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2D semiconductors, represented by transition metal dichalcogenides (TMDs), have the potential to be alternative channel materials for advanced 3D field-effect transistors, such as gate-all-around field-effect-transistors (GAAFETs) and complementary field-effect-transistors (C-FETs), due to their inherent atomic thinness, moderate mobility, and short scaling lengths. However, 2D semiconductors encounter several technological challenges, especially the high contact resistance issue between 2D semiconductors and metals. This review provides a comprehensive overview of the high contact resistance issue in 2D semiconductors, including its physical background and the efforts to address it, with respect to their applicability to GAAFET structures.
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In atomically thin van der Waals materials, grain boundaries-the line defects between adjacent crystal grains with tilted in-plane rotations-are omnipresent. When the tilting angles are arbitrary, the grain boundaries form inhomogeneous sublattices, giving rise to local electronic states that are not controlled. Here we report on epitaxial realizations of deterministic MoS2 mirror twin boundaries (MTBs) at which two adjoining crystals are reflection mirroring by an exactly 60° rotation by position-controlled epitaxy. We showed that these epitaxial MTBs are one-dimensionally metallic to a circuit length scale. By utilizing the ultimate one-dimensional (1D) feature (width ~0.4 nm and length up to a few tens of micrometres), we incorporated the epitaxial MTBs as a 1D gate to build integrated two-dimensional field-effect transistors (FETs). The critical role of the 1D MTB gate was verified to scale the depletion channel length down to 3.9 nm, resulting in a substantially lowered channel off-current at lower gate voltages. With that, in both individual and array FETs, we demonstrated state-of-the-art performances for low-power logics. The 1D epitaxial MTB gates in this work suggest a novel synthetic pathway for the integration of two-dimensional FETs-that are immune to high gate capacitance-towards ultimate scaling.
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BACKGROUND AND AIM: This study aimed to investigate the association between liver volume change and hepatic decompensation and compare the risk of hepatic decompensation in patients with liver cirrhosis (LC) and hepatocellular carcinoma (HCC) who underwent stereotactic body radiation therapy (SBRT). METHODS: A retrospective review of SBRT-treated HCC and compensated LC without HCC patients was conducted. Liver volume was measured using auto-segmentation software on liver dynamic computed tomography scans. The decompensation event was defined as the first occurrence of refractory ascites, esophageal variceal bleeding, hepatic encephalopathy, or spontaneous bacterial peritonitis. We evaluated the association between the rate of liver volume decrease and hepatic decompensation and compared decompensation events between the SBRT and LC cohorts using propensity score matching. RESULTS: A total of 138 patients from the SBRT cohort and 488 from the LC cohort were analyzed. The rate of liver volume decrease was associated with the risk of decompensation events in both cohorts. The 3-year rate of decompensation events was significantly higher in the group with a liver volume decreasing rate > 7%/year compared with the group with a rate < 7%/year. In the propensity score-matched cohort, the 3-year rate of decompensation events after a single session of SBRT was not significantly different from that in the LC cohort. CONCLUSIONS: The rate of liver volume decrease was significantly associated with the risk of hepatic decompensation in both HCC patients who received SBRT and LC patients. A single session of SBRT for HCC did not result in a higher decompensation rate compared with LC.
Subject(s)
Carcinoma, Hepatocellular , Liver Cirrhosis , Liver Neoplasms , Liver , Radiosurgery , Humans , Liver Neoplasms/radiotherapy , Liver Neoplasms/diagnostic imaging , Radiosurgery/adverse effects , Radiosurgery/methods , Male , Female , Carcinoma, Hepatocellular/radiotherapy , Carcinoma, Hepatocellular/diagnostic imaging , Aged , Retrospective Studies , Middle Aged , Organ Size , Liver/diagnostic imaging , Liver/pathology , Liver Cirrhosis/complications , Time Factors , Tomography, X-Ray Computed , Propensity Score , Risk , Aged, 80 and over , Cohort StudiesABSTRACT
Electrostatic capacitors are foundational components of advanced electronics and high-power electrical systems owing to their ultrafast charging-discharging capability. Ferroelectric materials offer high maximum polarization, but high remnant polarization has hindered their effective deployment in energy storage applications. Previous methodologies have encountered problems because of the deteriorated crystallinity of the ferroelectric materials. We introduce an approach to control the relaxation time using two-dimensional (2D) materials while minimizing energy loss by using 2D/3D/2D heterostructures and preserving the crystallinity of ferroelectric 3D materials. Using this approach, we were able to achieve an energy density of 191.7 joules per cubic centimeter with an efficiency greater than 90%. This precise control over relaxation time holds promise for a wide array of applications and has the potential to accelerate the development of highly efficient energy storage systems.
