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This study aimed to investigate the technical feasibility of a percutaneous endoscopic limited-dorsal laminectomy (PELDL) and to evaluate if the decompression and examination of the lumbosacral vertebral canals could be achieved using an endoscope in small dogs. A total of eight fresh canine cadavers were used for the study. Following the injection of a barium and agarose mixture (BA-gel), which simulates intervertebral disc herniation, a PELDL was performed over L7-S1 in these animals. Computed tomography (CT) scans were obtained pre- and postoperatively to evaluate the surgical outcomes. All the procedures were completed with a clear visualisation of the spinal cord and removal of the BA-gel. The mean surgery time for the PELDL was 30.00 ± 12.01 minutes. In two dogs, iatrogenic nerve root injuries were caused by the surgical instruments during the operation. The CT scans showed that the amount of BA-gel removed was sufficient for a spinal-cord decompression. A PELDL could be used for the BA-gel removal to decompress the spinal cord and provide a clear view of the spinal canal. Therefore, it could be used as an alternative surgical option to treat lumbosacral disc disease in dogs.

JungHyun Park, Jueun Kwak, Sukyung Chung, Hyo Ju Hong, Jin Young Chon, Ho Sik Moon Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaCorrespondence: Ho Sik MoonDepartment of Anesthesiology and Pain Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul 03312, Republic of KoreaTel +822-2030-3864Fax +822-2030-3861Email mhsjshgma@gmail.comPurpose: Endocrinological complications of an epidural steroid injection (ESI) are rare but dangerous. Nevertheless, despite the associated risks, repeated long-term ESIs are indispensable in some clinical situations. However, only a few reports to date have assessed the safety of this procedure. In this study, we evaluate the incidence of adrenal insufficiency (AI) and Cushing’s syndrome after long-term ESIs.Methods: This clinical observational study enrolled herniated nucleus pulposus or spinal stenosis patients who had received ESIs over a period of six months or longer. The adrenocorticotropic hormone (ACTH) stimulation test was performed to confirm AI and the late-night salivary cortisol (LNSC) test was performed to diagnose Cushing’s syndrome. To evaluate the hypothalamus pituitary adrenal axis suppression, salivary cortisol (SC) levels were measured on days 0, 1, 7, 21, 28, 35, and 42.Results: This study included 17 patients. Among these, two patients (11.8%) developed AI, but no cases of Cushing’s syndrome were reported. There was no predictor for the development of AI. The SC levels tended to increase with time after an ESI (β = 0.003). The slope of the mixed effect model between the AI and non-AI groups showed a significant difference (p value = 0.015). However, the differences in mean SC levels at each time point between the two groups were not significant (adjusted p value = 0.053).Conclusion: Long-term ESI use may be associated with AI development. An unexpected adrenal crisis due to AI could be life threatening. Therefore, regular monitoring of adrenal function in patients who have received long-term ESIs may be prudent.Keywords: epidural, glucocorticoid, salivary cortisol, adrenal insufficiency, long-term

Woo Ho Ban,1 Hyonsoo Joo,1 Jeong Uk Lim,1 Hyeon Hui Kang,2 Hwa Sik Moon,2 Sang Haak Lee2 1Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea; 2Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, St Paul’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Introduction: The detection of insomnia in patients with COPD is assumed to be significantly lower than the actual prevalence. In this study, we investigated the prevalence of insomnia and the relationship between insomnia and health status in patients with COPD using two fairly simple and straightforward questionnaires: COPD assessment test (CAT) and insomnia severity index (ISI). Patients and methods: A cross-sectional study was conducted using data from patients undergoing treatment for COPD at St Paul’s Hospital, The Catholic University of Korea, between December 2015 and August 2016. Patients were classified into three groups according to the ISI score: a “clinical insomnia” group (ISI≥15), a “subthreshold insomnia” group (ISI 8–15), and a “non-insomnia” group (ISI14, giving a sensitivity and specificity of 66.7% and 71.5%, respectively. Conclusion: CAT score was closely related to insomnia severity in patients with COPD. The use of CAT scores to assess for the presence and severity of insomnia in these patients may allow for better detection and management and improve clinical practice. Keywords: chronic obstructive, maintenance disorders, pulmonary disease, sleep initiation

