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The aim of this retrospective study was to evaluate the demographic characteristics of pediatric dental patients who underwent dental treatment under general anesthesia (DTGA) at the Seoul National University Dental Hospital from January 2011 through December 2020 and compare the patterns of repeated DTGA between dental patients with severe disabilities (DSD) and non-DSD (healthy or medically compromised patients without DSD). There were 1,857 DTGAs among 1,719 patients (mean age = 5.1 years; males = 59.3%; ASA 2 or above = 52.9%; DSD = 26.8%). Overall, 6.6% of patients underwent repeated DTGA, and the rate of repeated DTGA over a 10-year period was 7.4%. ASA 2 or above (p < 0.0001) and DSD (p < 0.0001) were more likely to undergo repeated DRGA compared to ASA 1 and non-DSD. At both GA1 and GA2, DSD received significantly more restorative treatment on permanent teeth than non-DSD (p = 0.002, p < 0.0001, respectively). There has been an increasing demand for DTGA in pediatric dentistry over the last 10 years. Regular check-ups and preventive oral health care are necessary for pediatric dental patients with severe disabilities to reduce the possibility of repeated DTGA.

The purpose of this study was to evaluate the effect of interceptive primary canine extraction in palatally and buccally displaced maxillary permanent canines, and to analyze the clinical and radiographic factors affecting the treatment outcome. 97 maxillary permanent canines from 86 patients whose maxillary permanent canine were in the mesio-occlusal directions and overlapped with the roots of the adjacent teeth were analyzed. In 64 of 97 (66.0%) maxillary permanent canines, the displaced crown was completely deviated from the adjacent lateral incisor root only by extraction of the primary canine. Not only the characteristics of maxillary permanent canines such as bucco-palatal displacement direction, horizontal and vertical position of the crown tip, and presence of apical closure, but also periapical rarefaction on the primary canine and peg-shaped adjacent lateral incisor significantly affected the treatment outcome.

This study aims to analyze the color distribution of maxillary permanent incisors in Korean pediatric patients and determine the effects of age and root developmental stage on tooth color. The L*a*b* values of 404 sound and fully erupted maxillary incisors without dental caries, restorations, trauma history or discoloration from 101 Korean patients between ages 7 and 15, with a mean age 10.0 ± 1.5, were analyzed with a spectrophotometer. CIE L*a*b* values were 84.01, 0.17, and 24.07 in maxillary central incisors, and 82.33, 0.31, and 25.99 in maxillary lateral incisors. L* values of maxillary central incisors were higher, and b* values of maxillary central incisors were lower than those of maxillary lateral incisors (p < 0.001). The color differences among the subregions exceeded the clinical perceptibility threshold in both of the maxillary central and lateral incisors. L* value for children at age 10 and younger was 84.13 in maxillary central incisors and 84.04 in maxillary lateral incisors, and those of older patients were 80.62 and 80.56, respectively. L* value of maxillary incisors of children at age 10 and younger was significantly higher than that of older patients. The root developmental stage did not affect tooth color. This study suggests that the color differences between maxillary central and lateral incisors and among the subregions of a tooth and the effects of age should be considered for aesthetic restorations of permanent incisors in pediatric patients.

To assess trans-regional differences, reproducibility across different MRI scanners, and interobserver agreement of liver surface nodularity (LSN) score from routine liver MRI and to evaluate the correlation between LSN score and liver stiffness (LS) value on MR elastography.Ninety patients who underwent gadoxetic acid-enhanced liver MRI twice using different MRI scanners within a year were evaluated. On axial hepatobiliary phase images, right anterior (LSNLSN scores from high to low were LSNIn our study, LSN measurement on liver MRI showed trans-regional differences and excellent reproducibility across different MRI scanners. To use LSN score more widely, standardization of quantification software and selected hepatic regions is needed.

This study aimed to evaluate the effectiveness of deep convolutional neural networks (CNNs) for diagnosis of interproximal caries in pediatric intraoral radiographs. A total of 500 intraoral radiographic images of first and second primary molars were used for the study. A CNN model (Resnet 50) was applied for the detection of proximal caries. The diagnostic accuracy, sensitivity, specificity, receiver operating characteristic (ROC) curve, and area under ROC curve (AUC) were calculated on the test dataset. The diagnostic accuracy was 0.84, sensitivity was 0.74, and specificity was 0.94. The trained CNN algorithm achieved AUC of 0.86. The diagnostic CNN model for pediatric intraoral radiographs showed good performance with high accuracy. Deep learning can assist dentists in diagnosis of proximal caries lesions in pediatric intraoral radiographs.