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Etching technology - one of the representative modern semiconductor device makers - serves as a broad descriptor for the process of removing material from the surfaces of various materials, whether partially or entirely. Meanwhile, thinning technology represents a novel and highly specialized approach within the realm of etching technology. It indicates the importance of achieving an exceptionally sophisticated and precise removal of material, layer-by-layer, at the nanoscale. Notably, thinning technology has gained substantial momentum, particularly in top-down strategies aimed at pushing the frontiers of nano-worlds. This rapid development in thinning technology has generated substantial interest among researchers from diverse backgrounds, including those in the fields of chemistry, physics, and engineering. Precisely and expertly controlling the layer numbers of 2D materials through the thinning procedure has been considered as a crucial step. This is because the thinning processes lead to variations in the electrical and optical characteristics. In this comprehensive review, the strategies for top-down thinning of representative 2D materials (e.g., graphene, black phosphorus, MoS2, h-BN, WS2, MoSe2, and WSe2) based on conventional plasma-assisted thinning, integrated cyclic plasma-assisted thinning, laser-assisted thinning, metal-assisted splitting, and layer-resolved splitting are covered in detail, along with their mechanisms and benefits. Additionally, this review further explores the latest advancements in terms of the potential advantages of semiconductor devices achieved by top-down 2D material thinning procedures.
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As the downscaling of conventional dynamic random-access memory (DRAM) has reached its limits, 3D DRAM has been proposed as a next-generation DRAM cell architecture. However, incorporating silicon into 3D DRAM technology faces various challenges in securing cost-effective high cell transistor performance. Therefore, many researchers are exploring the application of next-generation semiconductor materials, such as transition oxide semiconductors (OSs) and metal dichalcogenides (TMDs), to address these challenges and to realize 3D DRAM. This study provides an overview of the proposed structures for 3D DRAM, compares the characteristics of OSs and TMDs, and discusses the feasibility of employing the OSs and TMDs as the channel material for 3D DRAM. Furthermore, we review recent progress in 3D DRAM using the OSs, discussing their potential to overcome challenges in silicon-based approaches.
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The anomalous Hall conductivity (AHC) in magnetic materials, resulting from inverted band topology, has emerged as a key adjustable function in spin-torque devices and advanced magnetic sensors. Among systems with near-half-metallicity and broken time-reversal symmetry, cobalt disulfide (CoS2) has proven to be a material capable of significantly enhancing its AHC. In this study, the AHC of CoS2 is empirically assessed by manipulating the chemical potential through Fe- (hole) and Ni- (electron) doping. The primary mechanism underlying the colossal AHC is identified through the application of density functional theory and tight-binding analyses. The main source of this substantial AHC is traced to four spin-polarized massive Dirac dispersions in the kz = 0 plane of the Brillouin zone, located slightly below the Fermi level. In Co0.95Fe0.05S2, the AHC, which is directly proportional to the momentum-space integral of the Berry curvature (BC), reached a record-breaking value of 2507 Ω-1cm-1. This is because the BCs of the four Dirac dispersions all exhibit the same sign, a consequence of the d-wave-like spin-orbit coupling among spin-polarized eg orbitals.
