Search

Purpose: To evaluate the survival and clinical quality of individually layered indirect composite restorations (ICRs) in the mixed and permanent dentition at two study centers., Materials and Methods: A total of 155 adhesively cemented ICRs in 34 participants (aged 6 to 50 years and treated between 2008 and 2018) were evaluated for survival and clinical quality. All were individually layered restorations fabricated from laboratory sculptable composites by a specialized dental technician. Two calibrated independent investigators examined and graded each restoration as success, survival with repair, or failure based on the FDI criteria. The marginal quality and gap width of the restorations were analyzed by scanning electron microscopy. The periodontal health of treated teeth (TT) was evaluated in comparison with that of unrestored control teeth (CT) by measuring the pocket depth (PD), clinical attachment level (CAL), sulcus bleeding index (SBI), and the modified Turesky Plaque Index (TPI). A serial t-test (p 0.05) was used for statistical analysis of periodontal parameters. Success and functional survival rates were calculated using the Kaplan-Meier method., Results: Molar incisor hypomineralization (MIH) was the most common indication for treatment (41%). The median age at treatment was 14.9 years (68%-CI: 7.7-29.5). The median service time of the restorations was 5.7 ± 3.4 years. 132 restorations were classified as a success, 21 as survival with repair, and 1 as a failure. The success rates at 1, 5, and 10 years were 95.4%, 87.4%, and 78.8%, respectively, and the corresponding functional survival rates were 100.0%, 98.9%, and 98.9%. The clinical quality, encompassing esthetic, functional, and biological criteria, was rated as excellent or good in over 90%. Periodontal response, however, was the only criterion showing worse results since restored teeth (TPI = 1.9) had significantly more plaque than CT (TPI = 1.7; p = 0.0001). No significant differences were observed in PD, CAL, or SBI. The mean marginal gap width was 135.7 µm and 63.8% of the restorations had perfect margins., Conclusion: ICRs are suitable for minimally invasive restoration of large tooth structure defects in the developing dentition of children and adolescents and for long-term temporary restoration of the adult dentition.

Aim: Postmortem Computed Tomography (PMCT) is gradually introduced at forensic institutes. Image reconstruction software can increase diagnostic potential in CT by increasing distinction between structures and reduction of artifacts. The aim of this study was to develop and evaluate novel image reconstruction parameters for postmortem conditions, to increase image quality and diagnostic potential of CT scans., Method: Twenty PMCT scans of deceased hereof two in severe decay were subjected to four reconstruction techniques: a standard reconstruction algorithm, the detail reconstruction algorithm and two novel algorithms based on the standard algorithm, but with different Hounsfield settings. Image quality was evaluated by visual grading analysis (VGA) by four forensic radiologist observers., Results: The VGA did not prove that any of the reconstruction techniques were superior to the others. For standard and detail, the two pre-defined reconstruction algorithms, VGA scores were indiscernible and were superior to the equally indiscernible Hounsfield reconstructions on parameters translated into Sharpness and Low Contrast Resolution. The two alternative Hounsfield settings were superior with respect to Noise and Artifacts/Beam Hardening., Conclusion: The study elucidates the possiblity for multiple reconstructions specialized for PMCT conditions, to accommodate the special conditions when working with the deceased. Despite the lack of clear improvements in the tested reconstructions, this study provides an insight into some of the possibilities of improving PMCT quality using reconstruction techniques., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

This review gives a summary of osteoarthritis (OA) of the spine involving the facet and the sacroiliac joints. Facet joint OA is widely prevalent in adults, and is thought to be a common cause of back and neck pain. The prevalence of facet and SI-joint mediated pain increases with age, suggesting that OA might have a particularly important role in older adults with spinal pain. Treatment options of symptomatic facet- and SI-joint degeneration consist of non-opioid analgesics, physiotherapy or in patients with persistent back or leg pain of either spinal decompression or fusion.

Purpose: To investigate whether software optimisation can improve an observers' perception of image quality in low dose paediatric pelvic examinations., Methods: Twenty-five consecutive patients (3-7 years old) were referred for a pelvic digital radiography (DR) examination. They were prospectively enrolled in the study over a 3-month period. Images were taken at 80 kV and 2-4 mAs depending on pelvic thickness (9-15 cm). A small focal spot, 130 cm SID: 10 cm air gap and 1 mm Al and 0.2 mm Cu additional filtration were also utilised. Images were acquired on a Canon DR detector and optimised using five different combinations of the multi-frequency processing software (Canon DR system version NE, Version 7.1 with SPECTRA) to comply with the ALARA principle. Image quality was blindly evaluated using the subjective Visual Grading Analysis (VGA) by five experienced musculoskeletal radiologists, including the evaluation of six anatomical image quality criteria (scored from 1 to 5)., Results: Consistently, the VGA results indicated that by using software optimised parameters, image quality was suitable for diagnosis in 48-71% of all images. Based on a VGC analysis all software optimised images did have significant better image quality then the one with just the clinical settings. Noise reduction was the software setting which influenced the image quality the most, area under the curve (AUC) of 0.8172 95%CI 0.7953-0.8375., Conclusion: Software optimisation improve the radiologists' perception of image quality and should thus be thoroughly considered within clinical practise. Noise reduction is the software parameter which has the greatest influence., (Copyright © 2019 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.)

