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Rossana I, Chiara C, Marco N, Niccolò B, Filippo G, Antonio B. Maxillary sinus augmentation via the bone lid technique: A prospective, radiographic case series. Clin Adv Periodontics 2024. [PMID: 38646843 DOI: 10.1002/cap.10288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Maxillary sinus augmentation is one of the most performed procedures to increase the bone quantity of the atrophic maxilla to allow implant placement. The aim of the present case series was to describe a surgical protocol to perform maxillary sinus augmentation with the "bone lid technique," and its outcomes in a cohort of patients eligible for the procedure. METHODS After the initial clinical evaluation, a cone-beam computed tomography (CBCT) examination was performed for preoperative assessment. Patients were then scheduled for surgical intervention. At 6-9 months follow-up, patients underwent a second CBCT scan to evaluate bone height following bone graft and to schedule implant placement. RESULTS A total of 11 patients were enrolled in the study with a total of 13 sinus lift procedures. Membrane perforation was registered in 4 cases (30.76%). Mean surgical time was 67.69 min (SD 6.51). Postoperative period was uneventful in all patients, in the absence of complications. The mean graft volume increase was 2.46 cm3 (SD 0.85), and the mean height increase was 14.27 mm (SD 3.18). Mean membrane thickness was 1.40 mm (SD 0.75). In all the 4 cases with sinus membrane perforation, the membrane had a thickness lower than 1 mm. CONCLUSIONS The present study highlights that the maxillary sinus augmentation with bone lid repositioning could provide repeatable results in terms of bone height increase. The technique appears reliable both in terms of bone gain and absence of complications. KEY POINTS The bone lid technique for maxillary sinus augmentation provides repeatable results in terms of bone height increase. The favorable clinical outcomes can be related to an enhancement of bone formation due to the unique osteoconductive and osteoinductive properties of autogenous bone, along with a reduction of soft tissue ingrowth. Complications were not observed in any of the patients following the surgical procedures. The risk of Schneiderian membrane perforation is inversely proportional to membrane thickness; the thinner the membrane is, the higher the risk to perforate it.
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Affiliation(s)
- Izzetti Rossana
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, University Hospital of Pisa, Pisa, Italy
| | - Cinquini Chiara
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, University Hospital of Pisa, Pisa, Italy
| | - Nisi Marco
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, University Hospital of Pisa, Pisa, Italy
| | - Baldi Niccolò
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, University Hospital of Pisa, Pisa, Italy
| | - Graziani Filippo
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, University Hospital of Pisa, Pisa, Italy
| | - Barone Antonio
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, University Hospital of Pisa, Pisa, Italy
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Bingol HB, Bender JC, Opsteen JA, Leeuwenburgh SC. Bone adhesive materials: From bench to bedside. Mater Today Bio 2023; 19:100599. [PMID: 37063249 PMCID: PMC10102013 DOI: 10.1016/j.mtbio.2023.100599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Biodegradable bone adhesives represent a highly sought-after type of biomaterial which would enable replacement of traditional metallic devices for fixation of bone. However, these biomaterials should fulfil an extremely large number of requirements. As a consequence, bone-adhesive biomaterials which meet all of these requirements are not yet commercially available. Therefore, this comprehensive review provides an extensive overview of the development of bone adhesives from a translational perspective. First, the definition, classification, and chemistry of various types of bone adhesives are highlighted to provide a detailed overview of this emerging class of biomaterials. In this review we particularly focused studies which describe the use of materials that are capable of gluing two pieces of bone together within a time frame of minutes to days. Second, this review critically reflects on i) the experimental conditions of commonly employed adhesion tests to assess bone adhesion and ii) the current state-of-the-art regarding their preclinical and clinical applicability.
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Affiliation(s)
- Hatice B. Bingol
- Department of Dentistry-Regenerative Biomaterials, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- GATT Technologies BV, Nijmegen, the Netherlands
| | | | | | - Sander C.G. Leeuwenburgh
- Department of Dentistry-Regenerative Biomaterials, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Corresponding author.
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Hafeez. A A, Furmeen. S S, Durairaj D, Rajasekaran MA, Rajiah D. Application of N-Butyl-2-Cyanoacrylate for the Treatment of Comminuted Fractures in the Anterior Wall of the Maxillary Sinus: A Prospective Clinical Study. Cureus 2023; 15:e35487. [PMID: 37007388 PMCID: PMC10053562 DOI: 10.7759/cureus.35487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2023] [Indexed: 02/27/2023] Open
Abstract
Objective The purpose of the study was to assess the clinical outcome of patients by using n-butyl-2-cyanoacrylate in the management of comminuted fracture segments of the anterior wall of the maxillary sinus in the zygomatico-maxillo-facial complex region. Material and methods A prospective study was done at a tertiary care teaching institute in India with a study population of ten patients in a single group. The method of recruitment was a convenient sampling method. Out of all the study subjects, three patients had isolated maxillary sinus wall fractures, whereas the remaining seven had other associated facial fractures that required stable fixation with mini plates. The comminuted fractures of the anterior wall of the maxillary sinus were carefully reduced through an intra-oral approach, and n-butyl-2-cyanoacrylate was applied over the edges of fractured segments. The segments were left undisturbed for one minute and closed with a 3-0 vicryl. The outcome variables, namely bone alignment visualised through computed tomography (CT) scan postoperatively, paresthesia or hypoesthesia of the infraorbital nerve, postoperative infection, and wound dehiscence, were noted at one-week, one-month, three-month, and six-month intervals. Data were analysed using the Chi-square test. Results Among all patients, seven had satisfactory bone alignment. A total of seven patients recovered from hypoesthesia of the infraorbital nerve. The association of bone alignment with hypoesthesia or paresthesia revealed a highly significant p-value (0.002) using the Chi-square test. Also, an association between postoperative infection and wound dehiscence showed substantial results with a p-value less than 0.05. Conclusion Good bone alignment was seen postoperatively in 70% of patients. The cyanoacrylate used had no adverse reactions, and its application was restricted to non-load-bearing areas in this study. Further studies with a higher level of evidence and a larger sample size are needed to validate the use of adhesives for bone fixation in other regions of the face.
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Gomez V, Cairns M, Weinhold P, Jeffs AD, Bortner B, Paterno AV, Dahners L, Draeger RW. 2-Octyl Cyanoacrylate (Dermabond®) Inhibits Bridging Bone Formation of Articular Fractures in a Rat Model. Cureus 2021; 13:e16758. [PMID: 34476134 PMCID: PMC8403484 DOI: 10.7759/cureus.16758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2021] [Indexed: 11/05/2022] Open
Abstract
One technique often used for small intraarticular fracture fixation involves the use of 2-octyl-cyanoacrylate (2-OCTA) (Dermabond®, Ethicon, Inc., Raritan, USA). The purpose of this study was to determine if 2-OCTA impedes bony healing. Osteochondral plugs in 38 retired Sprague-Dawley rats were created in both hind legs. Each rat had one plug dipped in 2-OCTA before fixation and one control plug. H&E staining was used to quantify bone bridging. The 2-OCTA group had a mean bridging bone circumference of 22.80%, significantly less than 67.75% in the control group (p<0.05). Our data suggests that 2-OCTA blocks bridging bone formation, making it a poor choice for fracture fixation.
