Purpose: The bisecting angle technique (BAT) encounters difficulties in positioning the X-ray cone and aligningthe central beam with the tooth. To address this, a rectangular laser featuring a pointed light was integrated into theintraoral X-ray cone. This study evaluated its effectiveness in improving radiograph quality and minimizing errors. Materials and Methods: Fifty fifth-year Bachelor of Dental Surgery students were divided into 3 groups. Group1 (n = 16) used the paralleling technique, group 2 (n = 17) employed the conventional BAT, and group 3 (n = 17) utilized the laser-assisted BAT on mannequins. Two independent oral radiologists assessed the quality of the radiographs, categorizing the images as either diagnostically acceptable or not acceptable. Inter-group comparisons of quality and error rates were conducted using the chi-square test (significance level: P<0.05). Results: The paralleling technique group produced 77.5% diagnostically acceptable radiographs and 22.5% that were not diagnostically acceptable. These percentages were 65.3% and 34.7%, respectively, in the conventional BAT group and 75.3% and 24.7%, respectively, in the laser-assisted BAT group, showing results similar to the paralleling technique group. The quality of radiographs differed significantly among the groups (P<0.05). The percentage of error-free radiographs was 38.1% in the paralleling technique group, 20.6% in the conventional BAT group, and 40.0% in the laser-assisted BAT group, with these differences being statistically significant (P<0.05). Conclusion The device produced higher acceptability and fewer radiographic errors than the conventional BATtechnique, suggesting accurate adjustment of the X-ray cone and central beam to the desired teeth.

Background: Lowest instrumented vertebra (LIV) selection is controversial in Lenke 1A curves. Alignment of the LIV in coronal, sagittal, and transverse planes is important for correction of overall scoliosis, as well as the alignment of uninstrumented lumbar curve. In this study, we aimed to evaluate the 3-dimensional correction and clinical outcomes of Lenke 1A curves, corrected with rod derotation (RD) maneuver, according to the LIV level. Methods: Prospectively collected data of 46 consecutive idiopathic scoliosis surgery patients with Lenke 1A scoliosis who had been treated with posterior instrumentation and fusion were retrospectively evaluated. Patients were divided into 2 groups according to the LIV level: stable vertebra (SV) group (25 patients) and 1 level proximal to SV (SV-1) group (21 patients). Patients were compared pre- and postoperatively according to radiographic and clinical outcomes. Measured parameters in coronal plane were Cobb angle of thoracic curve, shoulder balance, coronal balance, LIV translation, and LIV tilt; in sagittal plane, thoracic kyphosis, lumbar lordosis, sagittal balance, and distal junctional angle. Transverse plane analysis included rotational measurement of apical vertebra (AV), LIV, and LIV+1 with computerized tomography. Clinical outcomes were evaluated with Scoliosis Research Society (SRS)-22 questionnaire. Surgical times were noted. Results: There were no statistically significant differences between the 2 groups in terms of preoperative radiographic values. In both groups, Cobb angle of thoracic curve, shoulder balance, LIV translation, and LIV tilt improved significantly after the surgery.Postoperatively, AV rotation decreased in both groups significantly. No significant change was observed in rotations of LIV and LIV+1 after the surgery. Clinical outcomes and surgical times were similar between the groups. Conclusions Selection of the LIV as SV or SV-1 in Lenke 1A patients led to similar results in terms of coronal and sagittal plane reconstruction, as well as AV and LIV rotation. With RD maneuver, an acceptable amount of rotation could be achieved at LIV and LIV+1. Radiologic and functional outcomes were satisfactory in both LIV levels. To save 1 more mobile segment, it seems reasonable to select SV-1 as the LIV if possible in order to obtain a well-aligned LIV in all 3 planes.