Structural lesion evaluation in axial spondyloarthropathy (SpA) can improve accuracy of diagnosis. However, structural lesions (bone erosions) are difficult to be assessed using conventional MRI compared to computed tomography (CT).To evaluate the diagnostic performance of ultrashort echo time (UTE) for detecting bone erosion in axial SpA compared to T1WI and three-dimensional double-echo steady-state (3D DESS) imaging using CT as the reference standard.Retrospective.Fourteen patients (eight females, 57.1%) and 14 healthy controls (seven females, 50.0%) who underwent sacroiliac (SI) joint MRI and CT.3 T; TSE T1WI, 3D DESS, 2D UTE.The bilateral SI joints were assessed for bone erosion. Three observers scored bone erosion for all three sequences of MRI. CT was used as the gold standard. Diagnostic confidence in axial SpA was measured based on a four-point confidence score.Correlation of erosion scores between CT and MRI were evaluated using Spearman's correlation test. Sensitivity, specificity, and positive-negative predictive values were calculated. Confidence scores were compared using the Wilcoxon sum rank test. Statistical significance was set at P 0.05.Compared with erosion scores of CT, the correlation coefficients for each MRI sequence showed significant low-to-high positive correlations (0.39-0.72). UTE imaging showed the highest correlation coefficients for all observers (0.70, 0.72, and 0.67, respectively). The specificity of UTE imaging was equal or higher than those of T1WI and 3D DESS for all observers (0.86 vs. 0.71 vs. 0.57; 0.93 vs. 0.71 vs. 0.57; 0.79 vs. 0.79 vs. 0.43). All observers had the highest confidence in interpreting UTE imaging for detecting bone erosion among the three sequences (3.5, 3.4, and 3.3 for UTE; 3.1, 3.0, and 2.6 for T1WI; and 3.2, 2.7, and 2.4 for DESS).UTE imaging can detect bone erosions in patients with axial SpA and show higher specificity than conventional T1WI and 3D DESS.4 TECHNICAL EFFICACY: Stage 2.

To compare the MRI-derived liver surface nodularity (LSN) scores acquired on both 1.5 T and 3 T.Forty chronic liver disease patients who underwent gadoxetic acid-enhanced MRI at both 1.5 and 3 T were included. Axial hepatobiliary phase images with the same voxel size were used to calculate the LSN score in both liver lobes with a quantitative software. Rank correlation, Wilcoxon test, and Bland-Altman limits of agreement were used for statistical analysis.There was a weak correlation between the right and left liver lobe on 1.5 T (rLSN scores differed significantly on 1.5 T vs. 3 T and right vs. left liver lobe. Caution should be made when comparing LSN scores derived from different field strengths or the hepatic lobe. Interplatform, interlobar reproducibility should be resolved to use LSN scores, which is relatively easy to perform without additional hardware or images.

Background The Liver Imaging Reporting and Data System (LI-RADS) assigns a risk category for hepatocellular carcinoma (HCC) to imaging observations. Establishing the contributions of major features can inform the diagnostic algorithm. Purpose To perform a systematic review and individual patient data meta-analysis to establish the probability of HCC for each LI-RADS major feature using CT/MRI and contrast-enhanced US (CEUS) LI-RADS in patients at high risk for HCC. Materials and Methods Multiple databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus) were searched for studies from January 2014 to September 2019 that evaluated the accuracy of CT, MRI, and CEUS for HCC detection using LI-RADS (CT/MRI LI-RADS, versions 2014, 2017, and 2018; CEUS LI-RADS, versions 2016 and 2017). Data were centralized. Clustering was addressed at the study and patient levels using mixed models. Adjusted odds ratios (ORs) with 95% CIs were determined for each major feature using multivariable stepwise logistic regression. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) (PROSPERO protocol: CRD42020164486). Results A total of 32 studies were included, with 1170 CT observations, 3341 MRI observations, and 853 CEUS observations. At multivariable analysis of CT/MRI LI-RADS, all major features were associated with HCC, except threshold growth (OR, 1.6; 95% CI: 0.7, 3.6; P = .07). Nonperipheral washout (OR, 13.2; 95% CI: 9.0, 19.2; P = .01) and nonrim arterial phase hyperenhancement (APHE) (OR, 10.3; 95% CI: 6.7, 15.6; P = .01) had stronger associations with HCC than enhancing capsule (OR, 2.4; 95% CI: 1.7, 3.5; P = .03). On CEUS images, APHE (OR, 7.3; 95% CI: 4.6, 11.5; P = .01), late and mild washout (OR, 4.1; 95% CI: 2.6, 6.6; P = .01), and size of at least 20 mm (OR, 1.6; 95% CI: 1.04, 2.5; P = .04) were associated with HCC. Twenty-five studies (78%) had high risk of bias due to reporting ambiguity or study design flaws. Conclusion Most Liver Imaging Reporting and Data System major features had different independent associations with hepatocellular carcinoma; for CT/MRI, arterial phase hyperenhancement and washout had the strongest associations, whereas threshold growth had no association. © RSNA, 2021 Online supplemental material is available for this article.