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Affiliation(s)
- Vincent Gomez
- Department of Orthopaedic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Mark Cairns
- Department of Orthopaedic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Paul Weinhold
- Department of Orthopaedic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Alexander D Jeffs
- Department of Orthopaedic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Benjamin Bortner
- Department of Orthopaedic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Anthony V Paterno
- Department of Orthopaedic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Laurence Dahners
- Department of Orthopaedic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Reid W Draeger
- Department of Orthopaedic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
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Kim Y, Beck-Broichsitter M, Banga AK. Design and Evaluation of a Poly(Lactide- co-Glycolide)-Based In Situ Film-Forming System for Topical Delivery of Trolamine Salicylate. Pharmaceutics 2019; 11:E409. [PMID: 31408990 PMCID: PMC6723844 DOI: 10.3390/pharmaceutics11080409] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/05/2019] [Accepted: 08/05/2019] [Indexed: 01/02/2023] Open
Abstract
Trolamine salicylate (TS) is a topical anti-inflammatory analgesic used to treat small joint pain. The topical route is preferred over the oral one owing to gastrointestinal side effects. In this study, a poly(lactide-co-glycolide) (PLGA)-based in situ bio-adhesive film-forming system for the transdermal delivery of TS was designed and evaluated. Therefore, varying amounts (0%, 5%, 10%, 20%, and 25% (w/w)) of PLGA (EXPANSORB® DLG 50-2A, 50-5A, 50-8A, and 75-5A), ethyl 2-cyanoacrylate, poly (ethylene glycol) 400, and 1% of TS were dissolved together in acetone to form the bio-adhesive polymeric solution. In vitro drug permeation studies were performed on a vertical Franz diffusion cell and dermatomed porcine ear skin to evaluate the distinct formulations. The bio-adhesive polymeric solutions were prepared successfully and formed a thin film upon application in situ. A significantly higher amount of TS was delivered from a formulation containing 20% PLGA (45 ± 4 µg/cm2) and compared to PLGA-free counterpart (0.6 ± 0.2 µg/cm2). Furthermore, the addition of PLGA to the polymer film facilitated an early onset of TS delivery across dermatomed porcine skin. The optimized formulation also enhanced the delivery of TS into and across the skin.
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Affiliation(s)
- Yujin Kim
- Centre for Drug Delivery Research, Department of Pharmaceutical Sciences, College of Pharmacy, Mercer University, Atlanta, GA 30341, USA
| | | | - Ajay K Banga
- Centre for Drug Delivery Research, Department of Pharmaceutical Sciences, College of Pharmacy, Mercer University, Atlanta, GA 30341, USA.
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Abstract
RATIONALE A Mason type III radial head fracture, which is characterized by comminuted fragments of the radial head, is a severe injury. Open reduction and internal fixation (ORIF) is an alternative treatment method; however, the technique of using an on-table reduction in combination with surgical glue is rarely reported. PATIENT CONCERNS A 48-year-old man was admitted to our department with complaints of elbow pain after falling down. Elbow radiography and computed tomography (CT) demonstrated characteristics of fractures before the operation. DIAGNOSIS Radiographic images showed a Mason type III radial head fracture. INTERVENTIONS The patient underwent ORIF at our hospital. During the operation, the technique of on-table reconstruction combined with surgical glue was used. OUTCOMES The patient recovered well and was able to participate in his usual work. LESSONS Mason type III radial head fractures could be treated with ORIF, and a satisfactory result could be anticipated, thus avoiding a radial head replacement or resection. Anatomical reduction of a comminuted radial head could be obtained via an on-table reconstruction and application of surgical glue.
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Affiliation(s)
- Da-Wei Chen
- Department of Orthopaedic Trauma, East Hospital, Tongji University School of Medicine
| | - Wan-Kun Hu
- Department of Orthopaedics, Shanghai Pudong Hospital, Fudan University Pudong Medical Center
| | - Jia-Qian Zhou
- Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
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Raja M, Shelton JC, Salamat-Zadeh F, Tavakoli M, Donell S, Watts G, Vadgama P. An electrochemical study of acrylate bone adhesive permeability and selectivity change during in vitro ageing: A model approach to the study of biomaterials and membrane barriers. Anal Chim Acta X 2019; 2:100009. [PMID: 33117976 PMCID: PMC7587029 DOI: 10.1016/j.acax.2019.100009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/20/2019] [Accepted: 02/26/2019] [Indexed: 12/02/2022] Open
Abstract
This study assessed the solute permeability of a family of UV and moisture cured acrylates-based adhesives during in vitro ageing in pH 7.4 buffer. Acrylates have a potential role in bone fracture fixation, but their inability to allow microsolute exchange between the fractured bone surfaces may contribute to ineffective healing. Cyclic voltammetry and chronoamperometry were used to determine the diffusion coefficients for various electrochemically active probe molecules (O2, H2O2, acetaminophen, catechol, uric acid and ascorbic acid) at proprietary acrylic, urethane – acrylate and cyanoacrylate adhesives. All adhesives proved to be impermeable for up to 9 days ageing, following which a near-exponential increase in permeability resulted for all solutes. At 18 days, the diffusion coefficients were in the range of 10−5 cm2s−1 for O2 and H2O2 and 10−6 cm2s−1 for the organic solutes; no transport selectivity was seen between the latter. Adhesive joint strength showed a direct, inverse, correlation with permeability, with the more hydrophilic cyanoacrylates showing the greatest loss of strength. Adhesive permeabilisation does not appear to be compatible with the retention of bonding strength, but it serves as a new non-destructive predictor of adhesion strength change during ageing and practical use.
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Affiliation(s)
- M Raja
- School of Materials and Engineering Science, Queen Mary University of London, Mile End Road, London, E1 4NS, UK
| | - J C Shelton
- School of Materials and Engineering Science, Queen Mary University of London, Mile End Road, London, E1 4NS, UK
| | | | - M Tavakoli
- KTN LTD, Suite 220 Business Design Centre, 52 Upper Street, London, N1 0QH, UK
| | - S Donell
- University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK
| | - G Watts
- Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK
| | - P Vadgama
- School of Materials and Engineering Science, Queen Mary University of London, Mile End Road, London, E1 4NS, UK
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Hochuli-Vieira E, Engler Pinto ACB, Pereira-Filho VA, Saska S, Monnazzi MS. Adhesives based on butyl-cyanoacrylate for fixation of autologous bone graft: Pilot study in rabbits. Dent Traumatol 2017; 33:261-268. [DOI: 10.1111/edt.12328] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Eduardo Hochuli-Vieira
- Department of Diagnosis and Oral and Maxillofacial Surgery; Dental School of Araraquara; UNESP; Araraquara Brazil
| | | | | | - Sybele Saska
- Department of General and Inorganic Chemistry; Institute of Chemistry at Araraquara; UNESP; Araraquara Brazil
| | - Marcelo Silva Monnazzi
- Department of Diagnosis and Oral and Maxillofacial Surgery; Dental School of Araraquara; UNESP; Araraquara Brazil
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Sarin J, Hiltunen M, Hupa L, Pulkkinen J, Vallittu PK. Compression properties and dissolution of bioactive glass S53P4 and n-butyl-2 cyanoacrylate tissue adhesive-composite. Biomed Mater Eng 2016; 27:425-436. [PMID: 27689575 DOI: 10.3233/bme-161596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Bioactive glass (BG)-containing fiber-reinforced composite implants, typically screw-retained, have started to be used clinically. In this study, we tested the mechanical strength of composites formed by a potential implant adhesive of n-butyl-2-cyanoacrylate glue and BG S53P4 particles. Water immersion for 3, 10 or 30 days had no adverse effect on the compression strength. When cyanoacrylate glue-BG-composites were subjected to simulated body fluid immersion, the average pH rose to 7.52 (SD 0.066) from the original value of 7.35 after 7 days, and this pH increment was smaller compared to BG particle-group or fibrin glue-BG-composite group. Based on these results n-butyl-2 cyanoacrylate glue, by potentially producing a strong adhesion, might be considered a possible alternative for fixation of BG S53P4 containing composite implants. However, the mechanical and solubility properties of the cyanoacrylate glue may not encourage the use of this tissue adhesive with BG particles.