Sei Won Kim,1 Jong Min Lee,1 Jick Hwan Ha,1 Hyeon Hui Kang,1 Chin Kook Rhee,1 Jin Woo Kim,1 Hwa Sik Moon,1 Ki Hyun Baek,2 Sang Haak Lee1 1Division of Pulmonology, Critical Care and Sleep Medicine, 2Division of Endocrinology and Metabolism, Department of Internal Medicine, St Paul’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Background: Patients with COPD are at an increased risk of osteoporosis. Although many studies have addressed the relationship between the vitamin D receptor (VDR) polymorphisms and bone health, this relationship has not been fully investigated in patients with COPD. In this study, we investigated the association of VDR polymorphisms with bone mineral density (BMD) and other clinical parameters in patients with COPD. Patients and methods: In total, 200 patients with COPD were included in this study. The VDR polymorphisms rs1544410 (A/G-BsmI), rs7975232 (A/C-ApaI), rs731236 (C/T-TaqI), and rs10735810 (C/T-FokI) were determined by Sanger sequencing using blood DNA samples. BMD of the lumbar vertebra and the femoral neck was measured by dual-energy X-ray absorptiometry. Other clinical parameters were also evaluated. Haplotype and multivariate analyses were also performed. Results: Sex, body mass index, steroid use, percentage of forced expiratory volume in 1 second (FEV1), alkaline phosphatase, and 25-hydroxyvitamin D significantly influenced the risk of osteoporosis. Patients with osteoporosis were more likely to carry the rs7975232 C allele compared to normal patients with BMD. Haplotypes GCT and GAT were related to osteoporosis. Patients without the haplotype GAT allele showed a significantly lower T-score at the femoral neck and an increased risk of osteoporosis (odds ratio [OR]= 2.78, 95% confidence interval [CI]= 1.20–6.48, P=0.018) compared with carriers in the dominant model. Conclusion: Genetic variations in VDR are significantly associated with osteoporosis among patients with COPD. Further studies are required to confirm the role of the VDR polymorphisms in osteoporosis among patients with COPD. Keywords: chronic obstructive pulmonary disease, osteoporosis, vitamin D receptor gene, polymorphism, haplotype

Objectives The purpose of this study was to determine the effects of alendronate on the peri-implant bone in rat maxillae with the aid of micro-computed tomographic, histologic, and biochemical analyses. Materials and Methods Thirty-six male Sprague- Dawley rats were used. After extraction of the maxillary first molars, each rat was given periodic subcutaneous injections of either alendronate (alendronate group) or saline (control group). Customized implants were placed bilaterally 4 weeks after these injections. The rats were sacrificed at either 4, 8, or 12 weeks after implantation (4-, 8-, and 12-week groups, respectively; n = 6 rats per group). Microcomputed tomographic and histologic analyses were conducted for all rats. Biochemical analyses were performed at four time points for the 12-week groups. Results There were no significant differences between the groups on microcomputed tomographic and histologic analyses. All of the measured biochemical parameters tended to decrease over time, with significant differences among some time points within each group. The serum osteocalcin level was significantly lower in the 12-week alendronate group than in the control group ( P < 0.05). Conclusions Three approaches were utilized in evaluating the effects of alendronate. It appears serum osteocalcin levels may serve as an adjuvant marker for this purpose, although further studies are required to confirm this. [ABSTRACT FROM AUTHOR]

Objective: Amylin interacts with leptin to alter metabolism. We evaluated, for the first time, amylin- and/or leptin-activated signaling pathways in human peripheral tissues (hPTs).Research Design and Methods: Leptin and amylin signaling studies were performed in vitro in human primary adipocytes (hPAs) and human peripheral blood mononuclear cells (hPBMCs) and ex vivo in human adipose tissue (hAT) from male versus female subjects, obese versus lean subjects, and subjects with subcutaneous versus omental adipose tissue.Results: The long form of leptin receptor was expressed in human tissues and cells studied in ex vivo and in vitro, respectively. Leptin and amylin alone and in combination activate signal transducer and activator of transcription 3 (STAT3), AMP-activated protein kinase, Akt, and extracellular signal-regulated kinase signaling pathways in hAT ex vivo and hPAs and hPBMCs in vitro; all phosphorylation events were saturable at leptin and amylin concentrations of ∼50 and ∼20 ng/ml, respectively. The effects of leptin and amylin on STAT3 phosphorylation in hPAs and hPBMCs in vitro were totally abolished under endoplasmic reticulum stress and/or in the presence of a STAT3 inhibitor. Results similar to those in the in vitro studies were observed in hAT studied ex vivo.Conclusions: Leptin and amylin activate overlapping intracellular signaling pathways in humans and have additive, but not synergistic, effects in signaling pathways studied in hPTs in vitro and ex vivo. [ABSTRACT FROM AUTHOR]