This study retrospectively analyzed the effect of clinical factors on the outcomes of REP(regenerative endodontic procedure). Patients who received the REP using triple antibiotic paste due to trauma or fracture of dens evaginatus from February, 2011 to January, 2020 were included in the study. Finally, 57 teeth in 54 patients were selected. Investigated clinical factors were as follows: intentional bleeding, etiology, and root development stage. Treatment outcomes evaluated were as follows: improvement of subjective symptoms, changes in the periapical lesion, and the amounts of root development after REP. To compensate for differences in angulation and position between repeated radiographic examinations, images were aligned by Turboreg plugin. To evaluate the amounts of root development, apical diameter, root area, and root length were measured by ImageJ software. Among the aforementioned factors, intentional bleeding had no significant effect on treatment results. Regarding the etiology, the increase in the root area and the root length was significantly less in trauma cases than in dens evaginatus fracture cases. Considering root development stage, more immature teeth presented more increase in the root area.

The purpose of this study is to analyze morphological characteristics of maxillary primary molar’s root and root canal. 268 children aged 3 - 7 years (175 boys, 93 girls) who had CBCT (152 children) and 3D CT (116 children) taken in Seoul National University Dental Hospital from January 2006 to April 2020 were included. The number of roots and root canals were analyzed in 1002 teeth without any root resorption or periapical pathologies. Curvature, angulation, length of root and root canal, as well as cross-sectional shapes of the root canal were analyzed in 218 teeth. By using Mimics and 3-Matics software, volume, surface area, and volume ratio of root canal was analyzed in 48 teeth. More than half of maxillary primary molars have 3 roots and 3 root canals. The degree of symmetry of root canal type was about 0.63 (Cohen’s kappa coefficient). The most frequent shape of roots and canals was linear in 1st primary molars and curved in 2nd primary molars. Angulation, length of root and root canals was the largest on palatal roots. Most teeth showed ovoid or round shapes at apex. The largest root canal volume, surface area, volume ratio was found in the palatal roots.

The purpose of this in vivo study was to assess the clinical screening performance of a quantitative light-induced fluorescence (QLF) device in detecting proximal caries in primary molars. Fluorescence loss, red autofluorescence and a simplified QLF score for proximal caries (QS-proximal) were evaluated for their validity in detecting proximal caries in primary molars compared to bitewing radiography. Three hundred and forty-four primary molar surfaces were included in the study. Carious lesions were scored according to lesion severity assessed by visual-tactile and radiographic examinations. The QLF images were analyzed for two quantitative parameters, fluorescence loss and red autofluorescence, as well as for QS-proximal. For both quantitative parameters and QS-proximal, the sensitivity, specificity and area under receiver operating curve (AUROC) were calculated as a function of the radiographic scoring index at enamel and dentin caries levels. Both quantitative parameters showed fair AUROC values for detecting dentine level caries (△F = 0.794, △R = 0.750). QS-proximal showed higher AUROC values (0.757 - 0.769) than that of visual-tactile scores (0.653) in detecting dentine level caries. The QLF device showed fair screening performance in detecting proximal caries in primary molars compared to bitewing radiography.