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Affiliation(s)
- Jussi Sarin
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Markus Hiltunen
- BioCity, Turku Biomaterials Research Program, Turku Clinical Biomaterials Centre - TCBC, Finland
| | - Leena Hupa
- Process Chemistry Centre, Laboratory of Inorganic Chemistry, Åbo Akademi University, Finland
| | - Jaakko Pulkkinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Pekka K Vallittu
- BioCity, Turku Biomaterials Research Program, Turku Clinical Biomaterials Centre - TCBC, Finland.,Department of Biomaterials Science and Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, and City of Turku Welfare Division, Oral Health Care, Turku, Finland
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Demirtaş MM, Cimen S, Ketenci B, Günay R, Akçar M, Özler A. Late Follow-Up of Cyanoacrylate Usage in Cardiothoracic Surgery. Asian Cardiovasc Thorac Ann 2016. [DOI: 10.1177/021849239900700308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In cardiovascular and thoracic surgery, troublesome bleeding and sternal dehiscence can be life-threatening if not managed appropriately. We used commercially available cyanoacrylate adhesive 21 times in 20 sporadic patients for the management of 6 different problems: sternal gluing in 7 cases; anastomotic line reinforcement and bleeding control with a glued Teflon or pericardial patch in 6; right ventricular or superior vena caval patch repair in 5; and 1 case each of left ventricular apical glued Teflon felt, arterial wall reinforcement, and control of air leakage after lung surgery. The mean age of the patients was 55.7 ± 12.5 years, ranging from 34 to 71 years. Successful results were obtained in 18 patients and 17 were alive on follow-up at 7.7 ± 5.5 months (range, 2 to 16 months). We used two different commercial brands of adhesive but obtained good results with only one of these preparations. Although commercially available cyanoacrylate is a new adjunct to cardiac surgery with documented safety and lifesaving results at negligible cost, the appropriate polymer for best results needs to be defined.
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Affiliation(s)
- M Murat Demirtaş
- Siyami Ersek Thoracic & Cardiovascular Surgery Center Istanbul, Turkey
| | - Serdar Cimen
- Siyami Ersek Thoracic & Cardiovascular Surgery Center Istanbul, Turkey
| | - Bülend Ketenci
- Siyami Ersek Thoracic & Cardiovascular Surgery Center Istanbul, Turkey
| | - Rafet Günay
- Siyami Ersek Thoracic & Cardiovascular Surgery Center Istanbul, Turkey
| | - Murat Akçar
- Siyami Ersek Thoracic & Cardiovascular Surgery Center Istanbul, Turkey
| | - Azmi Özler
- Siyami Ersek Thoracic & Cardiovascular Surgery Center Istanbul, Turkey
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Vieira JDS, Santos FR, de Freitas JV, Baratto-Filho F, Gonzaga CC, de Araujo MR. Bond strength evaluation of cyanoacrylate-based adhesives and screws for bone fixation. Oral Maxillofac Surg 2016; 20:157-160. [PMID: 26732084 DOI: 10.1007/s10006-015-0541-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 12/21/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Bone graft is a very common procedure that is performed when bone volume needs to be increased before a dental implant. Screws and miniplates are the clinical standards for osteosynthesis. However, some disadvantages for this method have been reported, including artifacts on radiological images, infection, screw loosening, and the need to remove screws that interfere with the dental implants. Bone adhesives are a promising alternative for bone graft surgery. PURPOSE The aim of this study was to compare the shear bond strength of two cyanoacrylate-based adhesives and titanium screws for bone graft fixation. METHODS Pig jaw samples were cut into rectangular bars (2 × 6 × 20 mm) and bonded with a 5-mm overlap of N-butyl cyanoacrylate and ethyl cyanoacrylate, and 1.5-mm titanium screws were inserted into the center of the contact area. The blocks were fixed on a shear bond strength device that was coupled to a universal testing machine. The maximum force (N) was recorded on a computer and divided by the bonded area (in mm(2)) in order to calculate the bond strength (MPa). The data were statistically analyzed with ANOVA and Tukey's test (α = 0.05). RESULTS The shear bond strengths of the screws were significantly higher than both cyanoacrylate adhesives, which presented statistically similar bond strength means, and have the biomechanical potential to be used for bone fixation. CONCLUSIONS Ethyl cyanoacrylate is an inexpensive adhesive that has multiple purposes and can be considered as an alternative for bone fixation.
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Affiliation(s)
- Juliana de Souza Vieira
- Graduate Program in Clinical Dentistry, Positivo University, Rua Professor Pedro Viriato Parigot de Souza 5300. Campo Comprido, Curitiba, Paraná, 81280-330, Brazil
| | - Felipe Rychuv Santos
- Graduate Program in Clinical Dentistry, Positivo University, Rua Professor Pedro Viriato Parigot de Souza 5300. Campo Comprido, Curitiba, Paraná, 81280-330, Brazil
| | - Jessica Vavassori de Freitas
- Graduate Program in Clinical Dentistry, Positivo University, Rua Professor Pedro Viriato Parigot de Souza 5300. Campo Comprido, Curitiba, Paraná, 81280-330, Brazil
| | - Flares Baratto-Filho
- Graduate Program in Clinical Dentistry, Positivo University, Rua Professor Pedro Viriato Parigot de Souza 5300. Campo Comprido, Curitiba, Paraná, 81280-330, Brazil
| | - Carla Castiglia Gonzaga
- Graduate Program in Clinical Dentistry, Positivo University, Rua Professor Pedro Viriato Parigot de Souza 5300. Campo Comprido, Curitiba, Paraná, 81280-330, Brazil
| | - Melissa Rodrigues de Araujo
- Graduate Program in Clinical Dentistry, Positivo University, Rua Professor Pedro Viriato Parigot de Souza 5300. Campo Comprido, Curitiba, Paraná, 81280-330, Brazil.
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Kim BH, Kim JY, Park JS, Kang SH, Lim DJ, Yu MS. Combined use of scoring incisions and 2-octylcyanoacrylate adhesive during endonasal septoplasty to correct cartilaginous deviations. Am J Rhinol Allergy 2015; 28:209-13. [PMID: 25514476 DOI: 10.2500/ajra.2014.28.4122] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Applying 2-octylcyanoacrylate (2-OCA) tissue adhesive onto scoring incisions may increase efficacy and prevent concavity recurrence after septal deviation treatment. The present study evaluates the utility of 2-OCA adhesive application during endonasal septoplasty. METHODS The postoperative outcomes were compared between two consecutive periods in a single surgical department. Between March 2011 and March 2012, 23 consecutive patients underwent septoplasty using scoring incisions without 2-OCA application (scoring alone group), and between April 2012 and April 2013, the scoring incision gaps were filled with 2-OCA in 27 patients (scoring + CA group). The patients were followed up for more than six months. RESULTS A straight septum was achieved in 37.0% of patients in the scoring alone group versus 58.3% in the scoring + CA group. The postoperative symptom score for nasal obstruction was significantly improved in both groups. Persistent septal swelling developed in three (12.5%) patients in the scoring + CA group. Neither group experienced major complications such as septal hematoma, abscess, or septal perforation. CONCLUSIONS Application of 2-OCA adhesive onto scoring incisions appears to be a reliable and effective technique to correct deviated cartilage during endonasal septoplasty. However, the volume of 2-OCA applied onto the septum should be minimized to avoid potential foreign body reaction. A long-term follow-up study is warranted.
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Affiliation(s)
- Bo-Hyung Kim
- Department of Otorhinolaryngology, Konkuk University School of Medicine, Chungju, South Korea
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Bicer YO, Koybasi S, Seyhan S, Firat T, Kazaz H. Outcomes from Cyanoacrylate Use in Tracheal Anastomosis in a Rat Model. Otolaryngol Head Neck Surg 2015; 153:815-21. [PMID: 26340926 DOI: 10.1177/0194599815601986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 07/31/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We aimed to investigate the histologic effects of N-butyl-2-cyanoacrylate (NBCA) and metacryloxisulfolane (MS) comonomer on tracheal anastomosis in vivo on a rat model of tracheal resection and end-to-end anastomosis. STUDY DESIGN Animal experiment. Rat model of tracheal resection and end-to-end anastomosis. SETTING Animal laboratory. SUBJECTS AND METHODS Tracheal resection and end-to-end anastomosis were performed in 28 Wistar albino rats. Rats were randomly divided into 2 groups: control (n = 14), in which anastomoses were performed with 8/0 Vicryl, and study (n = 14), in which NBCA and MS comonomer was used in addition to 8/0 Vicryl to perform anastomosis. Seven rats from each group were sacrificed on day 7 and the remaining on day 28 for gross and histologic examination. RESULTS Indurations at the site of anastomoses were detected in all rats of study group. Slight narrowing at the site of anastomosis was observed in 8 rats of the study group and in only 1 of the control group. The difference was significant on day 28 (P = .021). The inflammatory cell infiltration was significantly increased in the study group on day 28 (P = .022). Epithelial regeneration was found to be worse in the study group on day 28 (P = .022). CONCLUSIONS The use of NBCA and MS comonomer increased the inflammation in rat tracheal anastomosis with respect to inflammatory cell count and epithelial regeneration. So the use of NBCA and MS comonomer in tracheal surgery cannot be recommended yet in the light of our data.
