Combined Effects of Glutaraldehyde-based Desensitizer and Nd: YAG Laser on Dentinal Tubules Occlusion.

AIM: The aim of this study was to assess the impact of Nd:YAG laser, glutaraldehyde-based desensitizer (GD), or their combination on occluding dentinal tubules. MATERIALS AND METHODS: Fifty dentin samples were obtained from non-carious human third molars and randomly divided into five groups (n = 10): (1) Control group treated with 37% phosphoric acid, (2) GD group, (3) Nd:YAG laser group (1064 nm, 100 µs, 10 Hz, 300 µm fiber, 1 W power, 100 mJ energy, and 85 J/cm2 energy density), (4) GD followed by Nd:YAG laser group, and (5) Nd:YAG laser followed by GD group. Scanning electron microscopy (SEM) was used to capture five images from each sample for analysis of dentinal tubules using Image J software. SEM/EDX elemental analysis was performed to determine the main mineral contents. Data analyzed using one-way ANOVA and Tukey's post hoc test for statistical comparisons. RESULTS: Laser and combination groups showed a significant decrease in dentinal tubule counts compared with the control and GD groups (p < 0.0001). There were no significant differences in open dentinal tubule counts between the control and GD groups, as well as between the laser and combination groups. However, significant differences were observed in the total area, average size of the tubules, and percentage area between the control group and the treatment groups (GD, laser, GD + laser, laser + GD). No significant difference was found in the Ca/P ratio between the tested groups. CONCLUSION: The use of Nd:YAG laser alone or in combination with GD was more effective in occluding dentinal tubules compared to GD alone. CLINICAL SIGNIFICANCE: This study has shown that Nd:YAG laser alone and in combination with GD has superior dentinal tubule occlusion in vitro. Its clinical use in the treatment of dentinal hypersensitivity may overcome the drawback of conventional treatment approaches for dentin hypersensitivity needing repeated applications to achieve continuous relief from pain since acidic diet and toothbrushing result in the continuing elimination of precipitates and surface coatings. How to cite this article: Alzarooni AH, El-Damanhoury HM, Aravind SS, et al. Combined Effects of Glutaraldehyde-based Desensitizer and Nd: YAG Laser on Dentinal Tubules Occlusion. J Contemp Dent Pract 2024;25(1):52-57.

Postoperative sensitivity in posterior resin composite restorations with prior application of a glutaraldehyde-based desensitizing solution: A randomized clinical trial.

OBJECTIVES: To evaluate the effect of a glutaraldehyde-based desensitizer on the postoperative sensitivity (POS) in posterior resin composite restorations up to 12 months using a universal adhesive (Tetric N-Bond Universal) with selective enamel etching (SE) or an etch-and-rinse (ER) strategy. METHODS: Class I and class II resin composite restorations (n = 220) at least 3 mm deep were inserted in 55 subjects. The universal adhesive was applied using the SE (self-etch strategy on dentin with selective enamel etching) or the ER strategy, with or without prior application of a glutaraldehyde-based desensitizer (Gluma Desensitizer - GL) to form groups SEGL and ERGL. A bulk-fill resin composite (Tetric NCeram Bulk Fill) was used for all restorations. Spontaneous POS was assessed 7 days after the restorative procedure using the Visual Analog Scale (VAS) and the Numeric Rating Scale (NRS). After 7, 14, and 30 days of completing each restoration, the subjects were reassessed to evaluate POS caused by stimulation with an air blast, horizontal and vertical percussion. In addition, marginal discoloration, marginal adaptation, fracture, and recurrence of caries were evaluated using the FDI (World Dental Federation) criteria after 7 days and at 12 months. RESULTS: No significant spontaneous or stimuli-induced POS was observed when restorations with or without GL were compared (p>0.05). A higher risk of spontaneous POS was observed within 7 days (40.0%; 95% CI 28.1 to 53.1), without statistically significant differences among groups. None of the participants reported POS at 12 months, however five restorations were considered clinically unsatisfactory (p > 0.05). CONCLUSIONS: The previous application of GL did not significantly reduce spontaneous or stimuli-induced POS in posterior resin composite restorations at any time, regardless of the adhesive strategy used. CLINICAL SIGNIFICANCE: The use of a glutaraldehyde-based desensitizing agent did not generate lower incidence of postoperative sensitivity in resin composite posterior restorations.

