Tag: nevin manimala

J Prosthet Dent. 2025 Mar 19:S0022-3913(25)00201-X. doi: 10.1016/j.prosdent.2025.02.052. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Advances in implant planning have increased the use of printed surgical guides for precise implant placement. Accurate placement of implants relies on the stability of the surgical guide, therefore the effects of sterilization and disinfection on the dimensional accuracy of surgical guides require evaluation.

PURPOSE: The purpose of this in vitro study was to examine the level of distortion of printed surgical guides after steam sterilization and disinfection by immersion in 70% isopropyl alcohol to develop a protocol for the sterilization of surgical guides.

MATERIAL AND METHODS: A surgical guide was designed in Blue Sky Bio. Forty guides were printed with Formlabs Form 3B+ printer and Formlabs surgical guide resin following manufacturer’s instructions. Each guide was scanned with Primescan optical scanner before disinfection and sterilization. Twenty guides were individually packaged, and autoclave sterilized following manufacturer’s recommendation of 134 °C for 20 minutes. The remaining 20 guides were soaked in 70% isopropyl alcohol for 15 minutes. After sterilization and disinfection, the guides were scanned and standard tessellation language (STL) files from pre- and post-sterilization were compared by using the GeoMagic Control X software program to examine dimensional changes. Differences among the study groups were analyzed with a 1-sample t test to determine if the mean site’s value for each treatment group was statistically significant from zero and a 2-way repeat-measures ANOVA was used to detect differences among groups (α=.05).

RESULTS: The average deviation at the lingual, incisal, and buccal sites of the sterilized guides was 6.3 µm, -2.3 µm, and -20.6 µm, respectively. The average deviation at the lingual, incisal, and buccal sites of the chemically disinfected guides was -0.4 µm, 2.6 µm, and -0.8 µm, respectively. Sterilization showed a statistically significant value at the lingual and buccal surface (P<.05), while the chemical disinfection group did not show a statistically significant difference at any site (P>.05). The 2-way repeat-measures ANOVA test demonstrated there was a significant effect of treatment on the overall mean values (P<.001), with sterilization treatment giving an overall value 6.3 µm more negative than disinfection. There was also a significant effect of site (P<.001), and a significant interaction between treatment and site (P<.001).

CONCLUSIONS: Heat sterilization caused a significantly greater negative deviation than disinfection across the sites. A statistically significant distortion was found after sterilization, but not with chemical disinfection. However, the amount of distortion will likely not cause a clinically significant effect on the deviation of implant placement.

PMID:40113529 | DOI:10.1016/j.prosdent.2025.02.052

J Prosthet Dent. 2025 Mar 19:S0022-3913(25)00176-3. doi: 10.1016/j.prosdent.2025.02.028. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: The variability in color measurements between different dental devices complicates the accurate selection of tooth shades, which is crucial for esthetic dental restorations. Understanding the correlations between different devices can provide equations for inter-conversion, facilitating more consistent shade selection.

PURPOSE: The purpose of this clinical study was to evaluate and compare the colorimetric values measured from human teeth using colorimetric devices of the spot measurement type, including a conventional spectrophotometer, an intraoral spectrophotometer, and an intraoral colorimeter, and to develop inter-conversion equations based on device correlations.

MATERIAL AND METHODS: Forty healthy, non-smoking ethnic Korean volunteers aged 25 to 36 years with no anterior restorations or abnormal dental conditions were enrolled. Color measurement was made using a CM-700d spectrophotometer (Konica Minolta) (CM), Vita Easyshade intraoral spectrophotometer (Vita Zahnfabrik) (ES), and ShadeEye NCC colorimeter (Shofu) (SE) under controlled lighting conditions on maxillary central incisors using a transparent ethylene-vinyl acetate tooth guide with holes to ensure precise probe placement. ΔE_ab and ΔE₀₀ values indicated color differences between devices. Statistical analyses included Pearson correlation and regression to assess inter-device variations, with intraclass correlation coefficients calculated for intra-examiner reliability (α=.05).

RESULTS: Mean L* values for CM, ES, and SE in the maxillary central incisors were 66.1, 81.4, and 72.8, respectively. The mean a* values were 0.7, -0.9, and -0.4, while the mean b* values were 10.1, 16.3, and 12.3, respectively. The largest color discrepancies were observed between CM and ES. The r² values between each pair of devices for colorimetric values ranged from 0.111 to 0.488 (P<.01). Intra-examiner reliability was CM: L*=0.916, a*=0.826, and b*=0.797; ES: L*=0.984, a*=0.991, and b*=0.988; and SE: L*=0.940, a*=0.636, and b*=0.996.