A total of 580 patients, who visited and received an orthodontic diagnosis in the Department of Pediatric Dentistry, Seoul National University Dental Hospital from 2017 to 2019, were investigated in this study. The aim of this study was to evaluate skeletal patterns of pediatric orthodontic patients determined with lateral cephalometric analysis and to analyze the relationship between skeletal pattern and probable associated clinical features. Also, the modality of orthodontic treatment for each skeletal classification was investigated to aid in therapeutic decisions.Patients aged 7 year accounted for the largest age group; 54.2% of patients showed a skeletal class I pattern, 22.2% showed a skeletal class II pattern, and 23.6% showed a skeletal class III pattern. Bi-maxillary retrusion for skeletal class I, retruded mandible with normal positioning of the maxilla for skeletal class II, and retrusion of the maxilla with protrusion of the mandible for skeletal class III were the largest subgroups by skeletal pattern. Brachyfacial type accounted for 55.0% of patients, followed by 31.9% of mesofacial type and 13.1% of dolichofacial type. The prevalence of anterior crossbite in the study was 43.3%, higher than that in previous studies.

Combined hepatocellular-cholangiocarcinoma with a ductal plate malformation pattern is an extremely rare entity with unelucidated pathogenesis. We present the case of a 60-year-old male patient who underwent a sectionectomy for pre-operative diagnosis of hepatocellular carcinoma based on clinical and image findings. Gross examination of the specimen revealed a well-defined tumor with cystic change measuring 6.7 × 6.2 cm. Microscopically, the lesion had classical features of hepatocellular carcinoma and intrahepatic cholangiocarcinoma exhibited neoplastic glands with irregular-sized dilated lumens, resembling a ductal plate malformation. Postoperative diagnosis was combined hepatocellular-cholangiocarcinoma with ductal plate malformation pattern. Next-generation sequencing revealed genomic alteration in 15 genes: CDKN2A, CHD4, CYP2D6, ERBB3, KIR3DL1, KRAS, MDM2, PIM1, STAT6, TPMT amplification, FANCD2, FAT1, FLT4, RASA1, and TP53 point mutation. This is the first case report of molecular alteration in combined hepatocellular-cholangiocarcinoma with ductal plate malformation pattern.

Microcephalic osteodysplastic primordial dwarfism type II (MOPD II) is an autosomal recessive inherited disorder form of primordial dwarfism, caused by mutations in the pericentrin gene. The purpose of the study was to examine the clinical and radiological features, physicochemical properties and microstructures of the tooth affected with MOPD II. The mandibular 2nd molar was collected from the MOPD II patient. Micro-computerized tomography, scanning electron microscopy, energy dispersive spectrometry and Vickers microhardness analysis were performed on the MOPD II and the normal control. The morphology of the MOPD II tooth appeared to have malformed pulp and root and showed a small size. The mineral density measurement showed that the MOPD II tooth had similar scores in the enamel, but lower scores in the root 1/2 and apical dentin compared to the normal control. The microhardness values were smaller in the cusp enamel, root 1/2 dentin and apical dentin of the MOPD II compared to the normal control. In this study, the dental characteristics and the physicochemical properties of a tooth affected with MOPD II were analyzed to improve understanding of the oral manifestations of the disease and to assist in proper dental treatment by identifying precautions.

The purpose of this study was to investigate the three-dimensional characteristics of mesiodens using Cone-beam Computed Tomography(CBCT) and analyze the factors affecting complications and anesthetic methods of extraction. This study evaluated 602 mesiodens of 452 patients who underwent extraction of mesiodens at the department of Pediatric Dentistry in Seoul National University Dental Hospital between 2017 and 2019. The ratio of mesiodens patients over total patient per year was gradually increased over the past 20 years. Mesiodens with labio-palatally horizontal direction while root directing labial were the most common among the mesiodens with horizontal direction. Mesiodens were the most common at the cervical side of the adjacent teeth(37.0%) and mesiodens located in the near-palatal side were observed about 3.83 times higher than the far-palatal side. Most of the mesiodens(82.1%) were in contact with adjacent permanent teeth on all three sides of the CBCT and 46.2% of mesiodens had curved roots. The patient’s age, vertical position, presence of complications, and proximity showed a significant difference in the selection of general anesthesia among anesthetic methods. The direction and vertical position of mesiodens had a significant effect on complications. These results provide a better understanding of mesiodens for establishing an accurate diagnosis and treatment plan.

