dental treatment period. The objective of the present review is to document the reported effects the use of the local anesthetics most widely employed in dentistry, with or without association to vasoconstrictor agents may have in patients with any sort of cardiopathy. We have searched for randomized clinical trials on the assessment of the cardiovascular effects of local anesthetics used in dentistry, without limits as regards age or sex, conducted in patients with any type of cardiopathy which were published during the last decade and were index-linked in Cochrane, Embase and Medline. We have found six randomized clinical trials index-linked in Medline and Cochrane in the past ten years. These trials compare different types of anesthetics: lidocaine 2%, mepivacaine 2%, prilocaine 2% , associated or not to different vasoconstrictor concentrations such as adrenaline or felypressin. The cardiopathies affecting the patients included in the different trials range from hypertension, ischemic heart disease, arrythmias, chronic coronary disease to heart transplantation. The use of anesthetics associated to vasoconstrictor agents is justified in the case of patients with cardiopathies (once we get over the period in which any type of dental manipulation is contraindicated) and in controlled hypertensive patients. In any case, we must be very careful with the choice and execution of the anesthetic technique, being it possible to use a dose between 1.8 and 3.6 ml, on a general basis. Further studies are necessary to establish the effects of these drugs on severe hypertensive patients or in patients with other more advanced cardiopathies. Key words:Vasoconstrictor agents, epinephrine/adverse effects, local anesthetics, dental restoration, oral surgery, cardiovascular diseases, coronary arteriosclerosis, heart disease, hypertension, arrhythmias, coronariopathy.

Total or partial tissue damage and loss of function in an organ are two of the most serious and costly issues in human health. Initially, these problems were approached through organ and allogenic tissue transplantation, but this option is limited by the scarce availability of donors. In this manner, new bone for restoring or replacing lost and damaged bone tissue is an important health and socioeconomic necessity. Tissue engineering has been used as a strategy during the 21st century for mitigating this need through the development of guided bone regeneration scaffold and composites. In this manner, compared with other traditional methods, bone tissue engineering offers a new and interesting approach to bone repair. The poly-α-hydroxy acids, which include the copolymers of lactic acid and glycolic acid, have been used commonly in the fabrication of these scaffolds. The objective of our article was to review the characteristics and functions of scaffold with biomedical applications, with special interest in scaffold construction using poly(lactic-co-glycolic acid) polymers, in order to update the current methods used for fabrication and to improve the quality of these scaffolds, integrating this information into the context of advancements made in tissue engineering based on these structures. In the future, research into bone regeneration should be oriented toward a fruitful exchange between disciplines involved in tissue engineering, which is coming very close to filling the gaps in our ability to provide implants and restoration of functionality in bone tissue. Overcoming this challenge will provide benefits to a major portion of the population and facilitate substantial improvements to quality of life.

Background/Objectives: Oral mucositis (OM) is the most common acute complication among cancer patients. It initially manifests as an inflammatory process, beginning with erythema and edema of the oral mucosa, progressing to erosive lesions, and ultimately leading to highly painful ulcers. This systematic review seeks to evaluate the efficacy of preventive PBM protocols in mitigating chemotherapy-induced OM. Methods: The PRISMA guidelines were followed. The search was conducted in August 2024 in the following databases: Pubmed/Medline, Scopus, WoS, Cochrane, SciELO, BDTD, and BVS/IBECS. Only randomized clinical trials that utilized preventive photobiomodulation protocols in chemotherapy patients were included. All studies involving patients previously treated with radiation therapy were excluded. The Joanna Briggs Institute tool was employed for risk of bias analysis. Results: The total sample size consisted of 828 patients aged between 1 and 84 years. There was no predisposition based on gender or age. When the patients were evaluated under preventive protocols, some cases of mucositis manifested in a total of 339 cases. Of the total number of patients in the 13 selected studies (n = 828), 40.94% developed oral mucositis over the course of chemotherapy cycles. Comparing the experimental and control groups, 211 patients who did not receive preventive laser treatment developed oral mucositis; in contrast, only 128 in the experimental group did. Eighty-five percent of the studies exhibited a low risk of bias. Conclusions: Preventively applied photobiomodulation proves effective in minimizing or even preventing the manifestation of oral mucositis and reducing the severity of lesions that arise during oncological treatment. Registration PROSPERO (CRD42023465329).

Background: We report on the cost-effectiveness of photobiomodulation (PBM) for the prevention and treatment of oral mucositis (OM) derived from the cytotoxic effects of antineoplastic therapy. Methods: This review followed the PRISMA 2020 guidelines. A search was conducted in PubMed, Scopus, Web of Science, Embase, and OpenGrey. Articles published before 23 July 2024, were included. Randomized controlled trials (RCTs) that included patients with head and neck cancer undergoing chemotherapy and/or radiotherapy and a placebo group compared to an intervention group (PBM) were selected. The risk of bias was evaluated using the Joanna Briggs Institute tools. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and was rated as moderate. Results: A total of 3 RCTs and 229 patients were included. PBM may represent an additional cost in the short term, but the incremental expenses derived from the cytotoxic effects of antineoplastic therapy are greater in the medium–long term. The intervention group (PBM) showed a lower incidence of severe OM compared to the control group (placebo). Conclusions: PBM is a cost-effective long-term treatment, effective in preventing severe OM and improving the quality of life of cancer patients. More RCTs following the same standardized protocols are needed (registration CDR42024498825).

Placing implants in the posterior maxillary area has the drawback of working with scarce, poor quality bone in a significant percentage of cases. Numerous advanced surgical techniques have been developed to overcome the difficulties associated with these limitations. Subsequent to reports on the elevation of the maxillary sinus through the lateral approach, there were reports on the use of the crestal approach, which is less aggressive but requires a minimal amount of bone. Furthermore, it is more sensitive to operator technique, as the integrity of the sinus membrane is checked indirectly. The aim of this paper is to review the technical literature on minimally invasive sinus lift and compare the advantages of different techniques with Intralift™, a new technique. The present study is a review of techniques used to perform minimally invasive sinus lift published in Cochrane, Embase and Medline over the past ten years and the description of the crestal sinus lift technique based on minimally invasive piezosurgery, with the example of a case report. Only eight articles were found on minimally invasive techniques for sinus lift. The main advantage of this new technique, Intralift, is that it does not require a minimum amount of crestal bone (indeed, the smaller the width of the crestal bone, the better this technique is performed). The possibility of damage to the sinus membrane is minimised by using ultrasound based hydrodynamic pressure to lift it, while applying a very non-aggressive crestal approach. We believe that this technique is an advance in the search for less traumatic and aggressive techniques, which is the hallmark of current surgery.