Background: Despite the clinical benefits over nonoperative treatment or meniscectomy, the clinical outcomes of surgical repair for medial meniscus posterior root tear (MMRT) remain suboptimal, which may be attributed to the insufficient restoration of meniscal hoop tension during surgery., Purpose: To analyze the clinical outcomes of surgical repair of MMRT based on the appearance of the meniscal tension observed immediately after surgery., Study Design: Cohort study; Level of evidence, 3., Methods: Electronic medical records of patients who underwent arthroscopic transtibial pull-out repair of MMRT between 2010 and 2021 were retrospectively reviewed. Patients with at least a 2-year follow-up and whose overall meniscal status after the surgical repair could be evaluated via arthroscopic images or videos were eligible to be included. Patients were classified based on the presence of the curtain-cliff sign, potentially implying insufficient postoperative meniscal hoop tension (group 1, patients without the curtain-cliff sign; group 2, patients with the curtain-cliff sign). Regression analysis was performed to evaluate whether the curtain-cliff sign reflects postoperative meniscal extrusion. Subsequently, comparative analyses were conducted between the 2 groups regarding baseline demographic data, clinical scores, intraoperative data, and radiologic parameters., Results: A total of 79 patients were included (group 1, 59 patients; group 2, 20 patients). Regression analysis revealed a significant association between the curtain-cliff sign and postoperative meniscal extrusion, suggesting its potential to reflect the postoperative meniscal tension. In the between-group comparisons, there were no differences in baseline demographic data, preoperative clinical scores, and preoperative radiologic variables. However, at the final follow-up, group 2 showed a significantly lower International Knee Documentation Committee subjective score compared with group 1 (group 1, 61.7 ± 14.4; group 2, 52.9 ± 12.5; P = .017), while no significant differences were found in the visual analog scale for pain score and Lysholm score. Additionally, group 2 exhibited significantly higher postoperative meniscal extrusion compared with group 1, which was measured at both the midpoint of the medial femoral condyle (group 1, 4.0 ± 1.1 mm; group 2, 5.1 ± 1.5 mm, P = .004) and the posterior border of the medial collateral ligament (group 1, 4.4 ± 1.2 mm; group 2, 5.7 ± 1.5 mm; P = .004), with more pronounced progression compared with the preoperative status at these sites. Consistently, the progression of both the osteoarthritis grade and the hip-knee-ankle angle compared with preoperatively was significantly greater in group 2., Conclusion: In patients in whom the restoration of meniscal tension appears insufficient immediately after surgical repair of MMRT, relatively poor clinical outcomes can be anticipated. The findings of this study suggest that efforts to reinforce meniscal tension may be required during surgical repair of MMRT in some cases, especially those showing the curtain-cliff sign., Competing Interests: The authors declared that they have no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

This study analyzed the metabolite profiles and antioxidant capacities of two waxy and non-waxy Korean red rice accessions newly bred. Fifteen phenolic compounds were detected in the rice samples. Accession1 had high fatty acids, phytosterols, and vitamin E; accession3 had high vitamin E and phytosterol; and accession4 had a high total flavonoid. The correlation analysis findings from this study validated the positive association between all the metabolites and antioxidant activity. in silico results revealed that protocatechuic acid had a docking score of -9.541, followed by luteolin, quercetin, and caffeic acid, all of which had significant docking scores and a significant number of contacts. Similarly, molecular dynamics simulations showed that phytochemicals had root mean square deviation values of <2.8 Å with Keap 1, indicating better stability. This study provides valuable insights into potential directions for future investigations and improvements in the functional qualities of other colored rice varieties., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this study., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Various scoring systems have been developed to predict outcomes in patients with non-variceal upper gastrointestinal bleeding (NVUGIB). However, their accuracy remains unclear. This study aimed to compare and validate the predictive performance of several established scoring systems in patients with NVUGIB: Glasgow-Blatchford score (GBS) and the age, blood tests, and comorbidities (ABC), mental status-anesthesiologist score-pulse-albumin-systolic blood pressure-hemoglobin (MAP(ASH)), Japanese, and Charlson comorbidity index-in-hospital onset-albumin-mental status-Eastern Cooperative Oncology Group performance status-steroids (CHAMPS) scores. We retrospectively reviewed the records of 1,241 patients who presented to the emergency department with NVUGIB and subsequently required hospitalization. Each scoring system was evaluated for its ability to predict in-hospital mortality, rebleeding, and the need for radiological or surgical intervention. The ABC score showed the highest accuracy in predicting in-hospital mortality. The MAP(ASH) score was the most effective predictor of rebleeding and the need for interventions. Different scoring systems have been optimized for various clinical outcomes. The ABC score was the best for predicting mortality, whereas the MAP(ASH) score excelled in identifying rebleeding risks and intervention needs. The selection of an appropriate scoring tool based on specific clinical scenarios can improve patient management and resource allocation in NVUGIB., Competing Interests: Declarations Competing interests The authors declare no competing interests. Ethics approval This retrospective chart review study was approved by the Institutional Review Board (IRB) of Chungnam National University Hospital (IRB number: CNUH 2024-05-017). All procedures performed in studies involving participants were conducted in accordance with the ethical standards of the Association, National Research Council, and the 1964 Helsinki Declaration, as amended or equivalent thereto. Consent to participate The requirement for written informed consent was waived due to the retrospective study design., (© 2024. The Author(s).)

