Lara Jansiski Motta

Introduction: Dental caries remains one of the most prevalent chronic diseases in childhood worldwide. In Brazil, untreated carious lesions continue to affect oral health and quality of life in school-aged children. Minimally invasive approaches for caries management have demonstrated feasibility in community settings and may expand access to preventive and restorative care in socially vulnerable populations. Methods: This multicentre longitudinal intervention study will recruit 50 000 children aged 6–12 years from public schools in five Brazilian cities (Santos, Ponta Grossa, Brasília, Fortaleza and Belém). All participants will undergo clinical examination using the International Caries Detection and Assessment System (ICDAS) and will receive preventive and educational measures, including oral health counselling, supervised toothbrushing with fluoridated toothpaste (1100 ppm F), toothbrushes, toothpaste and application of Duraphat fluoride varnish to permanent molars and incisors. Among children with active carious lesions, 2500 will enter the longitudinal minimally invasive treatment phase according to lesion severity: fluoride varnish for ICDAS 1–2 lesions; fluoride varnish or atraumatic restorative treatment (ART) sealants for ICDAS 3 lesions; and ART with high-viscosity glass ionomer cement for ICDAS 4–6 lesions. Participants will be re-evaluated every 3 months for up to 24 months. Expected outcomes: The primary outcome will be control of caries activity assessed longitudinally using ICDAS criteria. Secondary outcomes include inactivation of white spot lesions, survival of restorations and sealants and adherence to preventive measures. The study is expected to generate evidence to support public oral health policies and minimally invasive strategies for school-based caries management in Brazil. Ethics and dissemination: This protocol has been approved by the human research ethics committee of Universidade Metropolitana de Santos—UNIMES (protocol number: 7.630.345. Approved on 10 June 2025). Results will be submitted to international peer-reviewed journals and presented at international conferences. Trial registration number: NCT06999005 (registered on 14 May 2025).

Objectives: The aim of this study was to compare the effectiveness of two antimicrobial photodynamic therapy (aPDT) protocols using different methylene blue formulations in the treatment of initial pericoronitis. The research question was whether the new methylene blue formulation provides superior clinical outcomes compared to the conventional formulation. Materials and methods: This randomized, controlled, double-blind clinical trial involved 34 healthy young patients with pericoronitis. The following groups were established: G1 (positive control, n = 17), irrigation with saline solution and aPDT with conventional methylene blue (0.005%, laser λ = 660 nm, 9 J per point, 318 J/cm²); and G2 (experimental, n = 17), using the same therapy but with a patented new formulation of methylene blue. Pain assessed using the Visual Analog Scale (VAS) was defined as the primary outcome. Secondary outcomes include mouth opening, edema, and quality of life (OHIP-14). Microbiological and immunological analyses were performed to complement clinical outcomes. All outcomes were assessed at baseline and on the fourth day after aPDT. Results: Both groups showed statistically significant improvement in pain (G1: p = 0.022; G2: p = 0.001) and mouth opening (G1: p < 0.001; G2: p = 0.002) after treatment. However, no statistically significant differences were observed between the groups in final pain and mouth-opening outcomes ( p = 0.845 and p = 0.318, respectively). Conclusions: Within the limitations of this study, both aPDT protocols were associated with improvements in clinical outcomes. No between-group differences were observed in clinical outcomes; differences were limited to microbiological and immunological parameters, with no clinical superiority of the new formulation. Clinical relevance: Both methylene blue formulations may be used as adjunctive treatment options for the management of initial pericoronitis. However, no additional clinical benefit was observed with the new formulation, and these findings do not support a change in current clinical practice.

Background/Objectives: In lingual frenectomy/frenotomy surgeries, thermal surgical instruments are commonly used because of their hemostatic effect, precise cutting, and lack of need for sutures. However, the effects of tissue heating on the biological repair process remain under investigation. This study aimed to evaluate the thermal and histological effects of a surgical lingual frenulum incisions performed with high-power diode lasers at 450 nm (blue) and 980 nm (infrared), compared with a surgical scissor incision (control group). Methods: The experimental project was conducted in two phases: first, an ex vivo experiment on porcine tongues using different surgical instruments, with different parameters, with thermal variations recorded using infrared thermography; and second, an in vivo phase using the instruments previously determined in the ex vivo phase. Results: Results demonstrated minimal tissue heating in the control group. There was a thermal elevation with the laser instruments, particularly with the 980 nm and 450 nm diode lasers; however, the 450 nm laser showed a high initial temperature increase, but exhibited faster tissue cooling. Thermal and histological analyses performed immediately after the procedure and on the seventh postoperative day showed clinically similar tissue repair across groups, with less disorganization of collagen fiber bundles on day seven in the group treated with the 450 nm laser. Conclusions: In conclusion, both diode lasers can be safely employed for lingual frenulum incision when appropriate parameters are used; however, further clinical studies are warranted to establish safe and effective parameters.