CONCLUSIONS: The findings suggest that values can be converted between different devices and compared against standard references measured by each device. This will help in understanding changes in tooth color measured on one device in terms of another.

PMID:40113527 | DOI:10.1016/j.prosdent.2025.02.028

J Prosthet Dent. 2025 Mar 19:S0022-3913(25)00205-7. doi: 10.1016/j.prosdent.2025.02.057. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: To ensure accurate robot-assisted surgery, it is essential to identify the handpiece position at the end effector of the robotic arm. Clinically, the relationship between the optical tracking device and the handpiece has been typically confirmed by using a calibration plate at the end effector of the robotic arm. However, the accuracy of the handpiece calibration methods for robot-assisted implant placement remains unclear.

PURPOSE: The purpose of this in vitro study was to evaluate the accuracy of bi-coordinate and multi-coordinate handpiece calibration methods, as well as the multi-coordinate handpiece plate under partial obstruction, in the context of robot-assisted implant placement.

MATERIAL AND METHODS: In total, 120 implants were divided into 6 groups based on the calibration plate used in the study: bi-coordinate handpiece calibration plate for the maxilla (Bmx), bi-coordinate handpiece calibration plate for the mandible (Bmn), multi-coordinate handpiece calibration plate for the maxilla (Mmx), multi-coordinate handpiece calibration plate for the mandible (Mmn), partially obscured multi-coordinate handpiece calibration plate for the mandible with the primary coordinate unblocked and the auxiliary coordinate covered (MmnPrim), and partially obscured multi-coordinate handpiece calibration plate for the mandible with the auxiliary coordinate unblocked and the primary coordinate covered (MmnAux). Calibration of the robotic arm was conducted separately for each group. Then the robot autonomously performed osteotomies and implant placements at the first and second premolars according to the preoperative plan. Following surgery, the robotic software program calculated the deviation values between the planned and actual implant positions. Differences between the test groups were analyzed using 1-way analysis of variance (ANOVA) and the Bonferroni post hoc test (α=.05).

RESULTS: The ranges of angular deviation and 3-dimensional deviations at the implant platform and apex across the 6 groups were 0.30 degrees to 0.48 degrees, 0.31 to 0.36 mm, and 0.31 to 0.38 mm, respectively. No statistically significant differences were found among the groups (P>.05).

CONCLUSIONS: Both the bi-coordinate and multi-coordinate handpiece calibration methods demonstrated acceptable accuracy for robot-assisted implant placement. The multi-coordinate calibration plate provides a feasible method for robot calibration in scenarios where the mandible is partially obstructed.

PMID:40113526 | DOI:10.1016/j.prosdent.2025.02.057

J Prosthet Dent. 2025 Mar 19:S0022-3913(25)00194-5. doi: 10.1016/j.prosdent.2025.02.042. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Although additive manufacturing (AM) has facilitated the fabrication of resin-based definitive restorations, knowledge of the effects of artificial aging on their physical and mechanical properties is lacking.

PURPOSE: The purpose of this in vitro study was to investigate the effects of material type and thermal cycling on the translucency, surface roughness, microhardness, and flexural strength of AM resins marketed for definitive restorations.

MATERIAL AND METHODS: Bar-shaped (25×2×2 mm) and disk-shaped (Ø10×2 mm) specimens from 4 different AM resin groups Crowntec (CT), Tera Harz TC-80DP (TH), VarseoSmile Crown plus (VS). and Permanent (CB) were prepared. The specimens were randomly distributed to 2 groups: (1) nonaged (stored in distilled water at 37 °C for 24 hours) and (2) aged (thermocycled for 10 000 cycles at 5 °C to 55 °C). For each specimen, the degree of conversion (DC) was determined using Fourier transform infrared spectroscopy. Color coordinates of the specimens were measured to calculate relative translucency parameter (RTP) values. Surface roughness (Ra) was measured with an optical profilometer, and Vickers microhardness values (VHN) were obtained. Flexural strength (σ) and elastic modulus (E) values were obtained by using the 3-point bend test. Scanning electron microscopy (SEM) was used to analyze the fractured surfaces. The data were statistically analyzed using factorial analysis of variance (ANOVA), followed by Tukey post hoc analyses and paired t tests (α=.05).