A randomized clinical trial of dentin hypersensitivity reduction over one month after a single topical application of comparable materials.

Dentinal hypersensitivity (DH) is a condition that causes patient discomfort. To evaluate the clinical efficacy of Gluma, fluoride varnish and Tetric N-Bond self-etch system in relieving DH immediately and over 30 days following a single topical application. The present randomized clinical trial was conducted on 55 patients with an age range 20-49 years. 70 teeth in total were incorporated and randomly assigned to the three groups. Parameters examined were: Tactile, air blast, and cold stimuli. VAS was used to assess tactile stimulus whereas the Schiff Cold Scale for air blast and cold stimuli. DH was evaluated immediately, at two weeks and 1 month follow up. Gluma showed a statistically significant reduction in DH scores over other materials. It was concluded that Gluma have statistically significant results over other materials in relieving DH immediately and over 30 days following a single topical application.Trial Registration: Clinical Trials.gov Identifier: NCT04351412, King Abdulaziz University Protocol Record 129-09-19. Registered 17 April 2020 - Retrospectively registered. http://ClinicalTrials.gov/NCT04351412 .

Pulmonary valve neocuspidisation with glutaraldehyde-treated autologous pericardium-A novel technique in pulmonary valve endocarditis.

Infective endocarditis (IE) is a serious condition leading to heart failure, persistent sepsis. The management of IE involving valve is mainly excision of the infected valve and replacement with a heart valve; which are also at the risk of prosthetic valve endocarditis. Hence repair of the valve with autologous pericardium is much more physiological. We had a 20-year-old male presented with features of heart failure and high-grade fever not responding to optimum medical management. Two-dimensional echocardiogram revealed vegetation on pulmonary valve cusps with the erosion of the left and right cusps. Neo cusps with autologous pericardium offered good hemodynamics with trivial regurgitation. The patient is doing well with normal pulmonary valve function 3 months after surgery. This technique is reliable, economic, and easily reproducible.

Aortic Valve Neocuspidization with Glutaraldehyde-Treated Autologous Pericardium (Ozaki Procedure) - A Promising Surgical Technique.

In cases of aortic valve disease, prosthetic valves have been increasingly used for valve replacement, however, there are inherent problems with prostheses, and their quality in the so-called Third World countries is lower in comparison to new-generation models, which leads to shorter durability. Recently, transcatheter aortic valve replacement has been explored as a less invasive option for patients with high-risk surgical profile. In this scenario, aortic valve neocuspidization (AVNeo) has emerged as another option, which can be applied to a wide spectrum of aortic valve diseases. Despite the promising results, this procedure is not widely spread among cardiac surgeons yet. Spurred on by the last publications, we went on to write an overview of the current practice of state-of-the-art AVNeo and its results.

Aortic valve neocuspidization with glutaraldehyde-treated autologous pericardium (ozaki procedure) - a promising surgical technique

Abstract In cases of aortic valve disease, prosthetic valves have been increasingly used for valve replacement, however, there are inherent problems with prostheses, and their quality in the so-called Third World countries is lower in comparison to new-generation models, which leads to shorter durability. Recently, transcatheter aortic valve replacement has been explored as a less invasive option for patients with high-risk surgical profile. In this scenario, aortic valve neocuspidization (AVNeo) has emerged as another option, which can be applied to a wide spectrum of aortic valve diseases. Despite the promising results, this procedure is not widely spread among cardiac surgeons yet. Spurred on by the last publications, we went on to write an overview of the current practice of state-of-the-art AVNeo and its results.

Effect of erosive and abrasive stress on sealing ability of different desensitizers: In-vitro study.