This clinical, randomized, controlled, and blinded trial evaluated photobiomodulation (PBM) using 850 nm (infrared) and 660 nm (red) LED clusters on cervical and mandibular mobility and masticatory muscles in temporomandibular disorder (TMD) patients. PBM was applied to the temporomandibular joint (TMJ) region, masseter, temporal, scalene, and trapezius muscles over six non‐consecutive sessions over 2 weeks. The Research Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were used to determine the presence of TMD. A caliper and goniometer were used to measure the mandibular and cervical range of motion, respectively. Pain was assessed with the visual analog scale (VAS) before and after intervention. Results showed pain reduction only in the LED group post‐intervention; the placebo group showed no difference. No differences were observed in mouth opening, right laterality, flexion, or extension between groups, but left laterality increased in the LED group. In conclusion, PBM with LEDs effectively reduced pain in TMD patients. Trial Registration: ClinicalTrials.gov identifier: NCT06068959

Tissue trauma related to operative vaginal delivery or the use of episiotomy has been associated with complications such as pain and infection, and successful management is a key factor in promoting a faster and better recovery after delivery. Strategies that promote analgesia and tissue regeneration are especially relevant in obstetric care. Background/Objectives: To evaluate the effects of photobiomodulation (PBM) on pain and perineal healing in women who underwent episiotomy or sustained second- and third-degree lacerations after vaginal delivery. Methods: Observational cohort study. PBM is routinely offered postpartum as an adjuvant to standard hospital treatment daily throughout hospitalization for postpartum women who underwent episiotomy or second- and third-degree lacerations after vaginal delivery, recruited over a prospective 6-month period. The treatment protocol used an 808 nm laser at 100 mW, applied to five perilesional points at 4 J/cm² daily during hospitalization. Propensity score matching (PSM) analysis and two-way ANOVA were used to compare subgroups of patients who agreed to receive adjuvant PBM and those who did not, in addition to conventional treatment. Daily pain was assessed using the numerical pain scale (NPS) before and after PBM and conventional treatment, and healing was evaluated using the REEDA scale. Results: Data from 149 PBM-treated women and 34 non-PBM-treated women were analyzed. After PSM matching, a mean difference in NPS scores of 1.6761 (standard error = 0.4379) was observed between the group submitted to two laser sessions and the no-laser group, indicating a statistically significant difference (F = 14.65; Pr = 0.000191). A significant decrease in NPS scores was observed with ANOVA before and after each PBM application (p < 0.05), over the three days of follow-up. Regarding the REEDA scale, the preliminary results indicate a trend toward lower scores (better outcomes) in the laser group, an effect that larger studies could confirm. Conclusions: PBM was associated with improvements in pain reduction and tissue healing.

Introduction Photobiomodulation (PBM) has shown promising effects in managing postoperative pain following conventional periapical surgery, although current evidence remains limited. This study aims to assess the effect of PBM on postoperative pain 24 hours after periapical surgery. Methods and analysis A randomised, controlled, double-blind trial will include 34 patients undergoing periapical surgery in the maxillary region, randomly assigned to an experimental group (n=17) or control group (n=17). The experimental group will receive PBM (GaAlAs diode laser, 808 nm, 100 mW, 4 J/cm², applied at five vestibular points) and placebo ibuprofen immediately and 24 hours postoperatively. The control group will receive simulated PBM and active ibuprofen. The primary outcome is postoperative pain assessed by the visual analogue scale at 24 hours. Secondary outcomes include pain at the seventh day, paracetamol intake, oedema, ecchymosis, soft tissue status and temperature at 24 hours and 7 days. Radiographic evaluation of healing will be performed at 1 and 3 months. Statistical analysis will be conducted based on data distribution, using repeated measures ANOVA (Analysis of Variance) or non-parametric equivalents for longitudinal outcomes, and appropriate tests for categorical variables. Significance will be set at pEthics and dissemination The study was approved by the Human Research Ethics Committee of Universidad Católica del Uruguay (process no. 220914). Results will be disseminated to participants, healthcare professionals, the public and scientific communities. Trial registration number NCT05935306.