RESULTS: Both DC and RTP were significantly affected by material type (P<.001). The highest and lowest DC values were reported in CT and CB, respectively. None of the tested resins exceeded clinical thresholds of ΔRTP. The material type also had a significant impact on Ra (P<.001). VHN was significantly affected by material type (P<.001) and aging (P<.001). CT had the highest value, while TH had the lowest value, regardless of the aging condition. In addition, the σ and E were significantly affected by both material type (P<.001) and aging (P≤.002).

CONCLUSIONS: The material type of the AM resins significantly impacted on their DC, RTP, Ra, VHN, σ, and E values. Thermal cycling of the tested resins also significantly affected their VHN, σ, and E values. No interactions were observed between material type and aging.

PMID:40113525 | DOI:10.1016/j.prosdent.2025.02.042

Transplant Proc. 2025 Mar 19:S0041-1345(25)00127-7. doi: 10.1016/j.transproceed.2025.02.046. Online ahead of print.

ABSTRACT

OBJECTIVE: We evaluated the willingness and influencing factors of Chinese medical students to donate an organ.

METHODS: A total of 17 articles on the willingness of Chinese medical students to donate organs and related influencing factors were collected from domestic and foreign databases. The retrieval period was from the inception of the database to August 31, 2023. RevMan5.3 software was used to conduct a meta-analysis of the binary data in the included literature, and meta-integration was performed on the influencing factors of organ donation.

RESULTS: In this study, we found that 52% of medical students in China (95% confidence interval, 39%-66%) were willing to donate organs. A subgroup analysis showed that clinical medical students (69%) had greater willingness to donate than nursing students (27%), and medical students in the western region (58%) had a greater willingness to donate than those in the eastern region (51%). Studies with a small sample size (54%) found a greater willingness to donate than studies with a large sample size (49%), and the difference was statistically significant (P < .001). Fifty influencing factors were summarized in the included study, categorizing them into 10 categories, and further integrating them into 3 factors, namely personal factors, family factors, and social factors.

CONCLUSIONS: The willingness to organs donation among medical students in China remains at a moderate level, and the demonstration effect has not been reflected fully.

PMID:40113493 | DOI:10.1016/j.transproceed.2025.02.046

Transplant Proc. 2025 Mar 19:S0041-1345(25)00138-1. doi: 10.1016/j.transproceed.2025.02.028. Online ahead of print.

ABSTRACT

Alcohol-associated liver disease is now the leading indication for liver transplantation in the United States in the context of liver transplantation for patients with less than 6 months of abstinence from alcohol. To determine whether patients with less than 6 months of sobriety have worse perioperative outcomes than those with standard sobriety requirements, we performed a retrospective cohort study, comparing limited and standard sobriety patients undergoing orthotopic liver transplantation from May 2018 to October 2022 at a single academic tertiary transplant center. The limited sobriety cohort comprised adult patients with end-stage liver disease secondary to alcohol use disorder who presented with their first episode of hepatic decompensation, with less than 6 months of sobriety. This group was compared with a standard sobriety cohort, consisting of patients with alcohol-associated liver disease with more than 6 months of sobriety. A total of 169 patients were selected for analysis, with 58 in the limited sobriety group and 111 in the standard sobriety group. The limited- sobriety group was younger (median 42 years vs 54 years; P < .01) and had more severe liver disease than the standard sobriety group (median Model for End-stage Liver Disease scores of 39 vs 34; P < .01) at the time of transplantation. There were no statistically significant differences in the primary outcomes between the 2 groups. Despite having more severe liver disease, the limited sobriety management pathway was not associated with worse perioperative outcomes than the standard sobriety pathway. Our findings indicate liver transplantation in patients with limited sobriety do not require increased perioperative resources.

PMID:40113492 | DOI:10.1016/j.transproceed.2025.02.028

Cont Lens Anterior Eye. 2025 Mar 19:102392. doi: 10.1016/j.clae.2025.102392. Online ahead of print.

ABSTRACT

PURPOSE: To assess changes in fluid reservoir (FR) thickness and optical quality following the removal and reapplication of a scleral lens worn for 5 h in participants with regular and irregular corneas.