This in vitro study examined the sealing ability of different desensitizing agents under a chemo-mechanical stress condition. For the study, a total of 144 extracted, caries-free human third molars were used to produce 1 mm-thick dentin discs. The specimens were divided randomly into four groups: Superseal (SS), Gluma (GL), Gluma Self-etch (GS), and Tooth Coat (TC). For each group, the permeability was measured before and after applying the desensitizer, after being exposed to Coca Cola for 5 minutes, and after 3150 strokes of a brushing abrasion. The decrease in permeability after the erosive and abrasive stress was analyzed by ANOVA and Tukey post hoc test. As a result, the dentin permeability decreased significantly for all desensitizers immediately after application (p < 0.05). SS and GS showed a significant difference in permeability reduction observed immediately after application and after acid action with Coca Cola (p < 0.05). After brushing abrasion, the permeability reduction decreased significantly for all desensitizers tested in this study (p < 0.05). TC showed the largest decrease in dentinal permeability compared to that of the other desensitizers and the differences were significant after brushing abrasion (p < 0.05). All tested desensitizers were effective in reducing dentin permeability. The behavioral characteristics under erosive and abrasive stress varied according to the products used. TC exhibited excellent sealing ability among the other desensitizers.

Twenty-four-month clinical performance of different universal adhesives in etch-and-rinse, selective etching and self-etch application modes in NCCL - a randomized controlled clinical trial.

OBJECTIVE: The aim of this randomized, controlled, prospective clinical trial was to evaluate the performances of two different universal adhesives and one etch-rinse adhesive for restoration of non-carious cervical lesions (NCCLs). MATERIAL AND METHODS: Twenty patients with at least seven NCCLs were enrolled. Lesions were divided into seven groups according to adhesive systems and application modes: GSE: GLUMA Universal-self-etch, GSL: GLUMA Universal-selective etching, GER: GLUMA Universal-etch-and-rinse, ASE: All-Bond Universal-self-etch, ASL: All-Bond Universal-selective etching, AER: All-Bond Universal-etch-and-rinse, SBE (Control): Single Bond2-etch-and-rinse. A total of 155 NCCLs were restored with a nano hybrid composite (Tetric N-Ceram). Restorations were scored with regard to retention, marginal discoloration, marginal adaptation, recurrent caries and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after one week, 6, 12 and 24 months. Statistical evaluations were performed using Chi-square tests (p=0.05). RESULTS: The recall rate was 81.9% after the 24-month follow-up. The cumulative retention rates for self-etch groups (GSE: 72.2%, ASE:75%) were significantly lower than other experimental groups (GSL: 93.7%, GER: 100%, ASL: 94.1%, AER: 100%, SBE: 100%) at the 24-month follow-up (p<0.05). Regarding marginal adaptation and marginal discoloration, GSE and ASE groups demonstrated more bravo scores after 6 and 12-month observations but differences were not significant (p>0.05). Only one restoration from ASL group demonstrated post-operative sensitivity at 6 and 12-month observations. No secondary caries was observed on the restorations at any recall. At the end of 24-month observations, no significant differences were detected among groups regarding any of the criteria assessed, except retention. CONCLUSION: GLUMA Universal and All-Bond Universal showed better results in etch-and-rinse and selective etching mode compared to the self-etch mode regarding retention. Etch-and-rinse and selective etching application modes of the current universal adhesives tended to provide better clinical outcomes considering the criteria evaluated at the end of 24-month evaluation.

Fluoride varnish versus glutaraldehyde for hypersensitive teeth: a randomized controlled trial, meta-analysis and trial sequential analysis.

OBJECTIVE: Reports indicate Gluma and Duraphat are commonly used in-office agents to treat hypersensitive teeth. Considering this, the aim of this paper is to compare Gluma and Duraphat using a randomized controlled trial, meta-analysis collating evidences from previous studies and trial sequential analysis. MATERIALS AND METHODS: Thirty-eight participants were randomized. Hypersensitivity and visual analog scale (VAS) scores were recorded at baseline, 5 min and 7 days. Oral health-related quality of life (OHIP) questionnaire was administered at baseline and 7 days. Statistical analysis was performed to identify significant differences between the variables. For the meta-analysis, electronic data bases were searched and eligible data was extracted and analysed using RevMan 5.0. Trial sequential analysis was performed using O'Brien-Fleming boundary approach for the primary outcome. RESULTS: Both agents caused significant reduction in hypersensitivity and VAS score at 5 min and 7 days in the randomized trial with no superiority. The quality of life significantly improved in patients treated with both the agents. Four studies including the present trial in meta-analysis and trial sequential analysis indicated that Gluma produced significant reduction in VAS scores at 7 days. CONCLUSION: Gluma produces significant reduction in hypersensitivity at 7 days post treatment compared with Duraphat. There is definite lack of evidence on the long-term effect of these agents. CLINICAL RELEVANCE: This paper provides strong evidence on the use of Gluma for hypersensitive teeth. This also is a way forward to future research on long-term effects, adverse effects and cost-effectiveness studies.

