Tag: pubmed

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Mar 20;60:278-284. doi: 10.3760/cma.j.cn115330-20240806-00464. Online ahead of print.

ABSTRACT

Objective: To evaluate the clinical efficacy of transoral robotic surgery (TORS) in the treatment of malignant tongue base tumors. Methods: A multicenter study was conducted to collect and analyze the clinical data of patients with malignant tongue base tumors who underwent TORS between January 2017 and January 2023 at five otolaryngology-head and neck surgery centers in China, including Eye Ear Nose and Throat Hospital of Fudan University, Sun Yat-sen University Cancer Center, Tongji Hospital of Huazhong University of Science and Technology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, and the First Affiliated Hospital of China Medical University. Among the patients, 38 were males and 11 were females, with a mean age of 59.0±8.8 years. Baseline characteristics, complications, and follow-up data were compared between groups. Independent sample t-tests or Mann-Whitney U tests were used for comparisons of continuous variables; chi-square tests or Fisher’s exact tests were applied for categorical variables. Survival analysis was performed using the Kaplan-Meier method to calculate overall survival and disease-free survival, with differences between groups compared using the log-rank test. Results: Among the 49 patients, 41 (83.7%) were diagnosed with squamous cell carcinoma (SCC), with a p16 positivity rate of 51.2% (21/41). There were no statistically significant differences between the p16-positive group (n=21) and the p16-negative group (n=20) in age, sex, or postoperative bleeding (all P>0.05). However, there was a significant difference in TNM stage between the two groups (χ²=14.556, P=0.020), with the p16-positive group predominantly in stage I (66.7%) and the p16-negative group primarily in stages Ⅲ and Ⅳ (40.0% and 30.0%, respectively). The postoperative tracheotomy rate was 30.6% (15/49), and the incidence of postoperative bleeding was 6.1% (3/49). The 1-year and 3-year overall survival rates were 98.0% and 92.5%, respectively, while the 1-year and 3-year disease-free survival rates were 89.2% and 84.9%, respectively. No significant differences were observed between the p16-positive and p16-negative groups in 3-year overall survival (100% vs. 83.8%, χ²=1.093, P=0.518) or 3-year disease-free survival (68.2% vs. 88.9%, χ²=2.161, P=0.382). Conclusion: TORS for malignant tongue base tumors demonstrates high clinical safety and favorable oncological outcomes.

PMID:40113566 | DOI:10.3760/cma.j.cn115330-20240806-00464

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Mar 20;60:258-265. doi: 10.3760/cma.j.cn115330-20240806-00463. Online ahead of print.

ABSTRACT

Objective: To explore the clinical application value of transoral robotic surgery (TORS) in the treatment of tonsil squamous cell carcinoma (TSCC). Methods: A retrospective analysis was conducted. The clinical data of 157 TSCC patients were collected who received TORS at five medical centers, namely the Sun Yat-sen University Cancer Center, Sun Yat-sen Memorial Hospital, Eye Ear Nose and Throat Hospital of Fudan University, the First Affiliated Hospital of China Medical University, and Tongji Hospital of Tongji Medical College, from 1 January 2017 to 31 July 2022. There were 130 males and 27 females, aged 24-85 years. All patients were followed-up at least for 2 years (2-year group), among them, 99 patients had a follow-up of 3 years (3-year group). The overall survival (OS), progression-free survival (PFS), clinical stage, human papillomavirus (HPV) infection status were analyzed. SPSS 25.0 and SAS 9.4 were used for statistical analysis. Results: The OS and PFS of the 2-year group were 91.7% and 87.9%, respectively. The OS and PFS of the 3-year group were 85.9% and 82.8%, respectively. The prognosis of patients with locally early-stage was better than that of locally advanced patients, with the OS of 94.4% for T1-2 vs. 78.0% for T3 (P=0.005) and the PFS of 91.2% for T1-2 vs. 75.0% for T3 (P=0.011) in the 2-year group; the OS of 91.1% for T1-2 vs. 65.0% for T3 (P=0.004) and the PFS of 88.6% for T1-2 vs. 60.0% for T3 (P=0.002) in the 3-year group; and also the OS of 90.0% for stage Ⅰ-Ⅱ vs. 79.5% for stage Ⅲ-Ⅳ (P=0.204) and the PFS of 86.7% for stage Ⅰ-Ⅱ vs. 76.9% for stage Ⅲ-Ⅳ (P=0.188) in the 3-year group. The prognosis of HPV-positive TSCC patients was better than that of HPV-negative patients in the 3-year group, with the OS of 90.9% for HPV-positive vs. 80.5% for HPV-negative (P=0.045) and the PFS of 90.9% for HPV-positive vs. 75.6% for HPV-negative (P=0.047). The average time of postoperative tracheal cannula indwelling was 25.1 days. The indwelling rate and average indwelling time of the postoperative nasogastric tube were 94.3% (148/157) and 8.5 days, respectively. Conclusion: TORS has outstanding survival benefits for TSCC patients. HPV-positive TSCC patients have a better prognosis than HPV-negative patients. TORS treatment of TSCC patients has advantages in postoperative recovery and quality of life.

PMID:40113565 | DOI:10.3760/cma.j.cn115330-20240806-00463

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Mar 20;60:300-304. doi: 10.3760/cma.j.cn115330-20240423-00227. Online ahead of print.

ABSTRACT

Objective: To investigate the complications of transoral robotic surgery (TORS) and to identify the risk factors for the complications. Methods: This was a retrospective study of 134 cases of head and neck tumors underwent TORS at the Department of Surgery of Beijing United Family Hospital from September 2017 to June 2024. There were 9 cases of benign tumors and 125 cases of malignant tumors, including 119 squamous cell carcinomas, 3 adenocarcinomas, 2 lymphomas, and 1 sarcoma. There were 37 cases of pure TORS and 97 cases of TORS combined with neck dissection. Postoperative complications within 90 days were collected and graded with the Clavien-Dindo system. χ² test was used for statistical analysis. Results: A total of 25 (18.7%) cases experienced surgical complications, including 9 cases with Clavien-Dindo grade≥Ⅲ complications. Postoperative complications included 2 cases of death, 3 cases of massive hemorrhage, 3 cases of pharyngeal fistula, 2 cases of aspiration pneumonia, 2 cases of minor bleeding, 1 case of tooth injury, 1 case of arytenoid dislocation, 2 cases of tongue laceration, and 10 cases of long-term (>3 months) tracheostomy open. Postoperative pharyngeal fistula was significantly correlated with the scope of neck dissection (χ²=9.86, P<0.05), and Clavien-Dindo grade≥Ⅲ complications were significantly correlated with the scope of neck dissection (χ²=13.91, P<0.05) and tumor N stage (χ²=14.33, P<0.05). Conclusion: The high N-stage and neck dissection involving more than three regions are risk factors for the complications of TORS for head and neck tumors.

PMID:40113561 | DOI:10.3760/cma.j.cn115330-20240423-00227

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