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Affiliation(s)
- Yusuf Ozgur Bicer
- Department of Otolaryngology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | - Serap Koybasi
- Department of Otolaryngology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | - Sinan Seyhan
- Department of Otolaryngology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | - Tulin Firat
- Department of Histology and Embryology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | - Hasan Kazaz
- Department of Otolaryngology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
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Foresta E, Torroni A, Gasparini G, Saponaro G, Longo G, Boniello R, Cervelli D, Marianetti TM, Pelo S, Moro A. Use of N-Butyl-2-Cyanoacrylate (Glubran2(®)) in Fractures of Orbital-Maxillo-Zygomatic Complex. J Maxillofac Oral Surg 2015. [PMID: 26225074 DOI: 10.1007/s12663-015-0751-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Fractures of the orbital-maxillo-zygomatic complex are among the most common fractures affecting the facial skeleton. Goal of surgical treatment is the realignment of fracture lines for a complete functional and aesthetic rehabilitation. MATERIALS AND METHODS From January 2008 to January 2011 in the Department of Maxillofacial Surgery of Complesso Integrato Columbus of the Università Cattolica del Sacro Cuore in Rome, 25 patients, affected by comminute fractures of the anterior wall of the maxillary sinus associated with fractures of the orbital-maxillary complex were selected. The synthesis of the larger fracture fragments was performed by plates and screws (1.5 mm) while a biocompatible glue (N-Butyl-2-Cyanoacrylate-Glubran2(®)) was applied to treat the comminute fractures of the anterior wall of the maxillary sinus. RESULTS AND CONCLUSION The aim of our article is to report our experience and a review of the literature on application of-Butyl-2-Cyanoacrylate for treatment of comminute fractures of the anterior wall of the maxillary sinus. According to the results achieved in our study the N-Butyl-2-Cyanoacrylate can be indicated to treat comminuted fractures of the anterior wall of the maxillary sinus which could not easily be treated with internal rigid fixation.
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Affiliation(s)
- Enrico Foresta
- c/o U.O.C. Chirurgia Maxillo Facciale, Complesso Integrato Columbus, Università Cattolica del Sacro Cuore, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - Andrea Torroni
- c/o U.O.C. Chirurgia Maxillo Facciale, Complesso Integrato Columbus, Università Cattolica del Sacro Cuore, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - Giulio Gasparini
- c/o U.O.C. Chirurgia Maxillo Facciale, Complesso Integrato Columbus, Università Cattolica del Sacro Cuore, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - Gianmarco Saponaro
- c/o U.O.C. Chirurgia Maxillo Facciale, Complesso Integrato Columbus, Università Cattolica del Sacro Cuore, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - Giuliana Longo
- c/o U.O.C. Chirurgia Maxillo Facciale, Complesso Integrato Columbus, Università Cattolica del Sacro Cuore, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - Roberto Boniello
- c/o U.O.C. Chirurgia Maxillo Facciale, Complesso Integrato Columbus, Università Cattolica del Sacro Cuore, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - Daniele Cervelli
- c/o U.O.C. Chirurgia Maxillo Facciale, Complesso Integrato Columbus, Università Cattolica del Sacro Cuore, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - Tito Matteo Marianetti
- c/o U.O.C. Chirurgia Maxillo Facciale, Complesso Integrato Columbus, Università Cattolica del Sacro Cuore, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - Sandro Pelo
- c/o U.O.C. Chirurgia Maxillo Facciale, Complesso Integrato Columbus, Università Cattolica del Sacro Cuore, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - Alessandro Moro
- c/o U.O.C. Chirurgia Maxillo Facciale, Complesso Integrato Columbus, Università Cattolica del Sacro Cuore, Via Giuseppe Moscati, 31, 00168 Rome, Italy
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Esteves JC, Monteiro JM, Aranega AM, Betoni Junior W, Sonoda CK. Utilization of Ethyl Cyanoacrylate and 2-Octyl Cyanoacrylate Adhesives for Autogenous Bone Graft Fixation: Histomorphometric Study in Rats. J ORAL IMPLANTOL 2014; 40:411-7. [DOI: 10.1563/aaid-joi-d-12-00063] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The present study analyzes the repair process of autogenous bone graft in a block fixed with ethyl cyanoacrylate and 2-octyl cyanoacrylate adhesives in rat calvaria. Forty-eight rats, divided into 3 groups, received round osteotomies at the right parietal bone for the attainment of autogenous bone graft fragment, which was fixed at the opposite side to the donor site with ethyl cyanoacrylate (ethyl group) and 2-octyl cyanoacrylate (octyl group) adhesives. In the control group, bone fragment was only juxtaposed at the parietal bone surface without any fixation material. The animals were euthanized after 10 and 60 postoperative days. The calvariae were processed in a laboratory for the attainment of slides stained through the hematoxylin and eosin technique for histological and histometric analysis. The qualitative analysis showed a discrete inflammatory infiltrate in the control group and moderate inflammatory infiltrate in the ethyl and octyl groups at the 10-day period, which remained at the 60-day period, mainly in the octyl group. The bone fragment remained bonded to the recipient site through the adhesive, but graft incorporation was not observed in any of the specimens. Resorption was higher in the octyl group followed by the ethyl and control groups, both at the 10- and 60-day periods, but with no statistical significance (P < .05). Although promoting graft fixation and its maintenance at the recipient site, both studied adhesives did not allow the graft incorporation, producing a localized and discrete inflammatory reaction, which persisted at 60 days, being more intense in the octyl cyanoacrylate group.
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Affiliation(s)
- Jônatas Caldeira Esteves
- Department of Diagnosis and Surgery, Division of Periodontology, Universidade Estadual Paulista, School of Dentistry, Araraquara, Brazil
| | | | - Alessandra Marcondes Aranega
- Department of Surgery and Integrated Clinic, Universidade Estadual Paulista, School of Dentistry, Araçatuba, Brazil
| | | | - Celso Koogi Sonoda
- Department of Surgery and Integrated Clinic, Universidade Estadual Paulista, School of Dentistry, Araçatuba, Brazil
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Short-Term Evaluation of Grafts Fixed With Either N-Butyl-2-Cyanocrylate or Screws. J Oral Maxillofac Surg 2014; 72:676-82. [DOI: 10.1016/j.joms.2013.11.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 10/08/2013] [Accepted: 11/15/2013] [Indexed: 11/21/2022]
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Hung SH, Tseng TM, Hsu HT, Tseng H. Adhesive strength of ethyl-2-cyanoacrylate tissue adhesive: how strong is it? Surg Today 2013; 44:927-32. [DOI: 10.1007/s00595-013-0777-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 04/01/2013] [Indexed: 12/12/2022]
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Lins RDAU, Gomes RCB, Santos KSAD, Silva PVD, Silva RTMD, Ramos IA. Use of cyanoacrylate in the coaptation of edges of surgical wounds. An Bras Dermatol 2013. [PMID: 23197206 PMCID: PMC3699926 DOI: 10.1590/s0365-05962012000600008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Cyanoacrylate has been used in several fields of different surgical specialties as an
adhesive for closure of gingival flaps and in mucous and cutaneous lacerations. One
of its advantages is that it has an excellent immunological response. In view of
aesthetic needs, cyanoacrylate has been applied with satisfactory results, when
compared with sutures. It presents better coaptation of edges of cutaneous and
mucosal lesions, smaller residual scars, and biocompatibility. However, it is limited
to areas of little tissue tension. This work attempts to provide a literature review
with the aim of revealing the advantages of using tissue adhesives, especially
cyanoacrylates, in wound coaptation in comparison with conventional methods.
