Surgical Removal of an Orthodontic Mini-Screw Displaced Into the Lateral Pharyngeal Space: A Case Report and Review of Pertinent Literature.

Oral and maxillofacial surgeons are often faced with the clinical challenge of foreign body displacement into the perioral tissues and soft tissues of the head and neck. This mainly occurs either because of trauma or inadvertently during dental treatment. In addition to the maxillary sinus, iatrogenic foreign body displacement during dental treatment could happen into one of the 16 distinct fascial spaces of the head and neck region. Commonly displaced foreign bodies related to dental treatment include tooth roots or fragments, local anesthetic needles, implants and restorations. The clinical sequelae of a displaced foreign body depend on its size, shape, anatomic location and proximity to vital structures. Although patients may remain asymptomatic for a considerable amount of time, retained foreign bodies result in persistent pain, recurrent infection and scarring of soft tissue due to inflammation, all of which may complicate delayed retrieval. In addition to the history, imaging modalities such as plain radiographs and computed tomography (CT) help in locating the displaced foreign body and its subsequent retrieval. Surgical retrieval may be attempted through intraoral, transcervical and endoscopic approaches. Additionally, surgery may be aided by real-time imaging such as fluoroscopy. The present report aims to detail a case of inadvertent displacement of an orthodontic mini-screw, commonly used as a temporary anchorage device (TAD), into the lateral pharyngeal space, while attempting placement in the mandibular retromolar area. The case report also describes the surgical retrieval procedure of the TAD screw using an intraoral approach and with fluoroscopy guidance using C-Arm radiographic imaging. This case is reported along with the pertinent review of literature, as it not only explains a rare complication of orthodontic mini-screw placement but also details a modality to remove displaced foreign bodies from fascial spaces of the head and neck, which are otherwise directly inaccessible.

Deciphering the fluorescence quenching potential of Croton bonplandianum leaves and detection of bioactive molecules using liquid chromatography and mass spectrometry.

In this study, liquid chromatography and mass spectrometry were used to screen the active phytochemicals and analyze antioxidant activity of Croton bonplandianum. In addition, cadmium telluride quantum dots were used to analyze the fluorescence quenching capabilities of Croton bonplandianum plants. UPLC-ESI-MS was used to screen polyphenols in the mass range of 100-2000, with both positive and negative ionizations. Based on molecular weight, 7-Spirostanoldihexoside isomer, Rutin, Quercetin hexoside, Kaempferol-3-O-(p-coumaroyl)-glucoside, Kaempferol, Quercetin, and (E) Catechin-(E) Gallocatechin were tentatively identified. In total, 63.34 mg of polyphenols and 20.36 mg of flavonoids were detected. Lipid peroxidation IC50 values were 212, 38, 56, and 365 g/mL for DPPH, ABTS, and superoxide radicals. Reducing power of the plant material showed the maximum absorbance of 0.56 in 500 µg/mL concentration. Furthermore, the plant extract quenched cadmium telluride quantum dots fluorescence in a dose dependent manner. The results from quenching concluded that Croton bonplandianum with QDs might be used as a drug targeting and delivery nanomaterial.

Using bonding agent prior to pits and fissure sealant application enhances the microtensile bond strength and the interface morphology.

BACKGROUND: A pits and fissures sealant is an effective method for preventing dental caries. Using a bonding agent before applying the sealant may increase its retention. This study aimed to compare the microtensile strength (µTBS) of a fissure sealant with and without a bonding agent and to characterize the enamel-sealant interface using confocal laser scanning microscopy (CLSM). The null hypothesis was that the use of a bonding agent before fissure sealant application would not change the microtensile strength or the enamel-sealant interface. MATERIALS AND METHODS: Twenty caries-free premolars were used. Each tooth was divided into four parts. The first two parts were assigned to the bonded group, where a bonding system was used before sealant application. The remaining two parts were treated only with a fissure sealant (i.e., the nonbonded group). In each group, the µTBS was examined after 24 h (n = 20) and after a 3-month aging period (n = 20). Five other caries-free extracted premolars were used to assess the enamel-sealant interface using CLSM. Two-way analysis of variance (ANOVA) and Pearson chi-square statistical analysis tests were used to analyze the µTBS and the enamel-sealant interface, respectively. RESULTS: The mean µTBS for the bonded group was significantly higher (p = 0.001) in the immediate group (36.87 ± 14.95 MPa) and the aged group (31.08 ± 15.88 MPa) than in the respective nonbonded groups (19.77 ± 9.67 MPa and 19.52 ± 14.14 MPa). The µTBS was not significantly different in either group after aging (p = 0.46 [bonded group] and p = 0.98 [nonbonded group]). In addition, using a dental adhesive, before applying a fissure sealant resulted in a significantly higher (53%) resin penetration into the enamel with the continuous integrity of the resin. CONCLUSION: The use of a bonding agent before the application of fissure sealant resulted in superior microtensile bond strength immediately and after aging. In addition, the enamel-sealant interface characteristics were improved.