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Background/Aims: Altered anatomy is a challenge in endoscopic retrograde cholangiopancreatography (ERCP) for patients with Billroth II anastomosis. In this study, we investigated the overall success and role of endoscopist experience. Methods: Data of patients who underwent ERCP between 2014 and 2018 after a previous Billroth II operation were retrieved retrospectively from 2 tertiary FRCP centers. The procedures were performed by 2 endoscopists with different levels of experience. Clinical success was defined as extraction of the stone, placement of a stent through a malignant stricture, and clinical and laboratory improvements in patients. Results: Seventy-five patients were included. The technical success rate was 83% for the experienced endoscopist and 75% for the inexperienced endoscopist (p=0.46). The mean (istandard deviation) procedure tune was 23.8 +/- 5.7 min for the experienced endoscopist and 40.684:6.07 min for the inexperienced endoscopist (p more...

Background/Aims: Acute pancreatitis (AP) runs a moderately severe and severe course in 20%-30% of cases. The purpose of the present study was to determine the effect of low molecular weight heparin (LMWH) for the prevention of pancreatic necrosis (PN) in moderately severe and severe AP (MSAP). Materials and Methods: A total of 100 patients with MSAP were randomized to receive either standard care (SC) or SC plus LMWH. LMWH was administered at 1 mg/kg via subcutaneous injection twice a day between days 1 and 7. The revised Atlanta criteria were used in the diagnosis of MSAP. Patients with a Harmless AP Score of ≥1 and a Balthazar computed tomography (CT) score of D and E were included in the study. Results: The mean age±SD of the patients (46 male and 54 female) was 52±19 years (range, 17-100). There were 50 patients in each group. On admission, clinical and laboratory parameters and Balthazar CT scores were similar between the groups. Initially, PN was present in one patient in the LMWH group and two in the SC group. Over the course, PN developed in 3 (6.1%) patients in the LMWH group and 11 (22.9%) in the SC group (p more...

Objective: The aim of this study was to compare the buccolingual inclination of maxillary and mandibular molars in adults with different vertical facial types. Methods: Cone-beam computed tomography images of 135 adult patients (age, 20–45 years) with skeletal Class I maxillomandibular relationships were assigned to normodivergent (n = 46), hypodivergent (n = 49), and hyperdivergent groups (n = 40) according to linear and angular sella-nasion/gonion-menton measurements. The normodivergent group consisted of 24 females and 22 males, hypodivergent group of 26 females and 23 males, and hyperdivergent group of 24 females and 16 males. Buccolingual inclination of the maxillary and mandibular first and second molars was measured relative to the occlusal plane. One-way analysis of variance was used for intergroup comparison. Gender differences were evaluated using independent t-tests. Results: Buccolingual molar inclinations did not differ significantly between females and males (p > 0.05). There were no statistically significant differences among the buccolingual inclinations of the first and second maxillary and mandibular molars of the groups (p > 0.05). Conclusions: Buccolingual inclinations of maxillary and mandibular molars are similar in normodivergent, hyperdivergent, and hypodivergent adults with Class I sagittal relationships. © 2018 The Korean Association of Orthodontists. more...

Objective: An appliance was designed to increase the cortical bone surface contact area of miniscrew implants (MSIs). The purpose of this in vitro study was to evaluate the effects of this appliance on the anchorage force resistance and the stability of orthodontic MSIs. Materials and Methods: A total of 48 MSIs were placed into bone specimens prepared from the ilium of bovines. Half were placed with the newly designed apparatus and half were placed conventionally. All the specimens were subjected to tangential force loading perpendicular to the MSI with lateral displacement of 0.6 mm, using an Instron Universal Testing machine. The maximum removal torque of each tested specimen was also recorded. Both study and control groups were divided into two subgroups based on whether they had thin and thick cortical bone. Results: The test group had statistically higher force anchorage resistance and maximum insertion torque values than the control group (p < 0.001). The results were found to be more significant in cases in which the cortical bone was thin (p < 0.001). Conclusions: Within the limits of this in vitro study, the present findings suggest that the newly designed apparatus might have a favorable effect on MSI stability in patients presenting with thin cortical bone. Clinical studies are necessary to confirm the results that were observed in vitro. more...