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BACKGROUND: Intensive multimodal treatment can improve survival in patients with high-risk neuroblastoma, and consolidative radiation therapy has contributed to local control. We examined the clinical outcomes of patients who underwent consolidative radiation therapy at our institution. METHODS: We retrospectively reviewed the records of patients with high-risk neuroblastoma who underwent consolidative radiation therapy from March 2001 to March 2021 at Asan Medical Center. Patients underwent multimodal treatment including high-dose chemotherapy, surgery, stem cell transplantation, and maintenance therapy. Radiation (median, 21.0 Gy; range, 14-36) was administered to the primary site and surrounding lymph nodes. RESULTS: This study included 37 patients, and the median age at diagnosis was 2.8 years (range, 1.3-10.0). Four patients exhibited local failure, and 5-year free-from locoregional failure rate was 88.7%, with a median followup period of 5.7 years. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 59.1% and 83.6%, respectively. Univariate analysis revealed that patients with neuron-specific enolase levels > 100 ng/mL had significantly worse DFS and OS (P = 0.036, 0.048), and patients with no residual disease before radiation therapy showed superior OS (P = 0.029). Furthermore, patients with 11q deletion or 17q gain exhibited poor DFS and OS, respectively (P = 0.021, 0.011). Six patients experienced grade 1 acute toxicity. Late toxicity was confirmed in children with long-term survival, predominantly hypothyroidism and hypogonadism, typically < grade 3, possibly attributed to combination treatment. Four patients experienced late toxicity ≥ grade 3 with chronic kidney disease, growth hormone abnormality, ileus, premature epiphyseal closure, and secondary tumor, and recovered by hospitalization or surgical treatment. CONCLUSIONS: In patients with high-risk neuroblastoma, consolidative radiotherapy to the primary tumor site resulted in excellent local control and a tolerable safety profile.
Subject(s)
Neuroblastoma , Child , Humans , Infant , Child, Preschool , Retrospective Studies , Neuroblastoma/radiotherapy , Neuroblastoma/pathology , Disease-Free Survival , Combined Modality TherapyABSTRACT
Negative-differential-resistance (NDR) devices offer a promising pathway for developing future computing technologies characterized by exceptionally low energy consumption, especially multivalued logic computing. Nevertheless, conventional approaches aimed at attaining the NDR phenomenon involve intricate junction configurations and/or external doping processes in the channel region, impeding the progress of NDR devices to the circuit and system levels. Here, an NDR device is presented that incorporates a channel without junctions. The NDR phenomenon is achieved by introducing a metal-insulator-semiconductor capacitor to a portion of the channel area. This approach establishes partial potential barrier and well that effectively restrict the movement of hole and electron carriers within specific voltage ranges. Consequently, this facilitates the implementation of both a ternary inverter and a ternary static-random-access-memory, which are essential components in the development of multivalued logic computing technology.
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BACKGROUND: Modified FOLFIRINOX (mFOLFIRINOX) is one of the standard first-line therapies in borderline resectable pancreatic cancer (BRPC) and locally advanced unresectable pancreatic cancer (LAPC). However, there is no globally accepted second-line therapy following progression on mFOLFIRINOX. METHODS: Patients with BRPC and LAPC (n = 647) treated with first-line mFOLFIRINOX between January 2017 and December 2020 were included in this retrospective analysis. The details of the treatment outcomes and patterns of subsequent therapy after mFOLFIRINOX were reviewed. RESULTS: With a median follow-up duration of 44.2 months (95% confidence interval [CI], 42.3-47.6), 322 patients exhibited disease progression on mFOLFIRINOX-locoregional progression only in 177 patients (55.0%) and distant metastasis in 145 patients (45.0%). The locoregional progression group demonstrated significantly longer post-progression survival (PPS) than that of the distant metastasis group (10.1 vs. 7.3 months, p = 0.002). In the locoregional progression group, survival outcomes did not differ between second-line chemoradiation/radiotherapy and systemic chemotherapy (progression-free survival with second-line therapy [PFS-2], 3.2 vs. 4.3 months; p = 0.649; PPS, 10.7 vs. 10.2 months; p = 0.791). In patients who received second-line systemic chemotherapy following progression on mFOLFIRINOX (n = 211), gemcitabine plus nab-paclitaxel was associated with better disease control rates (69.2% vs. 42.3%, p = 0.005) and PFS-2 (3.8 vs. 1.7 months, p = 0.035) than gemcitabine monotherapy. CONCLUSIONS: The current study showed the real-world practice pattern of subsequent therapy and clinical outcomes following progression on first-line mFOLFIRINOX in BRPC and LAPC. Further investigation is necessary to establish the optimal therapy after failure of mFOLFIRINOX.