Efficacy of Glutaraldehyde-Treated Leaflets for Mitral Valve Repair to Treat Active Infective Endocarditis: A Case Report.

We report the use of glutaraldehyde (GA) in a case of valve repair for mitral valve prolapse associated with active infective endocarditis. GA scrubbed at the site of infection decontaminates and reinforces infected fragile tissue, avoids excessive debridement, and strengthens the edges of valve leaflets to facilitate suturing.

Twenty-four-month clinical performance of different universal adhesives in etch-and-rinse, selective etching and self-etch application modes in NCCL - a randomized controlled clinical trial

Abstract Objective The aim of this randomized, controlled, prospective clinical trial was to evaluate the performances of two different universal adhesives and one etch-rinse adhesive for restoration of non-carious cervical lesions (NCCLs). Material and Methods Twenty patients with at least seven NCCLs were enrolled. Lesions were divided into seven groups according to adhesive systems and application modes: GSE: GLUMA Universal-self-etch, GSL: GLUMA Universal-selective etching, GER: GLUMA Universal-etch-and-rinse, ASE: All-Bond Universal-self-etch, ASL: All-Bond Universal-selective etching, AER: All-Bond Universal-etch-and-rinse, SBE (Control): Single Bond2-etch-and-rinse. A total of 155 NCCLs were restored with a nano hybrid composite (Tetric N-Ceram). Restorations were scored with regard to retention, marginal discoloration, marginal adaptation, recurrent caries and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after one week, 6, 12 and 24 months. Statistical evaluations were performed using Chi-square tests (p=0.05). Results The recall rate was 81.9% after the 24-month follow-up. The cumulative retention rates for self-etch groups (GSE: 72.2%, ASE:75%) were significantly lower than other experimental groups (GSL: 93.7%, GER: 100%, ASL: 94.1%, AER: 100%, SBE: 100%) at the 24-month follow-up (p<0.05). Regarding marginal adaptation and marginal discoloration, GSE and ASE groups demonstrated more bravo scores after 6 and 12-month observations but differences were not significant (p>0.05). Only one restoration from ASL group demonstrated post-operative sensitivity at 6 and 12-month observations. No secondary caries was observed on the restorations at any recall. At the end of 24-month observations, no significant differences were detected among groups regarding any of the criteria assessed, except retention. Conclusion GLUMA Universal and All-Bond Universal showed better results in etch-and-rinse and selective etching mode compared to the self-etch mode regarding retention. Etch-and-rinse and selective etching application modes of the current universal adhesives tended to provide better clinical outcomes considering the criteria evaluated at the end of 24-month evaluation.

Effects of a surgical sealant on leakage pressure and circumference of fresh canine cadaver small intestinal anastomoses.