Background: Neck pain and primary headache disorders are highly prevalent in populations and clinical cohorts. Medication-overuse headache (MOH) is a treatable secondary headache, mainly developing in migraine sufferers, that accounts for the majority of patients presenting to headache clinics. Nevertheless, the association between neck pain and MOH has not been reported. This study evaluated the prevalence and clinical course of neck pain in patients with MOH before and after MOH treatment., Methods: We analyzed 635 MOH patients enrolled in a nationwide, prospective, multicenter MOH registry. Demographics and clinical data were collected at baseline and 3 months to evaluate changes in the status and severity of neck pain and headache. Severity of neck pain was graded into 4 groups, and severe neck pain was defined as grade 3 or 4., Results: Among 635 patients with MOH, 366 (57.6%) reported neck pain at baseline. MOH patients with neck pain had an earlier onset of their primary headache disorder (23.4 ± 12.7 vs. 26.2 ± 13.3 years, p = 0.007). Although monthly headache days were comparable between the patients with neck pain and those without neck pain, the neck pain group had higher levels of anxiety (7.4 ± 5.8 vs. 6.4 ± 5.4, p = 0.017), more severe cutaneous allodynia (2.4 ± 3.3 vs. 1.8 ± 3.0, p = 0.038), and poorer quality of life (171.7 ± 70.4 vs. 184.0 ± 68.9, p = 0.029). At 3 months, 456 (71.8%) were followed-up, and 257 (56.4%) were recovered from MOH. Compared to the baseline, the proportion of severe neck pain (40.4% vs. 19.4%, p < 0.001) was decreased. The proportion of severe neck pain was much lower in patients with recovery from MOH compared to those without (4.7% vs. 15.1%, p < 0.001)., Conclusions: Neck pain in MOH patients was associated with earlier onset of headache, higher levels of anxiety and allodynia, and poorer quality of life. Improvement in neck pain improvement was linked to recovery from MOH. These findings suggest the potential importance of integrating and management of neck pain into clinical practice for MOH., (© 2024. The Author(s).)