Background: This retrospective midterm study aimed to analyze seating properties, fracture types, noisy hips, and survivorship of a delta ceramic liner with a titanium taper locking band. Methods: A total of 451 patients (538 hips) underwent cementless total hip arthroplasty using the same design delta ceramic liner. Patients’ clinical functions were evaluated using Harris Hip score, and the radiological migration or loosening of cementless cups was recorded. Component survival was evaluated by Kaplan-Meier survivorship analysis, with failure defined as revision of any component or ceramic bearing for any reason. The worst-case survival scenario for noisy hip revision recommendations was estimated. Results: A total of 475 patients (514 hips) were evaluated with an average follow-up of 9.5 years (range, 5–13.9 years). One hip (0.19%) had intraoperative asymmetric seating. No hips had loosening, osteolysis, wear, or delta ceramic liner or head fracture.Three patients (0.58%) reported reproducible squeaking. Two cups were revised due to recurrent dislocation, 2 femoral stems were revised for periprosthetic fractures, and 1 hip was treated for deep periprosthetic joint infection. Kaplan-Meier survivorship analysis showed a 10-year cup survival rate of 97.8% (95% CI, 95.2%–99.9%), with any revision as the endpoint. The worst-case scenario showed a 10-year survival rate of 96.4% (95% CI, 94.2%–99.2%). Conclusions The Delta ceramic liner with a titanium locking band on the mutlibearing cementless cup offered secure intraoperative seating properties with fewer ceramic-related complications at the midterm follow-up.

Purpose: Pilonidal sinus disease is a chronic inflammatory disease that affects approximately 1% of the population.Although many treatment methods have been described, there is no consensus on the exact treatment method. This study was conducted to evaluate the wound healing-promoting effect of platelet-rich plasma (PRP) in patients treated using the unroofing and curettage technique. Methods: A total of 140 patients diagnosed with pilonidal sinus disease were included in the study. The patients were randomized into 2 groups; one group was followed up with a standard dressing after the operation, and the patients in the other group were treated with PRP in addition to the standard dressing. In this study, the wound healing rate between the 2 groups was determined as the primary objective. Results: In postoperative follow-up, a difference in wound healing rate was detected on postoperative day 10 (P = 0.007). While the average wound healing time of the patients in the control group was 41.1 ± 11.0 days (median, 40; range, 20–65), it was 23.6 ± 8.5 days (median, 25; range, 6–45) in the PRP group (P < 0.001). It was determined that the wound closure time of patients in the PRP group was faster. Conclusion In our prospective randomized study, we found that PRP significantly increased the wound healing rate and patient comfort, with recurrence rates below 1% and minimal pain. We think that it should be the first-choice method before operations that cause extensive tissue loss, such as flap surgery.

Background: Currently, clinical T staging in non-small cell lung cancer (NSCLC) is based on the largest radiological diameter observed on computed tomography (CT). Under this system, tumors with varying shapes—such as spherical, amorphous, or spiculated tumors—can be assigned the same T stage even with different volumes. We aimed to propose a 3-dimensional (3D) volumetric staging system for NSCLC as an alternative to diameter-based T staging and to conduct comparative survival analyses between these methods. Methods: We retrospectively analyzed data from patients who underwent surgery for pT1-4N0M0 primary NSCLC between January 2018 and May 2022. Digital Imaging and Communications in Medicine data from patient CT scans were uploaded to 3D Slicer software for volumetric tumor measurement. Using the paired samples t-test or the Wilcoxon test, we compared the expected tumor volumes, calculated by tumor diameter, with the actual volumes measured by 3D Slicer. Receiver operating characteristic analysis was employed to determine the cut-off value for tumor volume. Kaplan-Meier analysis was utilized to assess overall survival, while the log-rank method was applied to compare survival differences between groups. The significance of changes in T stage was evaluated using the marginal homogeneity test. Results: The study included 136 patients. Significant differences were observed between expected and actual tumor volumes (p=0.01), and associated changes in T stage were also significant (p=0.04). The survival analysis performed using tumor volume (p=0.009) yielded superior results compared to that based on diameter (p=0.04) in paients with early tumor stage. Conclusion T-factor staging based on tumor volume could represent an alternative staging method for NSCLC.