METHODS: Two groups with 10 patients were recruited: IC Group-Irregular Cornea; RC Group-Regular Cornea. Both groups were fitted with a diagnostic 16.4 mm scleral lens (hexafocon A). FR thickness was measured with optical coherence tomography (MOCEAN 4000, MOPTIM, Shenzhen Slton Technology Co. Ltd., China l), high and low contrast visual acuity was measured with ETDRS, whole eye aberrometry was assessed with IRx3 Wavefront Aberrometer (ImaginEyes, Orsay, France) for a 5 mm pupil diameter, and the light disturbance under dim light conditions was assessed with Light Distortion Analyzer (LDA, Binarytarget, Portugal). Measurements were taken at 10 min and after 5 h lens wear, as well as following lens removal and reapplication.

RESULTS: Following lens removal and reapplication, FR thickness significantly increased in RC Group (294.3 ± 137.5 to 337.2 ± 141.4 µm, p = 0.005), and in IC Group (311.5 ± 150.3 to 339.5 ± 150.7 µm, p = 0.005, Wilcoxon). Although minor visual fluctuations of 2 letters were found in high and low contrast visual acuity, no statistically significant differences were observed after lens reapplication. Regarding the size and irregularity of light distortion, no statistically significant differences were observed in either group. The aberrometry results demonstrated significant changes, with an increase in comatic vertical aberrations (p = 0.037, Wilcoxon), observed exclusively in IC Group after lens removal and reapplication.

CONCLUSION: Practitioners should be aware that removing and reapplying a scleral lens with fresh saline solution will increase the FR thickness. However, this increase may not have a significant or clinically meaningful impact on visual acuity, light disturbance size or optical quality as measured by aberrometry.

PMID:40113466 | DOI:10.1016/j.clae.2025.102392

Ann Chir Plast Esthet. 2025 Mar 19:S0294-1260(25)00029-9. doi: 10.1016/j.anplas.2025.02.005. Online ahead of print.

ABSTRACT

INTRODUCTION: The advent of artificial intelligence technologies, such as ChatGPT and Gemini, presents new opportunities to enhance physician-patient communication through tailored patient-facing medical information (PFI). Effective postoperative care is critical to successful patient outcomes in hand surgery, making it essential to deliver information in a clear, comprehensible, and accurate manner. This study aims to evaluate the ability of ChatGPT to generate accessible PFI to enhance patient understanding in hand surgery.

METHODS: A cross-sectional study was conducted involving five French hand surgeons and 28 non-medical individuals. Participants blindly evaluated PFI containing text and images generated by ChatGPT and Gemini compared to those provided by established organizations (EOs). The evaluations focused on three common hand surgeries: carpal tunnel syndrome, Dupuytren’s disease, and synovial cyst. Hand surgeons evaluated PFI based on accuracy, clarity, comprehensiveness, and overall preference. Non-medical participants evaluated PFI based on clarity and overall preference. Surveys were used to capture these evaluations, allowing for a systematic and effective comparison between both sources. Readability was analyzed using six readability formulas, and Likert scale responses were statistically analyzed using paired t-tests.

RESULTS: No significant difference was found in terms of accuracy between ChatGPT-generated text responses and EO-provided text responses. However, text responses provided by EOs were rated significantly higher in terms of comprehensiveness and clarity by hand surgeons. Interestingly, non-medical participants rated the clarity and overall preference of ChatGPT-generated text responses higher than those from EOs. EO-provided images were also significantly favored in terms of comprehensiveness and clarity by hand surgeons. Notably, 65% of non-medical participants preferred EO-provided images over AI-generated ones. Both sources, however, produced information that exceeded the recommended readability levels for patient comprehension.

CONCLUSION: This study underscores the potential of AI-generated medical information to enhance patient understanding, particularly through the comprehensive nature of materials created by tools like ChatGPT. The divergence in preferences between hand surgeons and patients highlights the need to refine the accuracy, clarity, and relevance of AI-generated content to align with the standards upheld by healthcare professionals. Continued exploration in this area is crucial for optimizing patient education and communication, particularly in the context of postoperative care.

PMID:40113462 | DOI:10.1016/j.anplas.2025.02.005

Orthop Surg. 2025 Mar 20. doi: 10.1111/os.70029. Online ahead of print.