OBJECTIVE To evaluate the effect of a bovine albumin-derivatized glutaraldehyde (BA-DG) biopolymer sealant on leakage pressures of intestinal anastomoses in jejunal tissue collected from fresh canine cadavers and to evaluate changes in circumference and cross-sectional area of the anastomotic site resulting from sealant application. SAMPLE 24 jejunal anastomoses from 4 fresh canine cadavers. PROCEDURES Jejunal tissue specimens were collected, and adjacent segment anastomoses were created within 12 hours after euthanasia of each dog. The tissue constructs were randomly assigned to 1 of 2 groups in which sealant was or was not applied. The outer circumference of all anastomoses in the sealant group was measured before and after application of the sealant; the cross-sectional area at the anastomotic site was then calculated at each time point. Tissue constructs were pressure tested, and leakage pressure and site were recorded. All testing was completed within 24 hours after tissue collection. RESULTS Compared with preapplication findings, there were no significant changes in outer circumference or cross-sectional area at the anastomotic site after sealant application. Leakage pressures in the sealant group were significantly higher than those in the no-sealant group. CONCLUSIONS AND CLINICAL RELEVANCE The use of surgical sealant on fresh canine cadaver jejunal anastomoses resulted in significantly higher leakage pressure at the anastomotic site; no immediate tissue deformation of the outer circumference or cross-sectional area occurred after sealant application. Future in vivo investigations are warranted to evaluate the effects of this sealant and potential benefits for clinical patients undergoing enterectomy.

Safe Use of Glutaraldehyde to Repair the Destroyed Valve in Active Infective Mitral Valve Endocarditis.

BACKGROUND: The aim of this study was to review our experience of mitral valve (MV) repair for acute and active infective endocarditis (AAIE) and to identify the feasibility of a new approach together with the mid-term results. Methods and Results: A retrospective analysis was performed on 35 consecutive AAIE patients surgically treated in the isolated mitral position. Mean follow-up after the surgery was 4.3±3.7 years. 30 of the 35 patients were successfully treated by MV plasty (MVP); however, MV replacement (MVR) was necessary in the remaining 5 patients. Our novel approach included resection of the infective lesion, approximation with direct suture and/or patch repair with bovine or autopericardium after 2-min treatment of it and the defective leaflet edge(s) with 0.625% glutaraldehyde solution, reconstruction with artificial chordae and ring annuloplasty. The success rate of MVP was 85.7%. The longest postoperative follow-up echocardiography showed no mitral regurgitation (MR) in 4, trivial MR in 4, mild MR in 16 and moderate MR in 5 patients in the MVP group. The 5-year survival rate in the MVP group was 89±6%. MVR was required in 1 patient 2 months after MVP because of increasing MR. Recurrence of endocarditis has not been observed in any case. CONCLUSIONS: Glutaraldehyde was safely used in a surgical intervention for AAIE in the mitral position with acceptable early and mid-term results.

Preventive Use of a Resin-based Desensitizer Containing Glutaraldehyde on Tooth Sensitivity Caused by In-office Bleaching: A Randomized, Single-blind Clinical Trial.

OBJECTIVE: To evaluate the risk and intensity of bleaching-induced tooth sensitivity (TS) after in-office bleaching following topical application of a resin-based glutaraldehyde desensitizer. METHODS: Thirty-three patients were randomly assigned to the experimental (Gluma Desensitizer Liquid, Heraeus Kulzer, Hanau, Germany) and placebo groups. The placebo or Gluma Desensitizer Liquid was applied for one minute prior to application of an in-office bleaching gel. Bleaching was performed with 35% hydrogen peroxide gel (three applications × 15 minutes each) over two sessions, one week apart. The color of the anterior teeth was evaluated before and 21 days after treatment using the VITA Classical shade guide, Bleachedguide 3D, and Easyshade spectrophotometer. TS during and after the bleaching was recorded according to the visual analog (VAS) and numerical rating (NRS) scales. All data were submitted to statistical analysis (α=0.05). RESULTS: There was no significant difference in absolute risk or intensity of TS between the two groups (risk and VAS, p=0.93 and 0.31, respectively; NRS, p≥0.45). At the end of the bleaching protocol, tooth whitening was observed in both groups, as evident from color change in shade guide units (ΔSGU, 4.1-7.1; both guides) and overall color change (ΔE, 7.4-9.3 units); however, there were no significant differences in whitening between the two groups ( p>0.11). CONCLUSION: Gluma Desensitizer Liquid was not able to reduce the risk or intensity of TS. Bleaching efficacy was not affected by application of the desensitizer.

Efficiency of Lasers and a Desensitizer Agent on Dentin Hypersensitivity Treatment: A Clinical Study.