The purpose of this study was to calculate uncertainty of orthodontic measurement in skeletal class III malocclusion children using lateral cephalometry analysis software which obtained traceability in previous study. Using this data, standard reference of measurement value for skeletal class III malocclusion was obtained.Lateral cephalometric data was collected from 144 children who visited Pediatric Dentistry from 2017 to 2020 for orthodontic treatment. Orthodontic measurement was analyzed with software which obtained traceability. Type A evaluation of uncertainty and type B evaluation of uncertainty was calculated to obtain combined standard uncertainty and expanded uncertainty. Standard reference of skeletal class III children was compared to standard reference of skeletal class I children.Distribution range for skeletal class III malocclusion children aged 6 to 10 with 95% confidence interval was provided using calculated uncertainty of orthodontic measurement value.

Silver diamine fluoride (SDF) is an effective and efficient agent for arresting dental caries. It can be useful in treating children with behavioral or medical limitations. The purpose of this study was to evaluate the antimicrobial effect of SDF by using salivary biofilm.Pellicle-like saliva coated structure was prepared by using unstimulated saliva. For developing cariogenic biofilm, Streptococcus mutans was added to the mixture of pooled saliva and inoculated into a saliva coated glass or chamber. SDF was applied to cariogenic biofilm to evaluate the antimicrobial effect of SDF. As time passed, total bacteria and S. mutans were reduced after application of SDF (p < 0.000). Confocal laser scanning microscope also showed the increment of the ratio of dead cell.As a result of experiment using enamel and dentin of primary teeth, it was confirmed that the growth of cariogenic biofilm was inhibited when the SDF was treated (p = 0.029 each).This study showed excellent anti-microbial effect of SDF. And anti-caries effect in clinical practice can be expected.

BACKGROUND The contact areas in between primary teeth are broader, flatter, and located further cervically when compared with the contact areas of permanent molars. AIM We investigated the prevalence of interproximal contact area types of primary molars using CBCT images in children aged 3-10 years. Our second objective was to correlate OXIS contact areas when observed with CBCT images and clinical photographs. DESIGN A retrospective cross-sectional study was performed with 367 CBCT images of children, aged 3-10 years, obtained from Children's Dental Centre, South Korea. The type of contacts in between primary molars was scored at various levels, specifically, occlusal, middle, and cervical thirds, according to OXIS criteria. Following this, the same patient's records were checked for the presence of clinical photographs and scored according to the same criteria. Prevalence was stated as percentages along with numbers. Chi-square test was applied to determine association of contact areas across genders and arches. The correlation between the two methods was done by Cohen's Kappa correlation test. RESULTS The prevalence of the OXIS contacts obtained from CBCT images was as follows: I (79.7%), followed by X (10.0%), S (6.6%), and, finally, O (3.7%). The overall score of all the 1343 contact areas matched with the score observed at the occlusal third. All included contacts were of O (open) type at cervical third, and 1,231 contacts were of O (open) type at the middle third. Significant results were observed with respect to arches (P

The purpose of this study was to examine the prevalence of developmental anomalies of permanent lateral incisor and eruption disturbances and analyze the association between two components. Panoramic radiographs of 3984 patients (aged 5 to 13 years) who visited the Department of Pediatric Dentistry of Seoul National University Dental Hospital between November 2016 and October 2017 were screened.The prevalence of developmental anomalies of permanent lateral incisors was 10.2%. The most common developmental anomalies were congenitally missing teeth(66.1%), followed by peg lateralis(33.5%). The prevalence of eruption disturbances was 16.5%. Among the patient with developmental anomalies of permanent lateral incisors, associated eruption disturbances were appeared on 31.1% of patients. Peg lateralis(p < 0.001), underdeveloped lateral incisors(p < 0.001) and dens invaginatus(p = 0.004) were associated significantly with eruption disturbance of permanent teeth. Eruption disturbance in patients with peg lateralis and dens invaginatus was most prevalent in maxillary canine. For patients with underdeveloped lateral incisor, eruption disturbance of maxillary central incisor was most frequent.It is important for patients with developmental anomalies of lateral incisors to detect associated eruption disturbance early through regular checkup. Diagnosis and treatment plan in view of such relationships is important in order to treat appropriately at the optimal time.

The number of pediatric dental clinics has been increasing due to the development of dentistry and changes in public awareness of professional dental care for children. The purpose of this study was to investigate the present status of pediatric dental clinics in Korea in several respects, including regional distribution.There were 343 pediatric dental clinics (1.91%) among 17,917 dental clinics in Korea. 248 out of 343 private practitioners were board certified pediatric dentists. Of 248 board certified pediatric dentists, 25 displayed the specialty in their clinics’ name. Gyeonggi occupied largest share of the total pediatric dental clinics in Korea, followed by Seoul and Busan. Gangnam-gu occupied largest share of the total pediatric dental clinics in Seoul. Out of all pediatric dental clinics in Korea, 78.7% was run by only one dentist. 90.9% of pediatric dental clinics didn’t do night clinic on weekdays and 26.5% was open until after 15:00 on Saturday.