The evidence for photobiomodulation in reducing postoperative pain after endodontic instrumentation is classified as low or very low certainty, indicating a need for further research. Longitudinal pain assessments over 24 h are crucial, and studies should explore these pain periods. Background/Objectives: This double-blind, randomized controlled clinical trial evaluated the effect of PBM on pain following single-visit endodontic treatment of maxillary molars at 4, 8, 12, and 24 h. Primary outcomes included pain at 24 h; secondary outcomes included pain at 4, 8, and 12 h, pain during palpation/percussion, OHIP-14 analysis, and frequencies of pain. Methods: Approved by the Research Ethics Committee (5.598.290) and registered in Clinical Trials (NCT06253767), the study recruited adults (21–70 years) requiring endodontic treatment in maxillary molars. Fifty-eight molars were randomly assigned to two groups: the PBM Group (n = 29), receiving conventional endodontic treatment with PBM (100 mW, 333 mW/cm², 9 J distributed at 3 points near root apices), and the control group (n = 29), receiving conventional treatment with PBM simulation. Pain was assessed using the Visual Analog Scale. Results: Statistical analyses used chi-square and Mann–Whitney tests, with explained variance (η²). Ten participants were excluded, leaving 48 patients for analysis. No significant differences were observed in postoperative pain at 24, 4, 8, or 12 h, or in palpation/percussion or OHIP-14 scores. Pain frequencies ranged from 12.5% to 25%. Conclusions: PBM does not influence post-treatment pain in maxillary molars under these conditions. These results emphasize the importance of relying on well-designed clinical trials to guide treatment decisions, and future research should focus on personalized dosimetry adapted to the anatomical characteristics of the treated dental region to enhance the accuracy and efficacy of therapeutic protocols.

BACKGROUND Infants born with a short lingual frenulum, a condition known as ankyloglossia or tongue-tie, can experience breastfeeding difficulties and often require surgical frenotomy to restore functional mobility. Topical anesthesia is commonly used to minimize discomfort during the procedure, and adverse reactions are rare. This case report describes a 48-day-old female infant who experienced an allergic reaction to topical anesthesia with tetracaine and phenylephrine during frenotomy. CASE REPORT A 48-day-old infant with ankyloglossia and breastfeeding difficulties was referred for specialized dental evaluation. Laser frenotomy was indicated and performed under topical anesthesia with tetracaine and phenylephrine, followed by infiltrative anesthesia with lidocaine. During the application of the topical anesthetic, the patient developed lip edema and vesicles, which led to a diagnosis of ophthalmic anesthetic-induced angioedema. The procedure was completed without further complications, and the patient showed progressive improvement of the allergic condition postoperatively. CONCLUSIONS This case report highlights a rare complication of topical anesthesia with tetracaine and phenylephrine during frenotomy in a 48-day-old infant with breastfeeding difficulties. The observed allergic reaction emphasizes the importance of caution when using medications outside their intended scope and underscores the need for careful monitoring of adverse effects during procedures.

The present study investigated the effects of different photobiomodulation application frequencies on facial rejuvenation. Ninety-five women 45 to 60 years of age participated in the study. A red LED mask (660 ± 10 nm, 6.4 mW/cm², 8.05 J/cm², 5.02 mW, 21 min) was used, with the analysis of two different time intervals between applications. Group 1 received three weekly applications and Group 2 received two weekly applications for four weeks (total: 12 and eight sessions, respectively). The control group received sham photobiomodulation twice per week for four weeks. The participants were unaware of the allocation to the different groups. Three standardized photographs were taken before and after treatments for assessment using the Wrinkle Assessment Scale (WAS) by three specialists blinded to the allocation and period of the photograph. The Image J software was used by a researcher blinded to allocation and period of the photograph to measure wrinkles in the forehead, glabellar as well as right and left periorbital regions. Patient satisfaction was determined using the FACE-Q questionnaire. The data were analyzed statistically with the significance level set at 5% (p < 0.05). No significant differences among the groups were found with regards to the WAS. In the ImageJ assessment, significant reductions were found in the length of the glabellar and right periorbital wrinkles in the groups treated with photobiomodulation compared to the control group (p < 0.001). Participant satisfaction rates using FACE-Q were 79.6% and 73.4% in Groups 1 and 2, respectively, with significant differences in comparison to the control group (p = 0.001 and p = 0.034, respectively). The quantity of PBM sessions did not significantly alter the positive results achieved in terms of the satisfaction of the participants with their facial esthetics or the photographic assessments performed 30 days after treatment. Thus, two weekly sessions seem to be sufficient for improving patient satisfaction.