Posterior cranial vault distraction osteogenesis (PCVDO) is a relatively new paradigm in the treatment of syndromic craniosynostosis, having first been introduced in 2009. PCVDO directly addresses the underdeveloped cranial vault and appears to allow for a larger increase in intracranial volume when compared to traditional techniques. Although reported as safe in the literature, critical appraisal is still required as PCVDO is a relatively uncommon procedure that may require greater numbers to detect true complication rates. The overall reported incidence of serious complications in PCVDO to date is low. This presentation highlights a rare case of sagittal sinus obstruction following posterior cranial vault distraction and raises questions as to the safest technical considerations when planning the operation., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Microplastic (MP) pollution in urban environments is a pervasive and complex problem with significant environmental and human health implications. Although studies have been conducted on MP pollution in urban environments, there are still research gaps in understanding the exact sources, regulation, and impact of urban MP on the environment and public health. Therefore, the goal of this study is to provide a comprehensive overview of the complex pathways, harmful effects, and regulatory efforts of urban MP pollution. It discusses the research challenges and suggests future directions for addressing MPs related to environmental issues in urban settings. In this study, original research papers published from 2010 to 2024 across ten database categories, including PubMed, Google Scholar, Scopus, and Web of Science, were selected and reviewed to improve our understanding of urban MP pollution. The analysis revealed multifaceted sources of MPs, including surface runoff, wastewater discharge, atmospheric deposition, and biological interactions, which contribute to the contamination of aquatic and terrestrial ecosystems. MPs pose a threat to marine and terrestrial life, freshwater organisms, soil health, plant communities, and human health through ingestion, inhalation, and dermal exposure. Current regulatory measures for MP pollution include improved waste management, upgraded wastewater treatment, stormwater management, product innovation, public awareness campaigns, and community engagement. Despite these regulatory measures, several challenges such as; the absence of standardized MPs testing methods, MPs enter into the environment through a multitude of sources and pathways, countries struggle in balancing trade interests with environmental concerns have hindered effective policy implementation and enforcement. Addressing MP pollution in urban environments is essential for preserving ecosystems, safeguarding public health, and advancing sustainable development. Interdisciplinary collaboration, innovative research, stringent regulations, and public participation are vital for mitigating this critical issue and ensuring a cleaner and healthier future for urban environments and the planet., Competing Interests: Declaration of competing interest All authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background and Aims: No medication has been found to reduce liver-related events. We evaluated the effect of sodium-glucose cotransporter-2 inhibitor (SGLT2i) on liver-related outcomes., Approach and Results: Single nucleotide polymorphisms associated with SGLT2 inhibition were identified, and a genetic risk score (GRS) was computed using the UK Biobank data (n=337,138). Two-sample Mendelian randomization (MR) was conducted using the FinnGen (n=218,792) database and the UK Biobank data. In parallel, a nationwide population-based study using the Korean National Health Insurance Service (NHIS) database was conducted. The development of liver-related complications (ie, hepatic decompensation, HCC, liver transplantation, and death) was compared between individuals with type 2 diabetes mellitus and steatotic liver diseases treated with SGLT2i (n=13,208) and propensity score-matched individuals treated with dipeptidyl peptidase-4 inhibitor (n=70,342). After computing GRS with 6 single nucleotide polymorphisms (rs4488457, rs80577326, rs11865835, rs9930811, rs34497199, and rs35445454), GRS-based MR showed that SGLT2 inhibition (per 1 SD increase of GRS, 0.1% lowering of HbA1c) was negatively associated with cirrhosis development (adjusted odds ratio=0.83, 95% CI=0.70-0.98, p =0.03) and this was consistent in the 2-sample MR (OR=0.73, 95% CI=0.60-0.90, p =0.003). In the Korean NHIS database, the risk of liver-related complications was significantly lower in the SGLT2i group than in the dipeptidyl peptidase-4 inhibitor group (adjusted hazard ratio=0.88, 95% CI=0.79-0.97, p =0.01), and this difference remained significant (adjusted hazard ratio=0.72-0.89, all p <0.05) across various sensitivity analyses., Conclusions: Both MRs using 2 European cohorts and a Korean nationwide population-based cohort study suggest that SGLT2 inhibition is associated with a lower risk of liver-related events., (Copyright © 2024 American Association for the Study of Liver Diseases.)