Midazolam is a short-acting benzodiazepine that is widely used in pediatric dental sedation. However, its clinical effectiveness as an intravenous sedative agent in children has not been widely documented. A retrospective study was conducted to evaluate the efficacy and safety of intravenous midazolam and nitrous oxide inhalation sedation in pediatric dental treatment.The subjects were 115 patients (118 cases) who received dental treatment under intravenous midazolam and nitrous oxide inhalation sedation. Demographic factors, general health status, sedation time, midazolam and nitrous oxide dosage, and success rate of sedation were evaluated from electronic medical records.Behavioral management was the main reason of choosing sedation. Mean duration of sedation was 56.7 minutes for surgical treatment, and 74.4 minutes for restorative treatment. The initial dosage of intravenous midazolam was 0.051 ± 0.019 mg/kg. In 34 cases (28.8%), additional midazolam of 0.036 ± 0.057 mg/kg was delivered during the treatment. The concentration of nitrous oxide was maintained between 40% and 50%. The success rate of sedation was 99% (n = 117). In 1 case, laryngospasm occurred and the patient was reversed with benzodiazepine antagonist, flumazenil.Intravenous midazolam sedation with nitrous oxide was shown to be clinically effective for the dental treatment in children, if administered by trained personnel and patients are carefully selected in accordance with guidelines.

Amelogenesis imperfecta (AI) is a heterogeneous group of rare genetic disorders affecting amelogenesis during dental development. Therefore, the molecular genetic etiology of AI can provide information about the nature and progress of the disease. To confirm the genetic etiology of AI in a Korean family with an autosomal dominant inheritance, pedigree and mutational analyses were performed. DNA was isolated from the participating family members and whole-exome sequencing was performed with the DNA sample of the father of the proband. The identified mutation was confirmed by Sanger sequencing. The mutational analysis revealed a novel nonsense mutation in the

Molar root-incisor malformation (MRIM) or molar-incisor malformation (MIM) is a new type of dental anomaly characterized by dysplastic roots of permanent first molars, occasionally second primary molars, and the crowns of maxillary central incisors. MRIM involving permanent first molars and second primary molars is characterized by normal crowns with short, thin, and narrow roots, whereas MRIM involving permanent maxillary central incisors exhibits constrictions of the crown in the cervical area. In the first case, we extracted the affected first permanent molars at the optimal timing to minimize space deficiencies and induce space closure. In addition, composite resin restorations were performed on the anterior central incisors. In the second case, a mandibular lingual arch was used to stabilize the affected teeth in order to mitigate discomfort by reducing rotational biting forces.

Background Although sentinel lymph node biopsy (SLNB) is the current standard for identifying lymph metastasis in breast cancer patients, there are complications of SLNB. Purpose To evaluate preoperative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) of invasive breast cancer for predicting sentinel lymph node metastasis. Study type Retrospective. Population In all, 309 patients who underwent clinically node-negative invasive breast cancer surgery FIELD STRENGTH/SEQUENCE: 3.0T, DCE-MRI, DWI. Assessment We collected clinicopathologic variables (age, histologic and nuclear grade, extensive intraductal carcinoma component, lymphovascular invasion, and immunohistochemical profiles) and preoperative MRI features (tumor size, background parenchymal enhancement, internal enhancement, adjacent vessel sign, whole-breast vascularity, initial enhancement pattern, kinetic curve types, quantitative kinetic parameters, tumoral apparent diffusion coefficient [ADC], peritumoral maximal ADC, and peritumoral-tumoral ADC ratio). Statistical tests Multivariate logistic regressions were performed to determine independent variables associated with SLN metastasis, and the area under the receiver operating characteristic curve (AUC) was analyzed for those variables. Results 41 (13.3%) of the patients showed SLN metastasis. With MRI, tumor size (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.06-1.17), heterogeneous (OR, 5.33; 95% CI, 1.71-16.58), and rim (OR, 15.54; 95% CI, 2.12-113.72) enhancement and peritumoral-tumoral ADC ratio (OR, 72.79; 95% CI, 7.15-740.82) were independently associated with SLN metastasis. Clinicopathologic variables independently associated with SLN metastasis included age (OR, 0.96; 95% CI, 0.92-0.99) and CD31 (OR, 2.90; 95% CI, 1.04-8.92). The area under the curve (AUC) of MRI features (0.80; 95% CI, 0.73-0.87) was significantly higher than for clinicopathologic variables (0.68; 95% CI, 0.60-0.77; P = 0.048) and was barely below statistical significance for combined MRI features with clinicopathologic variables (0.84; 95% CI 0.78-0.90, P = 0.057). Data conclusion Preoperative internal enhancement on DCE-MRI and peritumoral-tumoral ADC ratio on DWI might be useful for predicting SLN metastasis in patients with invasive breast cancer. Level of evidence 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:615-626.