AIM: The aim of this clinical study was to determine and compare the efficiency of the glutaraldehyde-containing agent (GCA), Nd:YAG, Er,Cr:YSGG lasers, and the combination of them on the dentin hypersensitivity (DH) treatment. SUBJECTS AND METHODS: This study was performed with the participation of 17 healthy adult patients having 100 teeth with DH; the patients were randomly divided into five groups according to the treatment protocol: (1) application of GCA on sensitive teeth, (2) Nd:YAG laser (1 W/cm2, 10 Hz) irradiation on sensitive teeth, (3) application of GCA on sensitive teeth and then Nd:YAG laser irradiation, (4) Er,Cr:YSGG laser (0.25 W/cm2, 20 Hz) irradiation on sensitive teeth, (5) application of GCA on sensitive teeth and then Er,Cr:YSGG laser irradiation. Sensitivity levels were assessed by the Yeaple probe on the buccal surfaces of the teeth at a force setting of 10 g. Measurements were performed for 30 min, after 7, 90, and 180 days of the therapy to assess the effects of desensitization. The evaluations were analyzed using the one-way analysis of variance and repeated measurement test (P < 0.05). RESULTS: After sessions, DH was significantly reduced in all groups at each measurement point. The Er,Cr:YSGG laser with or without GCA application were the most effective ones in DH treatment (P < 0.05). Comparison of the treatment regimens demonstrated that the scores achieved with the Yeaple probe were not significantly higher for the Nd:YAG laser groups than the GCA alone group. CONCLUSIONS: This clinical study shows that the Er,Cr:YSGG laser have promising potential for the treatment of DH.

Efficacy of a commercial glutaraldehyde footbath product for the control of bovine digital dermatitis.

OBJECTIVE: To evaluate the relative efficacy of a novel, commercially available disinfecting agent containing ≥ 15 to < 20 % glutaraldehyde in a hydro-colloid matrix ("EIMÜ Klauen Sprint®"; Eimermacher, Nordwalde, Germany, Biozid-Desinfektionsmittel, BAuA Nr. N-57213) as a walkthrough footbath in order to treat digital dermatitis of dairy cattle. MATERIAL AND METHODS: The study was conducted in a dairy farm located in northern Germany from June 1st, 2015 to September 5th, 2015. Eighty-eight cows were enrolled in this study. In both trials of the study, a walkthrough footbath was applied on five consecutive milking times per week. Trial 1 was a blinded, randomised and controlled intervention study. The therapy group (n = 40) received the novel glutaraldehyde product in a 2 % solution while the control group (n = 40) was led through a footbath containing pure water. Trial 2 was a longitudinal study to investigate the development of claw health over a longer time period regarding the use of the new footbath solution. In trial 2 the disinfecting footbath was applied to all trial cows (therapy and control group) of trial 1. The development of claw health and lameness was systematically monitored in the two groups on days 0, 9, 17, 29, 35 (trial 1) and days 42, 68, 94 (trial 2), respectively. The adjusted odds of digital dermatitis lesions (DDL) throughout the study were analysed by mixed logistic regression models. RESULTS: The odds of DDL were 0.15 for the glutaraldehyde foot-bath group compared to the control group. Hence, the disinfecting footbath significantly reduced the DDL prevalence and increased the cure rate of DDL. However, no preventive effect on new digital dermatitis (DD) cases could be identified. CONCLUSION: The efficacy of the novel glutaraldehyde footbath was evaluated and it was concluded that "EIMÜ Klauen Sprint®" was well tolerated over a longer period of time and might therefore be an effective tool to control DD. CLINICAL RELEVANCE: In future, "EIMÜ Klauen Sprint®" could be used within a Mortellaro sanitation concept and thereby might help to solve a major problem of dairy cattle farms.