Subject(s)
Adenocarcinoma , Pancreatic Neoplasms , Humans , Pancreatic Neoplasms/pathology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Gemcitabine , Retrospective Studies , Adenocarcinoma/pathology , Fluorouracil/therapeutic use , Leucovorin/therapeutic use , Neoadjuvant Therapy , Disease Progression , Irinotecan , OxaliplatinSubject(s)
COVID-19 , Electroconvulsive Therapy , Psychotic Disorders , Humans , Mania , Depression/therapy , Psychotic Disorders/therapyABSTRACT
BACKGROUND: Othello syndrome (OS) is a condition characterized by a delusion of jealousy that one's spouse is having extramarital affairs. As in the eponymous Shakespearean tragedy, there is an unfortunate risk of violence. For patients with these symptoms, consultation-liaison psychiatrists may be asked to assist with evaluating the differential diagnosis, assessing safety, and developing treatment options. OBJECTIVE: This study's objective was to solidify current knowledge of the clinical presentations and management of OS through a systematic review of the literature and description of 2 new cases. METHODS: We conducted a literature search from the start of relevant databases through August 2023 to identify English language case reports of adults (≥18 years) with OS that described clinical evaluations, biological treatments, and outcomes. We extracted demographics, proposed etiologies, treatment choices and responses, duration of delusions, comorbid psychiatric symptoms, neuro-radiographic findings, and presence of physical violence. We reported clinical findings for 2 new cases. RESULTS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we screened 705 abstracts and conducted full-text reviews of 118 articles to identify 73 cases published from 1983 to 2023 meeting inclusion criteria. The mean age was 58.2 years with male predominance (M:F = 1.88). Etiologies included primary psychiatric disorders (16, 22%), other medical conditions (38, 52%), and medications or other substances (19, 26%). Delusional disorder, cerebrovascular accident, and dopaminergic agonists were the most common etiologies, respectively, in these groups. Antipsychotics were the most common treatment (57, 78%). Symptom remission was reported in 51 (70%) cases. The average duration of OS was 39.5 months. Of 32 cases reporting brain imaging insults, 12 of 20 (60%) showed right-sided lesions, and 8 of 20 (40%) showed left-sided lesions, with 9 of 32 (28%) located in the frontal lobes. The most commonly co-existing psychiatric symptom was depression (14, 19%). Violence was reported in 25 cases (34%). Our 2 new cases were consistent with these findings. CONCLUSIONS: OS may be a manifestation of several neuropsychiatric conditions, primarily delusional disorder, cerebrovascular accident, Alzheimer's dementia, and the use of dopaminergic agonists. One-third of cases include violent behaviors. It appears to respond to antipsychotic medications, but treatment is delayed more than 3 years on average. Available data have not localized OS to a specific brain region.
Subject(s)
Antipsychotic Agents , Stroke , Adult , Humans , Male , Middle Aged , Female , Schizophrenia, Paranoid/complications , Schizophrenia, Paranoid/drug therapy , Delusions/therapy , Delusions/diagnosis , Delusions/psychology , Dopamine Agonists/therapeutic use , Antipsychotic Agents/therapeutic use , Stroke/complications , Stroke/drug therapyABSTRACT
Emergent inhomogeneous electronic phases in metallic quantum systems are crucial for understanding high-Tc superconductivity and other novel quantum states. In particular, spin droplets introduced by nonmagnetic dopants in quantum-critical superconductors (QCSs) can lead to a novel magnetic state in superconducting phases. However, the role of disorders caused by nonmagnetic dopants in quantum-critical regimes and their precise relation with superconductivity remain unclear. Here, the systematic evolution of a strong correlation between superconductive intertwined electronic phases and antiferromagnetism in Cd-doped CeCoIn5 is presented by measuring current-voltage characteristics under an external pressure. In the low-pressure coexisting regime where antiferromagnetic (AFM) and superconducting (SC) orders coexist, the critical current (Ic ) is gradually suppressed by the increasing magnetic field, as in conventional type-II superconductors. At pressures higher than the critical pressure where the AFM order disappears, Ic remarkably shows a sudden spike near the irreversible magnetic field. In addition, at high pressures far from the critical pressure point, the peak effect is not suppressed, but remains robust over the whole superconducting region. These results indicate that magnetic islands are protected around dopant sites despite being suppressed by the increasingly correlated effects under pressure, providing a new perspective on the role of quenched disorders in QCSs.
