Monografias, Dissertações e Teses
URI permanente desta comunidadehttps://repositorioacademico.universidadebrasil.edu.br/handle/123456789/1
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Item Lasers aplicados à frenectomia em pacientes pediátricos com anquiloglossia: uma revisão sistemática da literatura com metanálise(Universidade Brasil, 2020) Nunes, José Edson Pavini; Navarro, Ricardo ScarparoAnkyloglossia, or tongue stuck, is a condition in which the lingual frenulum is short, which can lead to problems with the nutritional suction of infants, inadequate breastfeeding, and which can cause fissures in the maternal nipples. Frenotomy or frenectomy can correct the restriction on the movement of the tongue and allow effective breastfeeding. Surgical intervention is performed with a scalpel, but in recent years the use of lasers in this procedure has increased. The aim of the study was to conduct a systematic review of high-powered lasers applied to frenectomy in pediatric patients diagnosed with ankyloglossia. In the methodology, a systematic literature review of randomized clinical studies with a score ≥ 6 on the PEDro scale (Physiotherapy Evidence Database) published in the PubMed, Cochrane and SciELO databases was performed. Studies were selected that evaluated the application of high-powered lasers in the surgical treatment of children with ankyloglossia, according to the PRISMA guidelines, using using descriptors: Ankyloglossia x Laser descriptors; Frenectomy x Laser; Phrenectomy x Ankyloglossia; Laser x Pediatric Dentistry; Ankyloglossia x treatment; Surgical Procedures x Ankyloglossia; Surgery x Lingual Frenulum; Surgery x Ankyloglossia, from clinical studies published from 2009 to 2019. The results showed that a total of 7 clinical studies were analyzed using high-power laser (diode or CO2) in frenectomy techniques. In 401 patients who underwent lingual frenectomy, superior benefits and results of the surgical technique with high-power laser compared to the conventional one with a scalpel were observed. It can be concluded that the lingual frenectomy surgery with high power lasers provides a more efficient and comfortable treatment for the infant patient compared to the conventional method, there is no consensus on the high power laser wavelength more suitable for the procedure and irradiation parameters.Item Fotobiomodulação no tratamento de lesões por pressão: revisão sistemática com metanálise(Universidade Brasil, 2021) Macedo, Suellen Pereira Rodrigues; Navarro, Ricardo ScarparoPressure sores (PS) are important causes of morbidity, especially in patients admitted to intensive care units. Besides having a high cost to the health system, it adds an additional risk for the patients because it imposes the loss of the skin constitutional barrier. Photobiomodulation (PBM) with low-level laser has been shown to be effective in the treatment of PS in different stages. There is no consensus on the protocols of irradiation parameters, wavelength, energy, dose, intervals between sessions. The objective of this study was to evaluate the effects of photobiomodulation in the treatment of pressure sores from a systematic review of literature and meta-analysis. This is a systematic review carried out according to the PRISMA guidelines, which included studies without restrictions on year and language of publication, published until January 2020. Randomized studies that compared the effects of low-level laser therapy with a control group in patients with pressure ulcers were included. The studies were analyzed, reported descriptively and combined in a meta-analysis, the heterogeneity of the studies was assessed and the combined Odds Ratio for total PS healing in the follow-up period and the combined mean percentage area reduction were calculated. Six randomized clinical trials were included in the qualitative analysis and five trials in the quantitative analysis. A total of 207 patients were randomized to either FBM or control. The studies reported PBM with low-level laser with different wavelengths within the therapeutic window, in the range of 600 nm (red), 800 nm and 900 nm (infrared). From these data, subgroup analysis was performed and the combined Odds Ratio for each band was calculated, and no statistically significant difference was found in the set of studies as a whole and in the subgroups (p> 0.05). Only two studies described the percentage of reduction of the PS area. Analysis of these combined data showed Odds Ratio values equal to 1.34 (95% CI 0.8 - 2.24; Z 1.11; p= 0.82) in favor of the PBM but without statistical significance (p> 0.05). Of the included studies, only PBM with low-level laser therapy using red laser (660 nm) promoted a significant difference in the reduction of PS (p< 0.05). It can be concluded that in the studies included, photobiomodulation with red low-level laser was effective in the healing process of pressure sores in stages 2 and 3. It is suggested to carry out other randomized clinical trials to analyze the parameters of photobiomodulation.