El uso de adhesivo tisular de albúmina-glutaraldehído sérico bovino (BioGlue (R)) para el cierre del lecho tumoral después de una nefrectomía parcial abierta / The use of bovine serum albumin-glutaraldehyde tissue adhesive (BioGlue (R)) for tumor bed closure following open partial nephrectomy

Objetivos: Informar sobre los resultados del uso del adhesivo tisular de albúmina-glutaraldehído sérico bovino (BioGlue(R)) para el cierre del lecho tumoral en cirugía abierta de preservación de nefronas (CCN). Materiales y métodos: La cohorte incluyó a 255 pacientes con masa renal que se sometieron a CCN abierta. Se utilizó abordaje mediante lumbotomía, con hipotermia in situ y enucleación del tumor. Para el cierre del lecho tumoral utilizamos el sellante BioGlue(R) para el relleno del lecho tumoral, sin suturar los bordes. Resultados: La media de edad de los pacientes fue de 65,4 años. El 5,1% de los pacientes tenía insuficiencia renal crónica preoperatoria. El diámetro medio de la masa renal fue de 4,2 ± 1,6cm y la puntuación media de nefrometría R.E.N.A.L fue 8,0 ± 1,6. El tiempo medio de isquemia fue 21,8±7,6. La pérdida de sangre media estimada fue de 42 ± 82ml, y solo 2 pacientes requirieron transfusión de sangre. Se registraron pérdida de orina y pseudoaneurisma en 2 pacientes y en uno, respectivamente. Ninguna de las operaciones se convirtió a nefrectomía radical. El cambio medio entre la eGFR postoperatoria y preoperatoria (Δ = -1,7 ml/min) fue insignificante en un seguimiento medio de 30,1 ± 29,6 meses. La tasa de supervivencia libre de recurrencia a 10 años fue del 99%, y la tasa de supervivencia global a 10 años fue del 85%. Conclusiones: El uso de BioGlue(R) para hemostasia después de CCN es una alternativa factible y segura a la sutura clásica. Su uso permite un resultado funcional satisfactorio y podría reducir potencialmente el tiempo de isquemia

Objectives: To report the results of the use of Bovine Serum Albumin-Glutaraldehyde tissue adhesive (BioGlue(R)) for tumor bed closure in open nephron-sparing surgery (NSS). Materials and methods: The cohort included 255 patients with enhancing renal mass who underwent open NSS. We used open flank approach, with in-situ hypothermia and enucleation of the tumor. For tumor bed closure, we used the BioGlue(R) sealant for tumor bed filling, without suturing the edges. Results: Mean patients' age was 65.4 years. 5.1% of patients had pre-operative chronic renal failure. Mean renal mass diameter was 4.2 ± 1.6cm and mean R.E.N.A.L nephrometry score was 8.0 ± 1.6. Mean ischemia time was 21.8 ± 7.6. Mean estimated blood loss was 42 ± 82ml and only two patients required blood transfusion. Urine leak and pseudo-aneurysm were recorded in two and one patient, respectively. None of the operations were converted to radical nephrectomy. The average change between post-operative and pre-operative eGFR (Δ = -1.7ml/min) was insignificant in a mean follow-up of 30.1 ± 29.6 months. The 10-year recurrence-free survival rate was 99% and the 10-year overall survival rate was 85%. Conclusions: The use of BioGlue(R) alone for hemostasis after NSS is a feasible and safe alternative to classical suturing. Its use enables satisfactory functional outcome and could potentially reduce ischemia time

Efficacy of Three In-Office Dentin Hypersensitivity Treatments.

PURPOSE: This study assessed the comparative efficacy of three in-office treatment agents in patients presenting with dentin hypersensitivity (DH) at a university teaching hospital. MATERIALS AND METHODS: A randomised, controlled study was conducted to compare the efficacy of Gluma desensitiser, Pro-Relief and Copal F in relieving the pain of DH. In 68 subjects with 508 hypersensitive teeth, the agents and placebo (distilled water) were applied to 127 hypersensitive teeth each. At baseline, the pain of DH to tactile and evaporative stimuli was measured using the visual analogue scale (VAS) and verbal rating scale (VRS). Post-application assessment was carried out at 10 min, 1 week, 2 and 4 weeks. RESULTS: The mean difference in VAS between baseline and post-treatment periods significantly increased for all the desensitising agents (p < 0.05) with both tactile and air-blast stimuli, except for the placebo. Gluma desensitiser had the highest mean difference at 10 min (3.7 ±â€¯1.8) and 4 weeks (5.4 ±â€¯2.3) for tactile and air-blast stimuli, respectively. However, using the VAS, no statistical significance was noted in the mean differences between the agents. With the application of Gluma desensitiser, a significantly higher number of teeth had no pain at 4 weeks using the VRS. CONCLUSION: Gluma desensitiser can be suggested as an appropriate desensitising agent for in-office treatment of DH.

