MR enterography in nonresponsive adult celiac disease: Correlation with endoscopic, pathologic, serologic, and genetic features.

PURPOSE: To assess small bowel abnormalities on magnetic resonance enterography (MRE) in adult patients with nonresponsive celiac disease (CD) and investigate their associations with endoscopic, histopathologic, serologic, and genetic features. MATERIALS AND METHODS: This prospective study was carried out between September 2012 and August 2013. After approval by the Ethics Committee of our institution, informed consent was acquired from all participants. Forty consecutive patients with nonresponsive CD, aged 17-76 years, underwent MRE using a 1.5T unit. Sequences included T2 -HASTE, True-FISP, pre- and postcontrast VIBE to assess the quantitative (number of ileal and jejunal folds) and qualitative (fold pattern abnormalities, mural thickening, increased enhancement, bowel dilatation, or intussusception) measures. Endoscopic manifestations were categorized as normal/mild vs. severe. Histopathological results were divided into mild and severe. Genotyping of HLA-DQ2 and DQ8 was performed. Serum levels of tissue-transglutaminase, endomysial, and gliadin antibodies were also determined. Logistic regression analysis and receiver operating characteristic (ROC) curve were used. RESULTS: Twenty-nine (72.5%) cases showed abnormal MRE. Reversed jejunoileal fold pattern had significant association with severe endoscopic (odds ratio [OR] = 8.38, 95% confidence interval [CI] 1.73-40.5) and pathologic features (OR = 7.36, 95% CI 1.33-40.54). An increased number of ileal folds/inch was significantly associated with severe MARSH score and positive HLA-DQ8. (P < 0.001 and P = 0.026, respectively). Ileal fold number had the highest areas under the curve for prediction of severe endoscopic (AUC: 0.75, P = 0.009) and pathologic (AUC: 0.84, P < 0.001) findings and positive anti-transglutaminase antibody (AUC: 0.85, P = 0.027). CONCLUSION: Fold pattern reversal on MRE is highly associated with endoscopic and pathologic features of refractory celiac disease (RCD). Increased ileal folds showed higher correlation with endoscopic-pathologic features, HLA-DQ8, and anti-transglutaminase level. MRE might be more sensitive for detection of increased ileal folds in CD rather than reduction of duodenal and jejunal folds due to better distension of ileal loops. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017;46:1096-1106.

A Simplified Method for the Restoration of Severely Decayed Primary Incisors.

OBJECTIVES: Caries and dental trauma are common reasons for primary anterior teeth restorations in children. This non-control clinical trial was designed to evaluate crown restorations reinforced with a sectioned file post for the restoration of severely damaged primary maxillary incisors. MATERIALS AND METHODS: Thirty-eight primary maxillary incisors of 12 children (3-5 years old) with early childhood caries (ECC) received composite restorations with a custom made post. The restorations were evaluated using the modified United State Public Health Service (USPHS) criteria. The results were statistically analyzed by descriptive -analytical tests. RESULTS: In this trial, the quality of marginal adaptation decreased after three and 12 months intervals. Recurrent carious lesions were observed during intervals. In terms of restoration retention, only one patient lost both the post and the restoration at the 12-month follow up. CONCLUSION: The sectioned file post technique showed good retention and aesthetics for restoring severely damaged primary maxillary anterior teeth.

A comparison of shear bond strength of immediate and delayed bonding of brackets to FRC bars using various orthodontic adhesives.

BACKGROUND: Fibre reinforced composite bars (FRC) have applications as bonded retainers, space maintainers and anchorage/movement units. However, the bond strength of attachments to FRC anchorage bars is unknown. AIMS: To compare the shear bond strengths of brackets bonded immediately to FRCs with different orthodontic adhesive systems and bonded with the same adhesives after a 48-hour delay, abraded with a diamond bur and etched with phosphoric acid. METHOD: One hundred and five recently extracted upper premolars were randomly assigned to seven groups (N = 15 teeth per group). FRCs were bonded to the buccal surfaces of the teeth and stainless steel orthodontic brackets were bonded to the FRCs with the following adhesive systems: Group 0 (Tetric Flow); Groups 1, 2 and 3 (Immediate bonding with chemically cured, no-mix and light cured composites, respectively, the bars covered with Tetric Flow); Groups 4, 5 and 6 (Bonding to FRCs delayed 48 hours, then bonded with chemically cured, no-mix and light cured composites, respectively, the bars covered with Tetric Flow). The FRC bars in Groups 4, 5 and 6 were abraded with a coarse-grit diamond bur before bonding the attachments to the bars. The shear bond strengths (SBS) were measured with a universal testing machine, and the adhesive remaining on the teeth after debonding was scored with the Adhesive Remnant Index (ARI). Data were analysed using analysis of variance (ANOVA), Duncan's post-hoc and Fisher's Exact test. RESULTS: There were no statistically significant SBS differences between Groups 0 (Mean SBS: 9.56 MPa), 1 (Mean SBS: 9.74 MPa), 2 (Mean SBS: 10.72 MPa) or 3 (Mean SBS: 9.54 MPa). Groups 4, 5 and 6 (Bonding delayed by 48 hours) had SBSs of 11.79 MPa, 11.63 MPa and 13.11 MPa, respectively, and were significantly higher than the SBSs in Groups 1, 2 and 3 (Immediate bonding). There were no significant differences in ARI scores among the groups. CONCLUSIONS: The mean SBSs in all groups fell within the clinically acceptable range (> 7 MPa). The combination of a 48-hour delay between placement of an FRC bar and bonding an attachment, abrading the FRC with a diamond bur and etching with phosphoric acid resulted in higher bond strengths.

Comparison of dietary intake between fixed orthodontic patients and control subjects.

BACKGROUND: Adolescence is a period of rapid physiological and psychological development which is associated with an increased demand in nutritional requirements. Orthodontic therapy is also commonly initiated during this phase of life and nutritional intake may also change during treatment. AIMS: To compare the nutrient intakes of adolescents wearing fixed orthodontic appliances and a control group matched for age and gender. METHOD: A total of 180 patients aged between 15 and 17 years participated in this study (90 in the study group and 90 controls). Demographic data were collected by questionnaire and dietary intake was assessed using a 24-hour memory recall and was analysed using Dietplan6 software (Forestfield Software Ltd, UK). Comparisons between groups were assessed by the Independent sample t-test dnd the SPSS was used for statistical analysis. RESULTS: Orthodontic patients consumed a similar number of total calories, protein and carbohydrate (p > 0.05); however, they had a greater intake of total fat, saturated fat, monosaturated fat, polysaturated fat, linolenic fat, linoleic fat and cholesterol and significantly lower intake of fibre, chromium and beta-carotene (p < 0.05) compared with the Control group. The intake of other macro- and micro-nutrients did not differ significantly between groups. CONCLUSIONS: Adolescents receiving orthodontic treatment have an altered dietary intake that can be harmful to their health. As adolescents are at a critical stage of development and dietary intake is of particular importance, it is recommended that targeted nutritional guidance is provided to patients during orthodontic treatment.