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Osman MA, Elsharkawy MAM, Othman MHM. Repair of fistulae in-ano in children using image guided Histoacryl injection after failure of conservative treatment. J Pediatr Surg 2013; 48:614-8. [PMID: 23480921 DOI: 10.1016/j.jpedsurg.2012.11.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 11/02/2012] [Accepted: 11/09/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE Our aim is to determine the feasibility and safety of N Butyl Cyanoacrylate (HISTOACRYL), adhesive material in the treatment of fistula in-ano in infants and children. PATIENTS AND METHODS 30 patients who presented with a perianal fistula (25 males and 5 females) were studied. Their ages ranged from 9 months to 15 years. All patients received medical (conservative) treatment. Six patients improved, 7 patients were subjected to surgical intervention, and the remaining 17 patients were managed by injection of adhesive material through the fistula under fluoroscopic guidance and general anesthesia after failure of medical management. RESULTS Of the 17 children who underwent injection therapy to the fistula in-ano after failed medical management, 14 patients were males. The procedure time was 10 to 15 min. The mean follow up was 18 months. Two patients had a recurrence after one to two months. They were subjected to reinjection, and one of them had a second recurrence. Overall, 16 (94%) of 17 patients have had successful closure of their fistula, and one of them healed from a second injection. CONCLUSION Our method of tissue adhesive Cyanoacrylate injection is safe, feasible, and can be used repeatedly in treatment of fistula in-ano in infants and children.
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Affiliation(s)
- Mohamed A Osman
- Pediatric Surgical Unit, Surgery Department, Faculty of Medicine, Assiut University, Egypt.
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Cytotoxicity Testing of Methyl and Ethyl 2-Cyanoacrylate Using Direct Contact Assay on Osteoblast Cell Cultures. J Oral Maxillofac Surg 2013; 71:35-41. [DOI: 10.1016/j.joms.2012.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 07/19/2012] [Accepted: 09/02/2012] [Indexed: 11/30/2022]
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Schreader KJ, Bayer IS, Milner DJ, Loth E, Jasiuk I. A polyurethane-based nanocomposite biocompatible bone adhesive. J Appl Polym Sci 2012. [DOI: 10.1002/app.38100] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Mestieri LB, Saska S, Carrodeguas RG, Gaspar AMM. Evaluation of n -Butyl Cyanoacrylate Adhesive in Rat Subcutaneous Tissue. Dermatol Surg 2012; 38:767-71. [DOI: 10.1111/j.1524-4725.2011.02278.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Baş B, Özden B, Bekçioğlu B, Sanal K, Gülbahar M, Kabak Y. Screw fixation is superior to N-butyl-2-cyanoacrylate in onlay grafting procedure: a histomorphologic study. Int J Oral Maxillofac Surg 2012; 41:537-43. [DOI: 10.1016/j.ijom.2011.10.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 09/05/2011] [Accepted: 10/24/2011] [Indexed: 10/15/2022]
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Esteves JC, Borrasca AG, Aranega AM, Garcia Junior IR, Magro Filho O. Histomorphometric analysis of the repair process of autogenous bone grafts fixed at rat calvaria with cyanoacrylate. J Appl Oral Sci 2012; 19:529-34. [PMID: 21986659 PMCID: PMC3984202 DOI: 10.1590/s1678-77572011000500016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Accepted: 10/26/2010] [Indexed: 11/22/2022] Open
Abstract
Objective The purpose of this study was to perform histological and histometric analyses of
the repair process of autogenous bone grafts fixed at rat calvaria with
ethyl-cyanoacrylate adhesive. Material and Methods Thirty-two rats were divided into two groups (n=16), Group I - Control and Group
II - Adhesive. Osteotomies were made at the right parietal bone for graft
obtainment using a 4-mm-diameter trephine drill. Then, the bone segments were
fixed with the adhesive in the parietal region of the opposite side to the donor
site. After 10 and 30 days, 8 animals of each group were euthanized and the
calvarias were laboratorially processed for obtaining hematoxylin and
eosin-stained slides for histological and histometric analyses. Results An intense inflammatory reaction was observed at the 10-day period. At 30 days,
this reaction was less intense, despite the presence of adhesive at the
recipient-site/graft interface. Graft incorporation to the recipient site was
observed only at the control group, which maintained the highest graft size at 10
and 30 days. Conclusions Although the fragment was stable, the presence of adhesive in Group II did not
allow graft incorporation to the recipient site, determining a localized, discrete
and persistent inflammatory reaction.
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Ozyazgan I, Idacı O. A new method that uses cyanoacrylate tissue adhesive to fill scoring incisions in septal cartilage correction. Laryngoscope 2011; 121:1164-72. [PMID: 21557229 DOI: 10.1002/lary.21738] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Revised: 01/07/2011] [Accepted: 01/11/2011] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS Numerous methods are used in the correction of deviated septal cartilage. One of these methods is to perform partial-thickness incisions (scoring) on the concave side of the deviated cartilage. In this retrospective report, we present a series of patients who were treated by filling the scoring incision gaps with cyanoacrylate-based tissue adhesives to increase the effectiveness of scoring incisions and to maintain stability of the corrected concave cartilage segments. STUDY DESIGN A retrospective clinical study presenting a patient group who was treated using a new surgical method for septal deviation. METHODS Twenty-three patients with septum deviation and nasal deformity underwent surgery with the open rhinoplasty approach. Intra- or extracorporeal scoring incisions were performed on the concave side of the deviated septal cartilage, and cyanoacrylate tissue adhesives were applied to the incisions of the corrected cartilage. After polymerization and hardening of the cyanoacrylate tissue adhesive, the operation continued in the normal manner. Preoperative and postoperative clinical results and computed tomography images of the patients were assessed. RESULTS With a mean 24-month follow-up, all patients with respiratory complaints related to deviated septum reported improvement in nose breathing. Clinical and radiologic observations showed that the corrected septum was stable in its new position. There were no complications arising from the use of cyanoacrylate. CONCLUSIONS Cyanoacrylate is an effective, instant, safe method of treatment in correcting deviated septal cartilage with scoring incisions and filling the gaps of the incisions.
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Affiliation(s)
- Irfan Ozyazgan
- Department of Plastic, Reconstructive and Esthetic Surgery, Erciyes University, Faculty of Medicine, Kayseri, Turkey.
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Schneider G. Tissue adhesives in otorhinolaryngology. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2011; 8:Doc01. [PMID: 22073094 PMCID: PMC3199812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
The development of medical tissue adhesives has a long history without finding an all-purpose tissue adhesive for clinical daily routine. This is caused by the specific demands which are made on a tissue adhesive, and the different areas of application. In otorhinolaryngology, on the one hand, this is the mucosal environment as well as the application on bones, cartilage and periphery nerves. On the other hand, there are stressed regions (skin, oral cavity, pharynx, oesophagus, trachea) and unstressed regions (middle ear, nose and paranasal sinuses, cranial bones). But due to the facts that adhesives can have considerable advantages in assuring surgery results, prevention of complications and so reduction of medical costs/treatment expenses, the search for new adhesives for use in otorhinolaryngology will be continued intensively. In parallel, appropriate application systems have to be developed for microscopic and endoscopic use.