Objectives To identify the molecular genetic etiology of the families with non-syndromic multiple missing permanent teeth (oligodontia). Materials and methods Genomic DNA was isolated and measured, and whole-exome sequencing was performed. The obtained sequencing reads were aligned to the human reference genome and subsequently processed by a series of bioinformatics programs. Finally, short insertions/deletions and single nucleotide variations were annotated with dbSNP build 138. Results The proband of family 1 was missing 14 permanent teeth, and the mutational analysis revealed compound heterozygousWNT10A mutations (c.364A > T and c.511C > T). Two affected individuals in family 2 were missing 20 and 12 permanent teeth, respectively, and compound heterozygous WNT10A mutations (c.364A > T and c.637G > A) were also identified. Conclusions This study reveals compound heterozygousWNT10A missense mutations in two families with non-syndromic oligodontia which will improve the understanding of odontogenesis and the pathogenesis related to WNT10A mutations.

To compare the apparent diffusion coefficient (ADC) value of conventional diffusion-weighted imaging (cDWI) to simultaneous multislice-accelerated DWI (sDWI) and to evaluate the possibility of ADC normalization using the spleen as a reference organ. We retrospectively evaluated 92 patients (68 men, 24 women; mean age 60.0 years) who underwent liver magnetic resonance imaging (MRI) including both cDWI and sDWI. sDWI was obtained with an acceleration factor of 2. ADC values were measured from the right liver lobe, left liver lobe, spleen, pancreas, right kidney, and left kidney. ADC values of the spleen were used for normalization. Paired sample t test, Pearson’s correlation coefficient, and Bland–Altman method were used for statistical analysis. ADC values of cDWI were significantly lower than sDWI in all six anatomic regions (p

Objective: To compare the shear bond strength (SBS) after thermocycling of four universal adhesives applied in self-etch mode on dentin and etch-and-rinse mode on enamel. Study design: Flat 144 buccal or lingual dentin and enamel surfaces from 72 non-carious primary molars were prepared. Samples were segregated into 12 groups (n=12): Adper Single Bond 2 etch-and-rinse (SB_T) and Clearfil SE Bond self-etch (SE_S) applied to enamel and dentin served as controls. Scotch Bond Universal Adhesive (SBU), Clearfil S3 Bond Universal Adhesive (SEU), Tetric N-Bond Universal Adhesive (TEN), and All Bond Universal (BIS) were applied in etch-and-rinse mode to enamel and in self-etch mode to dentin. They were thermocycled for 5000 cycles. SBS testing and the evaluation of fracture mode were performed. Results: SB_T showed statistically higher SBS than other adhesive groups using etch-and-rinse mode on enamel. SE_S and BIS had statistically higher SBS than other adhesive groups using self-etch mode on dentin. Mixed failure was the most common failure mode in each group. Conclusion: The universal adhesives did not show higher SBS than SB_T when using etch-and-rinse on enamel. All universal adhesives showed higher SBS than SB_T and had SBS similar to SE_S, except SBU when using self-etch mode on dentin.

Liver fibrosis features excessive protein accumulation in the liver interstitial space resulting from repeated tissue injury due to chronic liver disease. Liver fibrosis eventually proceeds to cirrhosis and associated complications. So, early diagnosis and staging of liver fibrosis are of vital importance for clinical treatment. Liver biopsy remains the gold standard for the diagnosing and staging of fibrosis, but it is suboptimal due to various limitations. Recently, efforts have been made to migrate toward noninvasive techniques for assessing liver fibrosis. CT is relatively easy to perform, relatively standardized for different scanners, and does not require additional hardware in liver fibrosis staging. MRI is frequently performed to characterize indeterminate liver lesions. Because it does not use ionizing radiation and features high image contrast, its role has increased in the staging of liver fibrosis. More recently, several studies on liver fibrosis staging using deep learning algorithms in CT or MRI have been proposed and have shown meaningful results. In this review, we summarize the basic concept, diagnostic performance, and advantages and limitations of each technique to noninvasively stage liver fibrosis.