Introduction The purposes of this study were to evaluate and compare the periodontal, dentoalveolar, and skeletal effects of tooth-borne and tooth-bone-borne expansion devices using cone-beam computed tomography. Methods Twenty-five patients requiring maxillary expansion were randomly allocated into 2 groups. A tooth-borne hyrax appliance was used in the first group, consisting of 13 patients (8 girls, 5 boys; mean age, 14.3 ± 2.3 years), and a tooth-bone-borne hybrid hyrax appliance was used in the second group of 12 patients (6 girls, 6 boys; mean age, 13.8 ± 2.2 years). Cone-beam computed tomography records were taken before and 3 months after expansion, and periodontal, dentoalveolar, and skeletal measurements were made on the cone-beam computed tomography images with a software program. The 2 independent-samples t test and the Mann-Whitney U test were used to evaluate treatment changes for both groups. Paired-samples t test and Wilcoxon test were used to compare the measurements at 2 time points for variables. Results Significant skeletal changes and increases in interdental distances were observed in both groups. However, the distances between the first and second premolars increased more with the hyrax appliance (7.5 ± 4.2 and 7.9 ± 3.3 mm, respectively) than with the hybrid hyrax (3.2 ± 2.6 and 4.5 ± 3.8 mm, respectively) (P more...

Objective: To evaluate whether buccal cortical bone inclination varies for the maxillary alveolar processes of adult patients with decreased, normal, and increased facial heights. Materials and Methods: Cone-beam computed tomography images of 135 adult patients, including 49 hypodivergent subjects (26 women, 23 men), 40 hyperdivergent subjects (24 women, 16 men), and 46 normodivergent (25 women, 21 men) were analyzed. Cortical bone inclination measurements were made relative to the occlusal plane. Cross-sectional slices of the maxilla were taken at interdental sites from the distal aspect of maxillary canine to the mesial aspect of maxillary second molar. Results: Analysis of variance indicated significant differences (P < .05) between the angles formed by the line tangent to the cortical bone and the occlusal plane among the vertical facial types for the regions between canine and first premolar and between second premolar and first molar at miniscrew insertion sites. Conclusion: The results of this study indicate that vertical facial pattern should be taken into consideration when adjusting the insertion angle of miniscrews at the maxillary buccal region. more...

Lasers are effective in debonding ceramic brackets. Unfortunately, while reducing the adhesive bond strength, lasers are also reported to increase pulpal temperature. The aim of this study was to evaluate the shear bond strengths and temperature increase levels after debonding ceramic brackets using an Er-YAG laser with or without water-cooling. Sixty polycrystalline upper premolar ceramic brackets were placed on the labial surface of sixty human premolar teeth which were randomly divided into three groups of twenty. A laser pulse at 5 W for 9 seconds was delivered to each bracket in both study groups either with water-cooling (water group) or without water-cooling (waterless group) using an Er-YAG laser. Debonding was performed 45 seconds after laser exposure and shear bond strengths were measured. Data comparison revealed a statistically significant difference between the groups. Mean temperature increases of 2.41°C and 4.59°C were recorded for the water and waterless laser groups, respectively. The shear bond strength value for the control group was 22.76 MPa and 10.46 and 6.36 MPa for the water and waterless laser groups, respectively. The application of Er-YAG laser with water-cooling was an efficient and safe method of debonding ceramic brackets. © 2014 Didem Nalbantgil et al. more...

Introduction: The purpose of this study was to determine the cortical bone thickness of the alveolar process in the maxilla and the mandible on cone-beam computed tomographs of adults with low, normal, and increased facial heights. Methods: This study was conducted on 155 images of adult patients (20-45 years old) who were assigned to the low-angle, normal, and high-angle groups. The thickness of the buccal cortical plates of the maxilla and the mandible, and the palatal cortical plates of the maxilla, were measured. Results: There was no statistically significant difference between the groups regarding mean ages, sex, and sagittal facial types. High-angle patients had significantly lower values than did low-angle patients in all mini-implant insertion sites in both the maxillary and mandibular alveolar bones. The mandibular and maxillary buccal measurements showed a similar pattern; the lowest values were for the high-angle group, followed by the normal group; the highest values were measured in the low-angle patients. Conclusions: Clinicians should be aware of the probability of thin cortical bone plates and the risk of mini-implant failures at maxillary buccal alveolar mini-implant sites in high-angle patients, and at mandibular buccal alveolar mini-implant sites between the canine and the first premolar in normal and high-angle patients. Copyright © 2013 by the American Association of Orthodontists. more...

Introduction: The purpose of this in-vitro study was to develop a new method to debond ceramic brackets by scanning with an Er:YAG laser. Methods: Sixty bovine mandibular incisors were randomly divided into 2 groups of 30. Polycrystalline ceramic brackets were placed on their labial surfaces by using the orthodontic composite adhesive Transbond XT (3M Unitek, Monrovia, Calif) and light cured for a total of 40 seconds. The first group was the control group, with no laser application performed. The Er:YAG laser was used on each bracket in the study group at 4.2 W for 9 seconds with the scanning method. The force required for debonding the brackets was applied 45 seconds after laser exposure. Shear bond strengths were measured in megapascals with a universal testing machine, and adhesive remnant index scores were assigned to each specimen. Results: Statistically significant (P more...