Özalp Ö, et al. Imaging Sci Dent. 2018 Dec;48(4):269-275. https://doi.org/10.5624/isd.2018.48.4.269

Background data: In vivo and in vitro studies have reported that laser energy in differing wavelengths and irradiation regimes has a potential bactericidal effect on Staphylococcus aureus. Objective: The purpose of this study was to investigate whether a light wavelength of 808 nm in varying doses has an effect on chronic osteomyelitis induced experimentally in the rat tibia. Methods: Intramedullary cavities were surgically created in the left tibias of 39 adult Wistar albino rats. Five randomly selected subjects were injected with a sterile saline solution, and methicillin-resistant S. aureus (MRSA) was used to induce osteomyelitis in the remaining rats. After 3 weeks, rats with evidence of osteomyelitis were treated with debridement alone ( n = 7), with debridement plus laser irradiation to induce photoeradication ( n = 21), or were not treated at all [negative control, ( n = 6)]. Active irradiation was performed using an 808 nm, 100 mW continuous-wave diode laser with a beam spot size of 0.7854 cm ² (irradiance = 127.3 mW/cm ² ). Laser treatment commenced immediately after debridement surgery and was applied daily for 5 consecutive days. Irradiation lasted 60 secs (6 J at 7.64 J/cm ² : n = 7), 120 secs (12 J at 15.29 J/cm ² : n = 7), or 180 secs (18 J at 22.93 J/cm ² : n = 7). Rats in the sham and negative control groups were killed 21 days post-induction surgery, and those in the treatment groups were killed after 42 days. Following killing, tibias were removed and analyzed histopathologically, radiographically, and microbiologically. Results: Histopathological analysis showed that infection levels had decreased by 37%, 67%, 81%, and 93% in the groups treated by debridement or by debridement plus 7.64, 15.29, and 22.93 J/cm ² light therapy, respectively, compared to the negative control group. Osteomyelitis-induced rats had the highest bacteria count (5 × 10 ⁵ ). Bacterial counts fell to 1.6 × 10 ⁴ , 4.3 × 10 ² , 5.5 × 10 ¹ , and 3.3 × 10 ⁰ in groups treated by debridement or by debridement plus 7.64, 15.29, and 22.93 J/cm ² light therapy, respectively, compared to the negative control group. Conclusions: Within the limitations of this study, laser phototherapy with the appropriate irradiation parameters appears to be a promising adjunct and/or alternative technique to pharmacological agents in the treatment of osteomyelitis. The 808 nm 100 mW (127.3 mW/cm ² ) laser device used in this study achieved a maximum effect with an irradiation time of 180 secs, delivering 18 J at an energy density of 22.93 J/cm ² .

Background: Temporomandibular joint osteoarthritis (TMJ-OA) is a degenerative disease and manifests itself with pain and limitation of movement in the jaws. Arthrocentesis alone or in combination with intraarticular injections is one of the most commonly used treatment methods in these patients. The aim of the study is to examine the effectiveness of arthrocentesis plus tenoxicam injection and to compare it with arthrocentesis alone in patients with TMJ-OA. Methods: Thirty patients with TMJ-OA who were treated randomly with either arthrocentesis plus tenoxicam injection (TX group) or arthrocentesis alone (control group) were examined. Maximum mouth opening (MMO), visual analog scale (VAS) pain values, and joint sounds were the outcome variables, which were evaluated at pre-treatment and at 1, 4, 12, and 24 weeks after treatment. Statistical significance was set at p < 0.05. Results: The gender distribution and mean age were not significantly different between the two groups. Pain values (p < 0.001), MMO (p < 0.001), and joint sounds (p < 0.001) improved significantly in both groups. However, there was no significant difference between the groups in terms of outcome variables [pain (p = 0.085), MMO (p = 0.174), joint sounds (p = 0.131)]. Conclusions: Arthrocentesis plus tenoxicam injection showed no better outcomes in terms of MMO, pain, and joint sounds compared with arthrocentesis alone in patients with TMJ-OA. Trial registration: Injection of Tenoxicam Versus Arthrocentesis Alone in the Treatment of Temporomandibular Joint Osteoarthritis, NCT05497570. Registered 11 May 2022. Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000CD7A&selectaction=Edit&uid=U0006FC4&ts=6&cx=f3anuq

The aim of this study was to identify the prevalence of pathological changes in the pericoronal tissue of asymptomatic impacted lower third molars and to assess the correlation between pathological changes and patient demographic, radiographic and morphological characteristics. Follicles associated with fully impacted lower third molars were submitted for histological examination after surgical extraction from 50 patients. The correlation between pathological changes in the dental follicle and age, gender, depth of impaction, angular position, and coverage and tooth development was analyzed. Cystic changes were observed in 10% of specimens and inflammatory changes in 62%. Incidence of pathological changes was significantly higher in Class B impacted teeth when compared to Class C impacted teeth. A significant correlation was found between epithelial cell activity and the completion of tooth development. We recommend monitoring all third molars whether or not they are symptomatic and conducting histopathological analyses on all surgically extracted follicle tissue.