Alzheimer's disease (AD) presents complex challenges due to its multifactorial nature, poorly understood etiology, and late detection. The mechanisms through which genetic and modifiable risk factors influence disease susceptibility are under intense investigation, with APOE being the major genetic risk factor for late onset AD. Yet the impact of unique risk factors on brain networks is difficult to disentangle, and their interactions remain unclear. To model multiple risk factors, including APOE genotype, age, sex, diet, and immunity we used a cross sectional design, leveraging mice expressing human APOE and NOS2 genes, conferring a reduced immune response compared to mouse Nos2. We used network topological and GraphClass analyses of brain connectomes derived from accelerated diffusion-weighted MRI to assess the global and local impact of risk factors, in the absence of AD pathology. Aging and a high-fat diet impacted extensive networks comprising AD-vulnerable regions, including the temporal association cortex, amygdala, and the periaqueductal gray, involved in stress responses. Sex impacted networks including sexually dimorphic regions (thalamus, insula, hypothalamus) and key memory-processing areas (fimbria, septum). APOE genotypes modulated connectivity in memory, sensory, and motor regions, while diet and immunity both impacted the insula and hypothalamus. Notably, these risk factors converged on a circuit comprising 63 of 54,946 total connections (0.11% of the connectome), highlighting shared vulnerability amongst multiple AD risk factors in regions essential for sensory integration, emotional regulation, decision making, motor coordination, memory, homeostasis, and interoception. APOE genotype specific immune signatures support the design of interventions tailored to risk profiles. Sparse Canonical Correlation Analysis (CCA) including spatial memory as a risk factor resulted in a network comprising 80 edges, showing significant overlap with risk-associated networks from GraphClass. The largest overlaps were observed with networks impacted by diet (47 edges), immunity (39 edges), APOE3 vs 4 (26 edges), sex (23 edges), and age (19 edges), the resulting networks supporting the use of sensory cues in spatial memory retrieval. These network-based biomarkers hold translational value for distinguishing high-risk versus low-risk participants at preclinical AD stages, suggest circuits as potential therapeutic targets, and advance our understanding of network fingerprints associated with AD risk., Competing Interests: Declaration of competing interest The authors report no competing interests., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: To develop the most compatible cementation protocol for ensuring minimal residual cement and optimal retention of cement-retained implant-supported fixed dental prostheses., Materials and Methods: A total of 30 custom implant abutments and zirconia crowns with bilateral wings were prepared. Three cement types were used for cementation: noneugenol resin cement (Premier Implant Cement; Group IC), dual-polymerizing self-adhesive resin cement (SmartCem2; Group SC), and zinc oxide eugenol cement (Temp-Bond; Group TB; n &#61; 30 per group). Three cementation methods were applied for each cement type, and the samples were divided into subgroups: (1) cement was injected using a graduated syringe (ICN, SC-N, and TB-N); (2) a cementa/on jig made with a silicone impression material and temporary resin material was used (IC-CJ, SC-CJ, and TB-CJ); (3) 3D-printed abutments were used as replicas for cementation (IC-3DP, SC-3DP, and TB-3DP). The amount of cement injected, surface area of the residual cement, and retentive strength were measured. Kruskal- Wallis and post-hoc Mann-Whitney tests were used for statistical analyses., Results: Excess cement was not observed when cementa/on jig or 3D-printed replicas were used. For IC and SC subgroups, non-use of these auxiliary tools resulted in significantly higher amounts of injected cement. The retentive strength differed significantly among the IC subgroups but not among the SC subgroups. The retentive strength of subgroups TB-N and TB-CJ was significantly higher than that of subgroup TB-3DP., Conclusions: To prolong the main purpose of each cement type, a cementation jig or 3D-printed replica is highly recommended regardless of the cement type.

Statement of Problem: Clinical trials comparing outcomes associated with digital complete dentures (CDs) fabricated from intraoral scan data with those of CDs fabricated by using the conventional workflow are lacking., Purpose: The purpose of this randomized clinical trial was to evaluate the clinical performance of and patient satisfaction associated with digitally versus conventionally fabricated CDs., Material and Methods: Eight participants requiring CDs were enrolled in this study. Two sets of CDs were fabricated for each participant. One set was fabricated by using a digital workflow, which involved digital scanning with an intraoral scanner, whereas the other set was made by using the conventional workflow. The participants were given 1 set of CDs for 1 month and another set for the next month. The order of placing CDs was randomly selected for each participant. The internal adaptation, masticatory force, and masticatory efficiency of the CDs in each group were evaluated for objective analysis. Additionally, a questionnaire was provided to the participants, and the responses were evaluated for subjective satisfaction analysis. All parameters were analyzed by using t tests (α=.05)., Results: The internal adaptation did not statistically significantly differ between the conventional and digital CDs with regard to the maxillary arches (P=.406) and mandibular arches (P=.412). The average masticatory force (P=.051) and maximum masticatory force (P=.110) likewise did not statistically significantly differ between the 2 types of CDs. Masticatory efficiency, expressed via the mixing ability index, was statistically better for conventional CDs than the digital CDs (P=.009). No statistically significant differences were observed between the 2 types of CDs in terms of overall patient satisfaction as assessed by using the study questionnaire (P=.172 for maxillary CD and P=.161 for mandibular CD). However, the conventional CDs were statistically significantly better than the digital CDs with regard to subjective satisfaction with pronunciation ability (P=.006)., Conclusions: The digital CDs were inferior to the conventional CDs in terms of masticatory efficiency and pronunciation. However, internal adaptation and overall patient satisfaction were comparable between conventional and digital CDs. This finding suggests that intraoral scanning and additively manufactured CDs may be suitable for edentulous patients, at least for interim use., (Copyright © 2022 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)