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The potential for various future industrial applications has made broadband photodetectors beyond visible light an area of great interest. Although most 2D van-der-Waals (vdW) semiconductors have a relatively large energy bandgap (>1.2 eV), which limits their use in short-wave infrared detection, they have recently been considered as a replacement for ternary alloys in high-performance photodetectors due to their strong light-matter interaction. In this study, a ferroelectric gating ReS2 /WSe2 vdW heterojunction-channel photodetector is presented that successfully achieves broadband light detection (>1300 nm, expandable up to 2700 nm). The staggered type-II bandgap alignment creates an interlayer gap of 0.46 eV between the valence band maximum (VBMAX ) of WSe2 and the conduction band minimum (CBMIN ) of ReS2 . Especially, the control of poly(vinylidene fluoride-trifluoroethylene) (P(VDF-TrFE)) ferroelectric dipole polarity for a specific wavelength allows a high photoresponsivity of up to 6.9 × 103 A W-1 and a low dark current below 0.26 nA under the laser illumination with a wavelength of 405 nm in P-up mode. The achieved high photoresponsivity, low dark current, and full-range near infrared (NIR) detection capability open the door for next-generation photodetectors beyond traditional ternary alloy photodetectors.
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In-memory computing is an attractive alternative for handling data-intensive tasks as it employs parallel processing without the need for data transfer. Nevertheless, it necessitates a high-density memory array to effectively manage large data volumes. Here, we present a stacked ferroelectric memory array comprised of laterally gated ferroelectric field-effect transistors (LG-FeFETs). The interlocking effect of the α-In2Se3 is utilized to regulate the channel conductance. Our study examined the distinctive characteristics of the LG-FeFET, such as a notably wide memory window, effective ferroelectric switching, long retention time (over 3 × 104 seconds), and high endurance (over 105 cycles). This device is also well-suited for implementing vertically stacked structures because decreasing its height can help mitigate the challenges associated with the integration process. We devised a 3D stacked structure using the LG-FeFET and verified its feasibility by performing multiply-accumulate (MAC) operations in a two-tier stacked memory configuration.
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Sensory neuromorphic systems are a promising technology, because they can replicate the way the human peripheral nervous system processes signals from the five sensory organs. Despite this potential, there are limited studies on how to implement these systems on a hardware neural network platform. In our research, we propose a tactile neuromorphic system that uses a poly(dimethylsiloxane) (PDMS)-based triboelectric sensor and a molybdenum disulfide (MoS2)/poly(vinylidene fluoride-trifluoro ethylene) (P(VDF-TrFE)) heterostructure-based ferroelectric synapse. The triboelectric sensor mimics a human tactile organ by converting tactile stimuli into electrical signals in real time. The ferroelectric synapse we developed demonstrates exceptional long-term potentiation/depression characteristics with a maximum dynamic range of 78 and a symmetrical value of 4.7. To assess the practicality of our proposed system, we conducted training and recognition simulations using Morse code alphabets and MNIST handwritten digits. The maximum recognition rate that we achieved was 96.17%.
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PURPOSE: The aim of this systematic review was to compare treatment outcomes in terms of implant survival rate, marginal bone loss, and patient-reported outcome measures (PROMs) between narrow-diameter implants and regular-diameter implants (RDIs) for mandibular implant overdentures (MIOs). METHODS: This study was based on the methodology adapted as per Cochrane. Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus were searched for pertinent studies published by July 22, 2022. Outcome parameters included in this meta-analysis were implant survival rate, marginal bone loss, visual analogue scale score for patient satisfaction, and value of oral health impact profile. RESULTS: A total of 782 non-duplicate articles and 83 clinical study registrations were identified from database and hand searches, of which 26 were eligible for full-text searches. Finally, 12 publications reporting on 8 independent studies were included in this review. In the meta-analysis, implant survival rate and marginal bone loss did not significantly differ between narrow-diameter implants and RDIs. Regarding RDIs, narrow-diameter implants were associated with significantly better outcomes in general patient satisfaction and oral health-related quality of life than RDIs for mandibular overdentures. CONCLUSIONS: Narrow-diameter implants have competitive treatment outcomes compared to RDIs in terms of implant survival rate, marginal bone loss, and PROMs. [Correction added on July 21, 2023, after first online publication: The abbreviation RDIs was changed to PROMs in the preceding sentence.] Thus, narrow-diameter implants might be an alternative treatment option for MIOs in situations with limited alveolar bone volume.