Haematocolpos is a rare condition in young women that could be caused by imperforated hymen, vaginal atresia and vaginal agenesis. Haematocolpos is usually diagnosed at early puberty with unspecified abdominal pain and amenorrhoea. Three cases are presented. In one case the radiological examination showed incidentally a urogenital congenital anomaly known as Herlyn-Werner-Wunderlich syndrome. A gynaecological examination should be performed to confirm the presence of imperforated hymen, but in cases in which other pathology is suspected ultrasound and MRI should also be performed.

Visceral leishmaniasis (VL) caused by Leishmania chagasi is endemic to northeast Brazil. A positive delayed-type hypersensitivity skin test response (DTH+) is a marker for acquired resistance to disease, clusters in families and may be genetically controlled. Twenty-three single nucleotide polymorphisms (SNPs) were genotyped in the cytokine 5q23.3-q31.1 region IRF1-IL5-IL13-IL4-IL9-LECT2-TGFBI in 102 families (323 DTH+; 190 DTH-; 123 VL individuals) from a VL endemic region in northeast Brazil. Data from 20 SNPs were analyzed for association with DTH+/- status and VL using family-based, stepwise conditional logistic regression analysis. Independent associations were observed between the DTH+ phenotype and markers in separate linkage disequilibrium blocks in LECT2 (OR 2.25; P=0.005; 95% CI=1.28-3.97) and TGFBI (OR 1.94; P=0.003; 95% CI=1.24-3.03). VL child/parent trios gave no evidence of association, but the DTH- phenotype was associated with SNP rs2070874 at IL4 (OR 3.14; P=0.006; 95% CI=1.38-7.14), and SNP rs30740 between LECT2 and TGFBI (OR 3.00; P=0.042; 95% CI=1.04-8.65). These results indicate several genes in the immune response gene cluster at 5q23.3-q31.1 influence outcomes of L. chagasi infection in this region of Brazil.

Introduction: Endovascular repair as treatment of aortic diseases seems promising. We report the first Danish results of endografting of the descending thoracic aorta., Materials and Methods: Nineteen patients (median age 68 years, range 22-78 years) underwent endovascular treatment of diseases in the descending thoracic aorta: atherosclerotic aneurysm (n = 7), ruptured aneurysm (n = 3), Type B dissection (n = 3), traumatic rupture (n = 3), pseudoaneurysm (n = 2) and a defective aortic prosthesis (n = 1). The patients were followed with chest CT scans and clinically., Results: In all cases the endograft was successfully deployed in the intended positions. Median total hospital stay was 5 days, range 2-21 days. Eight patients had post-implantation syndrome. No deaths occurred within the first post-operative month. During the follow-up period (median 12 months, range 1-56 months) five deaths were observed. One of the patients died from aortobronchial fistula related to the endograft. One patient had an endoleak, and two had expanded aneurysm. None of these patients was treated., Conclusion: In selected patients, endoluminal grafting of the descending thoracic aortic is a safe and successful alternative to open graft repair in treating aneurysm, ruptured aneurysm, traumatic rupture and dissection. However, long-term evaluation is still required.

The authors studied the relation between residual angulation at the time of healing and final orientation of the distal radius as well as the clinical outcome in patients after Salter-Harris type II epiphyseal plate injury of the distal radius. Eighty-five patients were reviewed with a median follow-up of 8.5 years. Anteroposterior and lateral radiographs were taken at follow-up. The mobility of both wrists and forearms was examined, together with grip strength. Pain with activities and sports was evaluated. At follow-up, 73 patients (86%) were anatomically normal on radiographs; the remaining 12 patients had an incomplete remodeling of the volar and/or radial inclination of the distal radius. Premature closure of the growth plate in the distal radius or ulna did not occur in any of these children. Complete remodeling was seen in children aged up to 10 years in all but one patient. Remodeling after Salter-Harris type II epiphyseal plate injury occurs in all age groups, but the potential is greater in children up to 10 years of age. The incomplete remodeling does not seem to have any substantial long-term negative effect on mobility of the wrist and grip strength.

Cholecystoenteric fistula is a rare complication of biliary tract diseases. The symptoms are abdominal pain, fever, nausea, vomiting, flatulence, fat intolerance, diarrhoea and weight loss. The fistula may often be asymptomatic for a long time. We report a 76-year-old woman with a cholecystocolic fistula between the gallbladder and the right flexure of the colon. The symptoms were persistent right upper quadrant pain and diarrhoea. Barium enema demonstrated the fistula. The patient was treated with an open cholecystectomy and a resection of the fistula.

A patient with an epiphyseal separation through the base of the coracoid process of the shoulder associated with a grade I acromioclavicular sprain is reported. The epiphyseal separation was not visible on conventional roentgenograms. A CT scan demonstrated the abnormality. In patients with considerable intractable pain due to contusion of the shoulder, early use of CT should be considered to determine whether symptoms are caused by epiphyseal separation of the coracoid process.