Evaluation of different treatment protocols for dentin hypersensitivity: an 18-month randomized clinical trial.

This randomized and longitudinal in vivo study aimed to assess different protocols for the treatment of dentin hypersensitivity with low-power laser (with different doses), high-power laser, and a desensitizing agent, for a period of 12 and 18 months. The lesions from 32 patients (117 lesions), who were submitted to the inclusion and exclusion criteria, were divided into nine groups (n = 13): G1: Gluma Desensitizer (Heraeus Kulzer), G2: low-power laser with low dose (three points of irradiation in vestibular portion and an apical point 30 mW, 10 J/cm2, 9 s per point with the wavelength of 810 nm, with three sessions with an interval of 72 h), G3: low-power laser with high dose (one point in the cervical area, and one apical point 100 mW, 40 J/cm2, 11 s per point with the wavelength of 810 nm in three sessions with an interval of 72 h), G4: low-power laser with low dose + Gluma Desensitizer, G5: low-power laser with high dose + Gluma Desensitizer, G6: Nd:YAG laser (Power Laser™ ST6, Research® in contact 1.0 W, 10 Hz and 100 mJ, ≈85 J/cm2, with the wavelength of 1064 nm), G7: Nd:YAG laser + Gluma Desensitizer, G8: low-power laser with low dose + Nd:YAG laser, and G9: low-power laser with high dose + Nd:YAG laser. The level of sensitivity of each volunteer was assessed by visual analog scale of pain (VAS) with the aid of air from the triple syringe and exploration probe, 12 and 18 months after treatment. All analyses were performed separately for air and probe stimulus. The level of significance was considered for values of p < 0.05. After statistical analysis, all treatments were shown to be effective in reducing dentinal hypersensitivity, and the results were considered not statistically different from those at 12 months. Therefore, until the 18-month evaluation, it could be said that no statistical differences were observed in the sensitivity levels for all treatments.

Safety of immunotherapy with glutaraldehyde modified allergen extracts in children and adults

BACKGROUND: Glutaraldehyde-modified natural allergen extracts show significant reduction in the IgE-binding capacity and proteolytic activity. This allows the administration of higher doses in a shorter period of time, and to mix different allergen extracts. OBJECTIVE: Evaluate the safety of different concentrations and mixtures of glutaraldehyde-modified allergen extracts in a large group of paediatric and adult patients undergoing specific immunotherapy treatment. MATERIALS AND METHODS: 1855 patients (1156 adults and 699 children), suffering from rhinoconjunctivitis and/or asthma, participated in an observational multicentre cohort study, to evaluate the safety of immunotherapy using vaccines containing modified allergen extracts. Patients were monosensitised, or polysensitised, and received a therapeutic vaccine containing polymerised allergen extracts adsorbed onto aluminium hydroxide. Safety was assessed by recording all side reactions related to immunotherapy. RESULTS: The clinically relevant local reactions totalled 120, (90 immediate and 30 delayed) (1.02% of injections). Of them, 31 (0.26% of injections) occurred in children (26 immediate and 5 delayed) and 89 (0.76% of injections) in adults (64 immediate and 25 delayed). There were 38 systemic reactions. Eleven reactions were immediate (9 of grade 1 and 2 of grade 2) and 27 delayed (22 of grade 1 and 5 of grade 2). There were seven grade 2 systemic reactions (0.06% of the injections). No differences (P>0.05) in the number of reactions were observed between adults and children and between treatments were found in systemic reactions. All systemic reactions were mild and resolved spontaneously without the need of medication. CONCLUSION: Specific immunotherapy using natural modified allergen vaccines is safe to treat allergic patients, even at higher doses and in mixtures of unrelated allergen extracts. The percentage of adverse reactions detected is lower than those reported in the literature with native unmodified allergen extracts

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