Foreign body surgery in the inferior alveolar nerve canal following endodontic treatment

Endodontic treatment can result in the extrusion of dental sealant material beyond the apex of a tooth. Dental sealant materials are known to have potentially cytotoxic properties and can cause damage to biological structures. This article describes the case of a patient who had experienced a sustained painful dysaesthesia of the left inferior alveolar nerve as a result of extrusion of material beyond the apex of the tooth into the nerve canal, and the surgical approach taken to directly treat the nerve and improve her symptoms. CPD/Clinical Relevance: Awareness of the potential and sustained effects of dental sealant material on biological tissue, as well as the proximity of important anatomical structures, such as the inferior alveolar nerve, will help practitioners in the safe treatment of patients. Additionally, an awareness of the signs and symptoms of foreign body reactions within soft tissues will aid diagnosis and prompt onward referral for specialist treatments.

Plasticised Regenerated Silk/Gold Nanorods Hybrids as Sealant and Bio-Piezoelectric Materials

Manual and mechanical suturing are currently the gold standard for bowel anastomosis. If tissue approximation fails, anastomotic leaks occur. Anastomotic leaks may have catastrophic consequences. The development of a fully absorbable, biocompatible sealant material based on a bio-ink silk fibroin can reduce the chance of anastomotic leaks. We have produced a Ca-modified plasticised regenerated silk (RS) with gold nanorods sealant. This sealant was applied to anastomosed porcine intestine. Water absorption from wet tissue substrate applied compressive strains on hybrid RS films. This compression results in a sealant effect on anastomosis. The increased toughness of the hybrid plasticised RS resulted in the designing of a bio-film with superior elongation at break (i.e., ≈200%) and bursting pressure. We have also reported structure-dependent piezoelectricity of the RS film that shows a piezoelectric effect out of the plane. We hope that in the future, bowel anastomosis can be simplified by providing a multifunctional bio-film that makes feasible the mechanical tissue joint without the need for specific tools and could be used in piezoelectric sealant heads.

Fluoride Release of Giomer and Resin Based Fissure Sealants

Fissure sealants are applied to teeth to prevent caries development. The presence of the fissure sealant creates a protective barrier, which prevents plaque accumulation to the pits and fissure. They have a significant role in preventing pit and fissure caries. The aim of this study was to evaluate the time-dependent fluoride ion release of giomer- and resin-based fissure sealants. Fissure sealants were divided into 4 groups: BeautiSealant (Shofu, Japan), Clinpro Sealant (3M ESPE, USA), Helioseal F (Ivoclar Vivadent, Liechtenstein), Fissurit F (Voco, Germany). Disk shaped samples were prepared for each sealant material tested, and they were transferred into polyethylene vials containing 5 ml of deionized water. Fluoride ion diffusion was determined on days 1,2,3,7,14,21, and 28 (n=7). The fluoride concentration in these samples was analyzed using a pre-calibrated spectrophotometer in parts per million (ppm). These experiments were performed in triplicates at room temperature. ANOVA and Tukey’s HSD test were used for statistical analysis. BeautiSealant was released the highest amount of fluoride on day 1 (5.33 ppm), followed by a sudden decrease on the day 2 (2.17ppm). The burst effect was observed only in this group. Clinpro Sealant, Fissurit F and HelioSeal F groups presented fluoride release of 2.69, 2.94 and 2.91 ppm on the first day, respectively, without a significant difference (p > 0.05). After the first week, a constant fluoride release level has been reached. The fluoride release for the three resin-based fissure sealants was slightly lower than that for the giomer-based. After the first week, materials exhibited no significant difference and reached a plateau. The usage of a high and prolonged fluoride-releasing fissure sealant material should be considered by clinicians, particularly in patients with caries risk.

Effect of Surface Sealant Reapplication on Clinical Performance of HEMA-containing and HEMA-free Self-etch Adhesives: Two-year Results

SUMMARY Purpose: To evaluate the clinical performance of one-step self-etch adhesives over two years with and without the application of a surface sealant. Methods and Materials: In total, 160 restorations in 40 patients were performed for occlusal caries. Each patient received four Class I restorations, which included a 2-hydroxyethyl methacrylate (HEMA)–containing (Clearfil S3 Bond) and HEMA-free (G-aenial Bond) one-step self-etch adhesive system with and without surface sealant. Half of the restored teeth received Fortify Plus (Bisco) surface sealant material, and the other half were polished with Sof-Lex discs only. Two experienced calibrated examiners clinically evaluated the restorations at baseline and at one- and two-year recalls according to the modified US Public Health Service criteria. The filled surface sealant material was reapplied at each evaluation period. Results: After two years, none of the restorations had failed. There were no significant differences between the two dentin adhesives with or without a surface sealant application among the evaluation periods. Each dentin adhesive with and without surface sealant showed significant changes from the clinically ideal (Alfa) to clinically acceptable (Bravo) with regard to marginal discoloration, marginal adaptation, and surface texture. Sealed restorations exhibited lower ideal restoration rates with regard to color matching and surface texture and higher ideal restoration rates with respect to marginal adaptation compared with unsealed restorations. In addition, the surface sealant application reduced the marginal discoloration of the HEMA-free one-step self-etch adhesive. Conclusions: The two-year success rates of HEMA-containing and HEMA-free self-etch adhesives with and without surface sealing application were excellent. Although the surface sealant application was not effective with regard to changes in color matching and surface texture, it improved the marginal adaptation of the dentin adhesive and the marginal discoloration of a HEMA-free adhesive.

Clinical/Photographic/Scanning Electron Microscopy Analysis of Pit and Fissure Sealants After 22 Years: A Case Series

SUMMARY Pit and fissure sealant is a clinical technique adopted to prevent caries lesion development. Ionomeric and/or resin-based materials are commonly used for this purpose. This article presents a case series of sealed teeth with 22-year follow-up evaluated by clinical, photographic, and microscopic analysis. In 1992, sixteen patients (9-14 years of age) had at least three teeth sealed with one of the following materials: resin-modified glass ionomer cement (RMGIC, Vitrebond or Fuji II LC) or polyacid-modified resin composite (PMRC, VariGlass VLC), totaling 86 sealed permanent teeth. After 22 years, 10 patients were recalled, representing 41 teeth. The retention of sealants was assessed by three methods: clinical analysis by visual inspection; photography; and scanning electron microscope (SEM) images and classified as retained (pits and fissures filled by sealant material); partially retained (pits and fissures partially filled by sealant material); or totally lost (no material was found in pits and fissures). The SEM images provided a higher number of retained sealants when compared with the clinical and photographic evaluations. Also, no totally lost scores were found with SEM analysis, regardless of the sealing material. No caries lesions were found. A fully or partially retained sealant in pits and fissures was capable of preventing caries lesions after 22 years within the patient pool analyzed.