Subject(s)
Alveolar Bone Loss , Dental Implants , Humans , Quality of Life , Denture, Overlay , Dental Prosthesis, Implant-Supported , Treatment Outcome , Mandible/surgeryABSTRACT
BACKGROUND AND AIMS: The effectiveness of gemcitabine-based adjuvant chemotherapy is unclear in cholangiocarcinoma. We investigated the role of adjuvant gemcitabine plus cisplatin (GemCis) in a homogeneous group of high-risk patients with resected, lymph node-positive extrahepatic cholangiocarcinoma. APPROACH AND RESULTS: Adenocarcinoma of perihilar or distal bile duct with regional lymph node metastasis who underwent curative-intent surgery (R0/R1) was eligible. Patients were randomized to receive GemCis (gemcitabine 1000 mg/m2, cisplatin 25 mg/m2 on days 1 and 8) or capecitabine (1250 mg/m2 twice daily on days 1-14) every 3 weeks for 8 cycles. Primary endpoint was disease-free survival. Secondary endpoints were overall survival and safety. All p values are 1 sided and were considered significant if <0.1. Between July 2017 and November 2020, 101 patients (50 in the GemCis and 51 in the capecitabine group) were included in the intention-to-treat population. Perihilar and distal bile ducts were the primary sites in 45 (44.6%) and 56 (55.4%) patients, respectively, and 32 (31.7%) had R1 resections. Median (1-sided 90% CI) follow-up duration was 33.4 (30.5-35.8) months. In the GemCis and capecitabine group, 2-year disease-free survival rates were 38.5% (29.5%-47.4%) and 25.1% (17.4%-33.5%) [HR=0.96 (CI, 0.71-1.30), p=0.430], and median overall survival was 35.7 months (29.5-not estimated) and 35.7 months (30.9-not estimated) [HR=1.08 (CI, 0.71-1.64), 1-sided p=0.404], respectively. Grade 3-4 adverse events occurred in 42 (84.0%) and 8 patients (16.0%) in the GemCis and capecitabine groups, respectively. No treatment-related deaths were reported. CONCLUSIONS: In resected lymph node-positive extrahepatic cholangiocarcinoma, adjuvant GemCis did not improve survival outcomes compared with capecitabine.
Subject(s)
Bile Duct Neoplasms , Cholangiocarcinoma , Humans , Capecitabine/therapeutic use , Capecitabine/adverse effects , Gemcitabine , Cisplatin/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Deoxycytidine/therapeutic use , Cholangiocarcinoma/drug therapy , Cholangiocarcinoma/surgery , Cholangiocarcinoma/etiology , Chemotherapy, Adjuvant , Bile Duct Neoplasms/drug therapy , Bile Duct Neoplasms/surgery , Bile Duct Neoplasms/chemically induced , Bile Ducts, Intrahepatic/pathologyABSTRACT
OBJECTIVES: This retrospective study to evaluate the treatment outcomes of mandibular mini-implant overdentures (MIODs) placed under a two-step immediate loading protocol. BACKGROUND: The mini-implant overdenture emphasises the advantages of simplicity using flapless surgery and immediate loading. However, some mini-implant have lowe initial stability. MATERIALS AND METHODS: A total of 30 participants who used mandibular MIODs and maxillary removable complete dentures (RCDs) over 4 years were included. Four one-piece mini-implants (<3 mm in diameter) were placed by a flapless surgical approach after fabrication of new RCDs, and the O-ring attachment was attached at least 8 weeks after implant placement. RESULTS: The average observation period was 58.9 ± 9.2 months after mini-implant loading. The survival rate of the implants was 100.0%, and the overall change in mean marginal bone level (ΔMBL) was -0.9 ± 1.1 mm. The implant success rate was 83.3% at the implant level, and 66.7% at the patient level. The mean initial Periotest value was 0.9 ± 3.1, and it was positively associated with ΔMBL and implant success (P < .05). Patient satisfaction improved after conversion from RCDs to MIODs (P < .05), and mastication and pain showed greater satisfaction with longer loading time (P < .05). CONCLUSIONS: The mandibular MIODs could be chosen as an alternative treatment under a two-step immediate-loading protocol in edentulous patients with limited alveolar bone volume. To ensure superior treatment outcomes of MIODs, initial stability of implant must be obtained using as wide a diameter as possible within the anatomically allowable limits.