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Affiliation(s)
- Gerlind Schneider
- Department of Otorhinolaryngology, Friedrich Schiller University Jena, Germany,*To whom correspondence should be addressed: Gerlind Schneider, Department of Otorhinolaryngology, Friedrich Schiller University Jena, Lessingstrasse 2, 07743 Jena, Germany, Telephone 03641/935015, Fax 03641/935129, E-mail:
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de Oliveira Neto PJ, Cricchio G, Hawthorne AC, Okamoto R, Sennerby L, Lungren S, Salata LA. Tomographic, histological, and immunohistochemical evidences on the use of N-butyl-2-cyanoacrilate for onlay graft fixation in rabbits. Clin Implant Dent Relat Res 2010; 14:861-71. [PMID: 21176098 DOI: 10.1111/j.1708-8208.2010.00321.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The bone tissue responses to Cyanoacrylate have been described in the literature, but none used N-butyl-2-cyanoacrilate (NB-Cn) for bone graft fixation. PURPOSE The aims of the study were: (a) to analyze the bone grafts volume maintenance fixed either with NB-Cn or titanium screw; (b) to assess the incorporation of onlay grafts on perforated recipient bed; and (c) the differences of expression level of tartrate-resistant acid phosphatase (TRAP) protein involved in bone resorption. MATERIALS AND METHODS Eighteen New Zealand White rabbits were submitted to calvaria onlay grafting on both sides of the mandible. On one side, the graft was fixed with NB-Cn, while on the other hand the bone graft was secured with an osteosynthesis screw. The computed tomography (CT) was performed just after surgery and at animals sacrifice, after 1 (n = 9) and 6 weeks (n = 9), in order to estimate the bone grafts volume along the experiments. Histological sections of the grafted areas were prepared to evaluate the healing of bone grafts and to assess the expression of TRAP protein. RESULTS The CT scan showed better volume maintenance of bone grafts fixed with NB-Cn (p ≤ 0.05) compared with those fixed with screws, in both experimental times (analysis of variance). The immunohistochemical evaluation showed that the TRAP expression in a 6-week period was significantly higher compared with the 1-week period, without showing significant difference between the groups (Wilcoxon and Mann-Whitney). Histological analysis revealed that the NB-Cn caused periosteum damage, but provided bone graft stabilization and incorporation similar to the control group. CONCLUSION The perforation provided by screw insertion into the graft during fixation may have triggered early revascularization and remodeling to render increased volume loss compared with the experimental group. These results indicate that the NB-Cn possesses equivalent properties to titanium screw to be used as bone fixation material in osteosynthesis.
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Affiliation(s)
- Patricio José de Oliveira Neto
- Department of Oral and Maxillofacial Surgery and Periodontics, Faculty of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
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Ortiz Ruiz A, Vicente A, Camacho Alonso F, López Jornet P. A new use for self-etching resin adhesives: Cementing bone fragments. J Dent 2010; 38:750-6. [DOI: 10.1016/j.jdent.2010.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Revised: 06/07/2010] [Accepted: 06/11/2010] [Indexed: 11/30/2022] Open
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Schneider OD, Stepuk A, Mohn D, Luechinger NA, Feldman K, Stark WJ. Light-curable polymer/calcium phosphate nanocomposite glue for bone defect treatment. Acta Biomater 2010; 6:2704-10. [PMID: 20109587 DOI: 10.1016/j.actbio.2010.01.033] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Revised: 01/19/2010] [Accepted: 01/21/2010] [Indexed: 11/19/2022]
Abstract
Light-curable, methacrylate-based resins are clinically used for complex defect repair in dentistry (Heliobond). The present study investigates how such easy-to-apply polymers may be used on a much broader range of applications, particularly for gluing wet bone. We investigate the significantly improved adhesion of the polymer to wet bone surfaces in a close to in vivo setup using freshly cut cow hip bone as a model. The use of a reactive filler (20 wt.% amorphous, glassy calcium phosphate nanoparticles, a-CaP) allows for combination of the properties of the polymer (strength; light-curing) and the reactive filler (recrystallization of amorphous CaP to hydroxyapatite within minutes). This filler alone has been earlier suggested for use as an injectable bone cement since it reacts under in vivo conditions within 10-15 min. Our study transfers this reactivity into a composite, thus using the reactive CaP phase to establish an improved adhesion of the composite to wet bone surfaces. Additional in vitro bioactivity tests, compressive and tensile strength suggest use of such light-curable nanocomposites for complex-shaped load-bearing implant materials and fracture repair.
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Affiliation(s)
- Oliver D Schneider
- Institute for Chemical and Bioengineering, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
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Saska S, Gaspar AMM, Hochuli-Vieira E. Adesivos à base de cianoacrilato para síntese de tecido mole. An Bras Dermatol 2009; 84:585-92. [DOI: 10.1590/s0365-05962009000600003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Accepted: 09/26/2009] [Indexed: 11/22/2022] Open
Abstract
FUNDAMENTOS - Adesivos teciduais têm sido muito usados para síntese de ferida, em função de ser um método indolor, rápido e de fácil execução. OBJETIVOS -Analisar e comparar compatibilidade dos adesivos, etil- cianoacrilato (Super Bonder) e butilcianoacrilato (Histoacryl), e a reparação de incisões em dorso de ratos entre o fio de sutura e os respectivos adesivos. MÉTODOS - Foram usados 15 ratos. Realizaram-se duas lojas cirúrgicas no dorso. Em cada uma, foi implantado um tubo de polietileno (10mm x 1mm), os quais foram preenchidos com os adesivos Super Bonder (lado direito) e Histoacryl (lado esquerdo). As incisões, do lado esquerdo, foram coaptadas com Super Bonder, e as do lado direito, com Histoacryl. Uma incisão mediana, entre as duas incisões,foi realizada e suturada com fio de seda. Os animais foram mortos, depois de 7(sete), 35(trinta) e 120 (cento e vinte dia) dias. RESULTADOS: Os adesivos usados, no presente estudo, não promoveram reação inflamatória, quando usados para síntese das incisões. Porém, estes adesivos, quando implantados no subcutâneo, promoveram reação inflamatória até 120 (cento e vinte dia) dias, no entanto, a reação é mais intensa com Histoacryl. CONCLUSÕES: Super Bonder e Histoacryl permitem o processo cicatricial dos tecidos incisados; facilitam a sutura das incisões. Desta forma, estes podem ser utilizados para sínteses de feridas, lacerações ou incisões cutâneas.
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Evaluation of the toxicity of onyx compared with n-butyl 2-cyanoacrylate in the subarachnoid space of a rabbit model: an experimental research. Neuroradiology 2009; 52:125-34. [PMID: 19756562 DOI: 10.1007/s00234-009-0594-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Accepted: 08/25/2009] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The toxic effects of onyx, its solvent dimethyl sulphoxide (DMSO), and n-butyl 2-cyanoacrylate (NBCA) were evaluated after infusion into the subaracnoid space of a rabbit model. METHODS Each of the two various concentrations of onyx, pure DMSO, NBCA, and normal saline solution were percutaneously infused into the pontocerebellar cisternae of 39 domestic male albino rabbits, after which, the brain stems and medial cerebellar tissues were harvested for biochemical and histopathological studies. RESULTS The specimens infused in various concentration of onyx, DMSO, and NBCA showed neural tissue necrosis and edema with inflammatory cell infitration in the acute stage. Although the mean values of the lipid peroxidase in the control, saline, and NBCA groups were found to be almost similar, they were found to be low in the onyx and DMSO groups. CONCLUSION This experimental study suggests that NBCA, and various concentrations of onyx and DMSO have toxic effects on the neural tissues of rabbits when infused into the subarachnoid space.
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Fixation of autogenous bone grafts with ethyl-cyanoacrylate glue or titanium screws in the calvaria of rabbits. Int J Oral Maxillofac Surg 2009; 38:180-6. [DOI: 10.1016/j.ijom.2008.12.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2007] [Revised: 10/08/2008] [Accepted: 12/02/2008] [Indexed: 11/19/2022]
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Endres K, Marx R, Tinschert J, Wirtz DC, Stoll C, Riediger D, Smeets R. A new adhesive technique for internal fixation in midfacial surgery. Biomed Eng Online 2008; 7:16. [PMID: 18489785 PMCID: PMC2430571 DOI: 10.1186/1475-925x-7-16] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2007] [Accepted: 05/19/2008] [Indexed: 12/02/2022] Open
Abstract
Background The current surgical therapy of midfacial fractures involves internal fixation in which bone fragments are fixed in their anatomical positions with osteosynthesis plates and corresponding screws until bone healing is complete. This often causes new fractures to fragile bones while drilling pilot holes or trying to insert screws. The adhesive fixation of osteosynthesis plates using PMMA bone cement could offer a viable alternative for fixing the plates without screws. In order to achieve the adhesive bonding of bone cement to cortical bone in the viscerocranium, an amphiphilic bone bonding agent was created, analogous to the dentin bonding agents currently on the market. Methods The adhesive bonding strengths were measured using tension tests. For this, metal plates with 2.0 mm diameter screw holes were cemented with PMMA bone cement to cortical bovine bone samples from the femur diaphysis. The bone was conditioned with an amphiphilic bone bonding agent prior to cementing. The samples were stored for 1 to 42 days at 37 degrees C, either moist or completely submerged in an isotonic NaCl-solution, and then subjected to the tension tests. Results Without the bone bonding agent, the bonding strength was close to zero (0.2 MPa). Primary stability with bone bonding agent is considered to be at ca. 8 MPa. Moist storage over 42 days resulted in decreased adhesion forces of ca. 6 MPa. Wet storage resulted in relatively constant bonding strengths of ca. 8 MPa. Conclusion A new amphiphilic bone bonding agent was developed, which builds an optimizied interlayer between the hydrophilic bone surface and the hydrophobic PMMA bone cement and thus leads to adhesive bonding between them. Our in vitro investigations demonstrated the adhesive bonding of PMMA bone cement to cortical bone, which was also stable against hydrolysis. The newly developed adhesive fixing technique could be applied clinically when the fixation of osteosynthesis plates with screws is impossible. With the detected adhesion forces of ca. 6 to 8 MPa, it is assumed that the adhesive fixation system is able to secure bone fragments from the non-load bearing midfacial regions in their orthotopic positions until fracture consolidation is complete.