Background: Lowest instrumented vertebra (LIV) selection is controversial in Lenke 1A curves. Alignment of the LIV in coronal, sagittal, and transverse planes is important for correction of overall scoliosis, as well as the alignment of uninstrumented lumbar curve. In this study, we aimed to evaluate the 3-dimensional correction and clinical outcomes of Lenke 1A curves, corrected with rod derotation (RD) maneuver, according to the LIV level. Methods: Prospectively collected data of 46 consecutive idiopathic scoliosis surgery patients with Lenke 1A scoliosis who had been treated with posterior instrumentation and fusion were retrospectively evaluated. Patients were divided into 2 groups according to the LIV level: stable vertebra (SV) group (25 patients) and 1 level proximal to SV (SV-1) group (21 patients). Patients were compared pre- and postoperatively according to radiographic and clinical outcomes. Measured parameters in coronal plane were Cobb angle of thoracic curve, shoulder balance, coronal balance, LIV translation, and LIV tilt; in sagittal plane, thoracic kyphosis, lumbar lordosis, sagittal balance, and distal junctional angle. Transverse plane analysis included rotational measurement of apical vertebra (AV), LIV, and LIV+1 with computerized tomography. Clinical outcomes were evaluated with Scoliosis Research Society (SRS)-22 questionnaire. Surgical times were noted. Results: There were no statistically significant differences between the 2 groups in terms of preoperative radiographic values. In both groups, Cobb angle of thoracic curve, shoulder balance, LIV translation, and LIV tilt improved significantly after the surgery.Postoperatively, AV rotation decreased in both groups significantly. No significant change was observed in rotations of LIV and LIV+1 after the surgery. Clinical outcomes and surgical times were similar between the groups. Conclusions Selection of the LIV as SV or SV-1 in Lenke 1A patients led to similar results in terms of coronal and sagittal plane reconstruction, as well as AV and LIV rotation. With RD maneuver, an acceptable amount of rotation could be achieved at LIV and LIV+1. Radiologic and functional outcomes were satisfactory in both LIV levels. To save 1 more mobile segment, it seems reasonable to select SV-1 as the LIV if possible in order to obtain a well-aligned LIV in all 3 planes.

Background: This retrospective midterm study aimed to analyze seating properties, fracture types, noisy hips, and survivorship of a delta ceramic liner with a titanium taper locking band. Methods: A total of 451 patients (538 hips) underwent cementless total hip arthroplasty using the same design delta ceramic liner. Patients’ clinical functions were evaluated using Harris Hip score, and the radiological migration or loosening of cementless cups was recorded. Component survival was evaluated by Kaplan-Meier survivorship analysis, with failure defined as revision of any component or ceramic bearing for any reason. The worst-case survival scenario for noisy hip revision recommendations was estimated. Results: A total of 475 patients (514 hips) were evaluated with an average follow-up of 9.5 years (range, 5–13.9 years). One hip (0.19%) had intraoperative asymmetric seating. No hips had loosening, osteolysis, wear, or delta ceramic liner or head fracture.Three patients (0.58%) reported reproducible squeaking. Two cups were revised due to recurrent dislocation, 2 femoral stems were revised for periprosthetic fractures, and 1 hip was treated for deep periprosthetic joint infection. Kaplan-Meier survivorship analysis showed a 10-year cup survival rate of 97.8% (95% CI, 95.2%–99.9%), with any revision as the endpoint. The worst-case scenario showed a 10-year survival rate of 96.4% (95% CI, 94.2%–99.2%). Conclusions The Delta ceramic liner with a titanium locking band on the mutlibearing cementless cup offered secure intraoperative seating properties with fewer ceramic-related complications at the midterm follow-up.