This study aimed to compare the change of surface roughness (Ra) and gloss units (GU) of five dental composites (Filtek Z250, Filtek Z350XT, Metafil CX, Ceram X one, and Venus Diamond) polished with three systems (Sof-Lex XT, Enhance/Pogo, and Sof-Lex Diamond) before/after simulated brushings and to determine the amount of time required to achieve maximum gloss. Ninety rectangular specimens (n=18 per composite) were prepared. Six specimens of each composite were assigned to one of the polishing systems. The Ra and GU of each specimen were measured after each polishing step. Five polished specimens per composite were brushed with a toothbrush machine, and the Ra and GU values were determined. Filtek Z350XT exhibited the most stable and lowest Ra during the brushing cycles regardless of polishing system. When using the Sof-Lex Diamond and Enhance/Pogo systems, the highest gloss and the smoothest surfaces were achieved after polishing and brushing.

To compare the diagnostic performance of diffusion-weighted imaging (DWI), gradient-recalled echo-based magnetic resonance elastography (GRE-MRE), and spin-echo echo-planar imaging-based MRE (SE-EPI-MRE) in liver fibrosis staging. A systematic literature search was done to collect studies on the performance of DWI, GRE-MRE, and SE-EPI-MRE for diagnosing liver fibrosis. Pooled sensitivity, specificity, diagnostic odds ratio, positive and negative likelihood ratio, and a summary receiver operating characteristic (ROC) curve were estimated with a bivariate random effects model. Subgroup analyses on various study characteristics were performed. Sixty studies with a total of 6620 patients were included in the meta-analysis. Pooled sensitivity and specificity of GRE-MRE and SE-EPI-MRE showed high diagnostic accuracy and did not differ significantly. The area under the summary ROC curve for all stages of fibrosis differed significantly between DWI (0.83–0.88) and either GRE-MRE (0.95–0.97) or SE-EPI-MRE (0.95–0.99). Substantial heterogeneity was detected for all three imaging methods. Both GRE-MRE and SE-EPI-MRE are highly accurate for detection of each liver fibrosis stage, with high potential to replace liver biopsy. Although DWI had a moderate accuracy in distinguishing liver fibrosis, it could be regarded as an alternative to MRE, since it is widely available and easily implemented in routine liver MRI.

OBJECTIVE. The purposes of this study were to evaluate the accuracy of a semiautomatic method of measuring liver surface nodularity (LSN) on contrast-enhanced MR images and to compare the LSN score with pathologic fibrosis stage. MATERIALS AND METHODS. This retrospective study included patients who had undergone gadoxetate disodium-enhanced liver MRI 6 months before or after histopathologic investigation including percutaneous parenchymal biopsy and surgical biopsy for staging of chronic liver disease between January 2010 and December 2018. Semiautomated LSN quantification software was developed to measure LSN at MRI. Aspartate aminotransferase to platelet ratio index and fibrosis-4 index were derived from serum laboratory test results. The reference standard for staging of liver fibrosis was Metavir score. The accuracy of LSN score for staging of liver fibrosis was evaluated with AUC, and the optimal cutoff value was calculated by Youden index. Spearman correlation coefficient was used for correlation analysis. RESULTS. The study included 132 patients (93 men, 39 women). LSN score was evaluated without technical failure. There was high correlation between LSN score and Metavir score (Spearman ρ = 0.713, p < 0.001). The AUCs of LSN score for distinguishing Metavir score were 0.93 for F0-F1 versus F2-F4 (95% CI, 0.88-0.97; p < 0.001), 0.98 for F0-F2 vs F3-F4 (95% CI, 0.95-1.00; p < 0.001), and 0.83 for F0-F3 versus F4 (95% CI, 0.76-0.90; p < 0.001). The optimal cutoff value for differentiating F0-F2 from F3-F4 was 0.850 with 100% sensitivity and 85.4% specificity. CONCLUSION. LSN score calculated semiautomatically from MR images of the liver has high accuracy and correlates directly with the pathologic fibrosis stage.