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Affiliation(s)
- Kira Endres
- University Hospital Aachen, Dental Prosthetics Clinic, Medical Materials R&D Laboratory, Pauwelsstrasse 30, 52057 Aachen, Germany.
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Costa HJZR, Pereira CSB, Costa MP, Fabri FSSS, Lancellotti CLP, Dolci JEL. Experimental comparative study in rabbits of three different ways of cartilage graft fixation: suture, gelatin-resorcin-formaldehyde and butyl-2-cyanoacrylate. Acta Otolaryngol 2007; 127:947-51. [PMID: 17712674 DOI: 10.1080/00016480601089689] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONCLUSION The compound gelatin-resorcin-formaldehyde (GRF) was a better stabilizing material for cartilage grafts in rabbits than butyl-2-cyanoacrylate. GRF was also better than the suture when comparing fixation of cartilage to the periosteum and inflammatory reaction. OBJECTIVE Cartilage grafting is an interesting option for refinements on rhinoplasties. The objective of this study was to compare butyl-2-cyanoacrylate to GRF and suture to determine the efficacy of these methods in restraining grafted cartilage in rabbits. MATERIALS AND METHODS Fifteen male adult New Zealand rabbits underwent surgery with the aim of collecting six auricular cartilage grafts from each animal. Two of these grafts in each animal were glued together with butyl-2-cyanoacrylate, two were glued together with compound GRF, and two were sewn together with nylon suture. These sandwich grafts were then glued or sutured to the periosteum of the glabella. After 2, 6, and 12 weeks, groups of five animals were sacrificed and histological analysis for inflammation was performed. Cartilage graft migration, adhesion, and deformities of the grafts were also evaluated. RESULTS There was less migration of the cartilages glued with GRF than with cyanoacrylate and suture. GRF showed statistically less inflammatory reaction and angiogenesis than the other two methods. The three methods showed a tendency to decrease of fibrosis, inflammation, and angiogenesis as weeks passed. There was no detachment or deformity in the cartilage sandwiches sutured to the glabella's periostium. The majority of detached and deformed cartilages were those glued with cyanoacrylate. The number of detached cartilages was directly related to the number of deformed cartilages. The data were statistically significant (p<0.05).
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Eskandari MM, Ozturk OG, Eskandari HG, Balli E, Yilmaz C. Cyanoacrylate adhesive provides efficient local drug delivery. Clin Orthop Relat Res 2006; 451:242-50. [PMID: 16760809 DOI: 10.1097/01.blo.0000224055.24743.c8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Biodegradable drug delivery systems have advanced treatment of a wide spectrum of musculoskeletal problems. However, their lack of availability and cost can restrict use. To find an easily available and inexpensive biodegradable implant, we tested a widely used tissue adhesive, n-butyl-2-cyanoacrylate, as a drug-trapping material. We tested vancomycin with commercially available absorbable gelatin-sponge pieces as the scaffold. We evaluated the in vitro and in vivo drug release profiles and in vivo inflammatory response. A mouse muscle pouch model was used for in vivo evaluations. The released vancomycin level was measured by fluorescence polarization immunoassay technique, and a leukocyte count-based grading system was used to evaluate inflammatory response. Our findings suggest the proposed implant provides effective drug release for as much as 42 days in vitro and 14 days in vivo. The presence of n-butyl-2-cyanoacrylate led to a local inflammatory response which decreased after 3 weeks in the group with less adhesive. These results showed that n-butyl-2-cyanoacrylate could efficiently trap and slowly release a drug when used in the structure of a biodegradable local drug delivery device.
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Ayan I, Colak M, Comelekoglu U, Milcan A, Ogenler O, Oztuna V, Kuyurtar F. Histoacryl glue in meniscal repairs (a biomechanical study). INTERNATIONAL ORTHOPAEDICS 2006; 31:241-6. [PMID: 16761150 PMCID: PMC2267562 DOI: 10.1007/s00264-006-0158-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2006] [Revised: 03/27/2006] [Accepted: 03/28/2006] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to investigate the biomechanical efficacy of Histoacryl (cyanoacrylate, N-asetil 2 butyl sistein) in meniscal tear repair. In our study, the primary stability of three different repair techniques in delaying the formation of a gap of 2 mm was investigated. A meniscal tear was repaired with two vertical sutures and Histoacryl in the first group; it was repaired only with Histoacryl in the second group, and with only two vertical sutures in the third group. Menisci were then placed in a tensile loading machine, and the primary stability of the repair zones was measured until a displacement of 2 mm occurred. Biomechanical force was significantly (P<0.05) high (112.0+/-17.20 N) in all groups when vertical suture and Histoacryl glue were used together during displacements of 0.5, 1.0, 1.5 and 2.0 mm. We believe that Histoacryl is superior to vertical sutures regarding gap delaying. It potentiates the effect of vertical suture strength, permits early motion and thus merits an in vivo study.
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Affiliation(s)
- Irfan Ayan
- Department of Orthopaedics and Traumatology, Mersin University Medical School, Mersin, Turkey.
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Milcan A, Ayan I, Zeren A, Sinmazcelik T, Yilmaz A, Zeren M, Kuyurtar F. Evaluation of cyanoacrylate augmentation of transpedicular screw pullout strength. ACTA ACUST UNITED AC 2006; 18:511-4. [PMID: 16306840 DOI: 10.1097/01.bsd.0000143311.70185.23] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Pedicle screw fixation of osteoporotic bone in the elderly is a challenge. Various augmentation methods have been studied by many authors. Although polymethylmethacrylate (PMMA) augmentation is believed to be a standard method, its usage is fraught with complications. Butyl-2-cyanoacrylate is an alternative to PMMA as it is bioresorbable, biocompatible, inexpensive, and noninfective. The objective of the current study was to determine the pullout strength of the pedicle screws when butyl-2-cyanoacrylate is used for augmentation. METHODS Fresh calf lumbar vertebrae were obtained from male calves weighing 100-120 kg and implanted with pedicle screws. The screws were placed in native, unaugmented bone (group 1), butyl-2-cyanoacrylate-augmented bone (group 2), and PMMA-augmented bone (group 3). Axial pullout tests were done by an Instron 4411 universal testing machine. Statistical analysis was performed using the SPSS 9.0 for Windows program. Paired samples t test was used, and P < 0.05 was considered significant. RESULTS The mean bone mineral density of the vertebrae was 1.6 +/- 0.1 g/cm2. The mean pullout strengths were 1.55 +/- 0.23 kN for group 1, 1.62 +/- 0.42 kN for group 2, and 2.55 +/- 0.22 kN for group 3. There was no statistically significant difference between groups 1 and 2. PMMA augmentation increased the pullout strength significantly when compared with butyl-2-cyanoacrylate augmentation and native bone (P = 0.002 and P = 0.001, respectively). CONCLUSIONS The results of this study show that butyl-2-cyanoacrylate has no contribution to the augmentation of pedicle screw fixation in a calf model when compared with native bone or PMMA augmentation. Further studies are required to evaluate the effectiveness of butyl-2-cyanoacrylate in osteoporotic specimens and under cyclic loading in calf vertebra and animal and cadaver models before dispensing with its utility as an augmentation method in the clinical setting.