ABSTRACT

OBJECTIVE: The degeneration characteristics of adjacent segment disease are complex. Improper surgical planning has caused unnecessary surgical trauma and costs. The purpose of this study was to establish a staging system for adjacent segment disease and evaluate its guiding significance for surgical decisions in adjacent segment disease.

METHODS: A retrospective study was performed on 103 patients with adjacent segment disease who underwent treatment between January 2017 and January 2023. Based on radiological findings, adjacent segment disease was categorized into four stages, with no cases identified in Stage IV. Patients were divided into four intervention groups: Group A (control group, traditional posterior lumbar fusion with rod-screw revision), Group B (Stage I, percutaneous endoscopic decompression), Group C (Stage II, oblique lumbar interbody fusion), and Group D (Stage III, cortical bone trajectory screws with posterior lumbar interbody fusion). Clinical and radiological outcomes were evaluated postoperatively, at 3 months, and at 12 months. Statistical analysis was conducted using t-tests, Mann-Whitney U tests, chi-square tests, and Spearman’s correlation.

RESULTS: Surgical expenses, duration, estimated blood loss, postoperative hospital stays, disc height index, and Pfirrmann grading all demonstrated significant correlations with the established grading system (p < 0.05). Patients achieved favorable clinical outcomes. Specifically, Groups B, C, and D showed earlier functional recovery compared to Group A, with Groups B and C experiencing more rapid relief from low back pain. Furthermore, Groups B, C, and D had shorter surgical times and reduced blood loss, while Groups B and C also incurred lower surgical costs and shorter hospital stays (p < 0.05).

CONCLUSION: The new grading system, developed based on the characteristics of adjacent segment degeneration, showed excellent surgical adaptability, despite varying degrees of correlation across different factors. This system was closely linked to the degree of intervertebral disc degeneration and the intervertebral disc height index. All patients achieved favorable surgical outcomes, suggesting that this grading system could provide valuable guidance in making surgical treatment decisions.

PMID:40113451 | DOI:10.1111/os.70029

Zhonghua Zhong Liu Za Zhi. 2025 Mar 23;47(3):275-282. doi: 10.3760/cma.j.cn112152-20240810-00336.

ABSTRACT

Objective: The 5th edition of the WHO classification of central nervous system (CNS) tumors in 2021 made significant revisions to the nomenclature and grading system of solitary fibrous tumors (SFT). This study aimed to explore the changes in the grading of CNS SFT and its relationship with clinical pathological features and prognosis. Methods: This study retrospectively reviewed the clinical and pathological data of 82 patients with CNS SFT diagnosed at the First Affiliated Hospital of Fujian Medical University from March 2006 to June 2021, reassessed their grading according to the WHO 5th edition CNS tumor classification, and conducted a comprehensive analysis of their histological morphology, immunohistochemical characteristics, and clinical imaging data. Results: The age of the patients ranged from 21 to 83 years, with a median age of 48 years. Follow-up was completed for 82 patients, during which 10 patients died, 24 recurred, and 5 metastasized. MRI imaging showed that SFT exhibited isointense signals on T1-weighted imaging (T1WI) and complex signals on T2-weighted imaging (T2WI), with signal intensity decreasing as the content of collagen fibers increased. According to the 2021 grading criteria, there was a significant change in the grading of SFT, with the number of grade 1 SFT increasing from 10 cases under the 2016 standard to 39 cases, while the number of grade 2 and 3 SFT decreased accordingly. The 2016 grading system was significantly correlated with the overall survival (OS) of patients (P=0.009), while the 2021 grading system did not reach statistical significance. Both grading systems were correlated with histological phenotype, Ki-67 index, mitotic figures, and necrosis (P＜0.05). All cases expressed STAT6, and showed varying degrees of expression of vimentin, CD99, BCL-2, and CD34. The staining intensity of type Ⅳ collagen fibers, as analyzed semi-quantitatively, was correlated with the OS of the patients (P=0.017). Conclusions: The new grading system for CNS SFT has undergone significant changes, and its association with OS requires further validation. In-depth study of the content and fine structure of collagen fibers in SFT may have important clinical significance for the prognosis assessment and the formulation of treatment plans for patients. Moreover, quantitative analysis of T2WI signal intensity may provide a new method for preoperative preliminary assessment of the collagen fiber content in SFT.

PMID:40113429 | DOI:10.3760/cma.j.cn112152-20240810-00336