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Affiliation(s)
- Abtullah Milcan
- Department of Orthopedics and Traumatology, Faculty of Medicine, University of Mersin, Mersin, Turkey.
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Abstract
Cyanoacrylate glue was invented by Ardis in 1949 and was first used in surgery in 1959 by Coover. By further modifications, a nonhistotoxic form, butyl-2-cyanoacrylate, which had strong tissue binding properties even in nondry environments, was developed. Its use in the fixation of fractures and osteotomies is still under investigation and has had promising results in treatment of craniofacial and mandibular injuries. We fixed a talar osteochondral fracture with cyanoacrylate. After 3 months, magnetic resonance imaging showed an anatomically reduced and intact chondral surface. The clinical result was excellent. We believe cyanoacrylate glue may form an alternative means of fixation for osteochondral and, possibly, for chondral fractures.
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Affiliation(s)
- Cengiz Yilmaz
- Department of Orthopedics and Traumatology, Mersin University Medical School, Mersin, Turkey.
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Yilmaz T, Yilmaz G. Accidental cyanoacrylate glue ingestion. Int J Pediatr Otorhinolaryngol 2005; 69:853-5. [PMID: 15885341 DOI: 10.1016/j.ijporl.2005.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2004] [Accepted: 01/20/2005] [Indexed: 11/18/2022]
Abstract
Cyanoacrylates have a variety of medical and commercial applications as adhesives. They are commonly found as glue in the household. They can be swallowed accidentally by children. However, no case was reported so far in the English medical literature. Their effect on the mouth, pharynx, larynx, esophagus and the rest of gastrointestinal system is unknown. Here we report our own child who accidentally ingested cyanoacrylate glue without unwanted sequelae due to prompt intervention.
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Affiliation(s)
- Taner Yilmaz
- Hacettepe University Faculty of Medicine, Department of Otolaryngology-Head and Neck Surgery, Hacettepe, 06100 Ankara, Turkey.
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Maurer P, Bekes K, Gernhardt CR, Schaller HG, Schubert J. Comparison of the bond strength of selected adhesive dental systems to cortical bone under in vitro conditions. Int J Oral Maxillofac Surg 2004; 33:377-81. [PMID: 15145041 DOI: 10.1016/j.ijom.2003.10.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2003] [Indexed: 10/26/2022]
Abstract
The study was performed to compare the tensile bond strength attained between composite and bone and between bone and bone using two different adhesive systems (Clearfil New Bond and Histoacryl) in vitro. Sixty porcine bone specimens with a total thickness of 4.0 mm (+/- 0.5 mm) and a cortical layer of 1.5 mm (+/- 0.2 mm) were obtained under standardised conditions. Ten specimens each were assigned to four experimental groups: group A: Clearfil New Bond (bone-composite); group B: Clearfil New Bond (bone-bone); group C: Histoacryl (bone-composite); group D: Histoacryl (bone-bone). The tensile bond strength of the adhesive agents mentioned above was measured 15 min after application and also after light-curing of the composite filling material (Tetric Ceram, colour A2; groups A and C) using a universal testing machine. The tensile bond strength measured was as follows: group A 8.00 MPa (+/- 1.36 MPa), group B 6.39 MPa (+/- 2.05 MPa), group C 5.22 MPa (+/- 1.96 MPa), and group D 1.95 MPa (+/- 0.49 MPa). Tensile bond strength was significantly increased in group A compared to groups C and D (P < 0.05, Tukey's test). The values in group D were significantly reduced compared to all other groups (P < 0.05, Tukey's test). Despite the limitations of an in vitro investigation, it can be concluded that adhesive systems might be a useful alternative in bone bonding. The use of dentin adhesives seemed to produce higher bond strength to bone than that attained with the cyanoacrylate adhesive.
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Affiliation(s)
- P Maurer
- Department of Oral and Plastic Maxillofacial Surgery, Martin Luther University, Halle-Wittenberg, Halle 06097, Germany.
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Maurer P, Bekes K, Gernhardt CR, Schaller HG, Schubert J. Tensile bond strength of different adhesive systems between bone and composite compared: an in vitro study. J Craniomaxillofac Surg 2004; 32:85-9. [PMID: 14980587 DOI: 10.1016/j.jcms.2003.11.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2003] [Accepted: 11/06/2003] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The aim was to compare tensile bond strength of three dentine adhesive systems (Excite, Clearfil New Bond, Etch & Prime 3.0) and two cyanoacrylate adhesives (Cyano Veneer, Histoacryl) to animal bone in vitro. MATERIAL AND METHODS Specimens from five porcine mandibles (diameter 9 mm) with a total thickness of 4mm (+/-0.5mm) and a cortical layer of 1.5mm (+/-0.2mm) were prepared using trephine burs under constant water cooling and under standardized conditions. They were assigned to five experimental groups. Tensile bond strength of five different adhesive agents (Clearfil New Bond, Etch & Prime 3.0, Excite, Histoacryl and Cyano Veneer was measured 15 min after application and after light curing of a composite material (Tetric Ceram, colour A2) added thereupon using a universal testing machine. Qualitative control was performed by scanning electron microscopy, while examining loaded and unloaded specimens. RESULTS The measured tensile bond strength was as follows: Clearfil New Bond 8.00 MPa (+/-1.36 MPa), Etch & Prime 3.0 4.05 MPa (+/-1.52 MPa), Excite 2.96 MPa (+/-1.34 MPa), Histoacryl 5.22 MPa (+/-2.00 MPa), Cyano Veneer 4.56 MPa (+/-0.76 MPa). Clearfil New Bond showed significantly higher bond strength than the other four adhesives. Scanning electron microscopy analysis of unloaded specimens showed mixed modes of fracture. As regards the loaded specimens, no tag formation as known for dentine was found. CONCLUSION Within the limitations of an in vitro investigation it can be concluded that dentine adhesive systems might be useful for bone bonding. Tensile bond strength of the dentine adhesive systems tested on bone is comparable to that evaluated for dentine in earlier investigations.
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Affiliation(s)
- Peter Maurer
- Department of Oral and Plastic Maxillofacial Surgery, Martin Luther University, Halle-Wittenberg, Germany.
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Helbling C, Schlumpf R. Sutureless Lichtenstein: first results of a prospective randomised clinical trial. Hernia 2003; 7:80-4. [PMID: 12820029 DOI: 10.1007/s10029-002-0114-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2002] [Accepted: 12/04/2002] [Indexed: 01/31/2023]
Abstract
Inguinal hernia repair, according to Lichtenstein, is very popular due to its minimal invasiveness (local anaesthesia), easy and reproducible technique, low recurrence rate, and low morbidity. However, recent publications demonstrate an elevated rate of chronic irritations and pain, probably due to tension or nerve compression by the fixing sutures. We, therefore, established a concept to avoid these sutures by attaching the prosthesis with glue. After a pilot study, a randomised prospective trial was started. The aim of our study was to compare the results of the classical Lichtenstein repair (group 1) vs the "Sutureless Lichtenstein" (group 2) in terms of postoperative complications and recurrences. Operative access and management of the hernial sac was equal to Lichtenstein for both groups. In group 1, we sutured the mesh with PDS 2/0; in group 2, the mesh was glued with n-butyl-cyanoacrylate. In both groups, the operation was then completed according to Lichtenstein, and unrestricted activity was allowed after 2 weeks. A total of 46 patients have been operated on. The follow-up results at 3 weeks and [3 months] were: group 1 ( n=24) vs group 2 ( n=22): recurrences 0 [0] vs 0 [0], minor pain 8 [4] vs 4 [1], local numbness 14 [10] vs 10 [6]. No adhesive-related complications were seen. Patients will be followed for 2 years. The results in group 2 were excellent, and there was no difference vs group 1. Furthermore, there was a tendency for better results in group 2. These results are very promising and justify a continuation of the study.
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Affiliation(s)
- Arun K Gosain
- Department of Plastic Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
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