Accuracy of Artificial Intelligence-Based Virtual Assistants in Responding to Frequently Asked Questions Related to Orthognathic Surgery.

BACKGROUND: Despite increasing interest in how conversational agents might improve health care delivery and information dissemination, there is limited research assessing the quality of health information provided by these technologies, especially in orthognathic surgery (OGS). PURPOSE: This study aimed to measure and compare the quality of four virtual assistants (VAs) in addressing the frequently asked questions about OGS. STUDY DESIGN, SETTING, AND SAMPLE: This in-silico cross-sectional study assessed the responses of a sample of four VAs through a standardized set of 10 questionnaires related to OGS. INDEPENDENT VARIABLE: The independent variables were the four VAs. The four VAs tested were VA1: Alexa (Seattle, Washington), VA2: Google Assistant (Google Mountain View, California), VA3: Siri (Cupertino, California), and VA4: Bing (San Diego, California). MAIN OUTCOME VARIABLE(S): The primary outcome variable was the quality of the answers generated by the four VAs. Four investigators (two orthodontists and two oral surgeons) assessed the quality of response of the four VAs through a standardized set of 10 questionnaires using a five-point modified Likert scale, with the lowest score (1) signifying the highest quality. The main outcome variables measured were the combined mean scores of the responses from each VA, and the secondary outcome assessed was the variability in responses among the different investigators. COVARIATES: None. ANALYSES: One-way analysis of variance was done to compare the average scores per question. One-way analysis of variance followed by Tukey's post hoc analyses was done to compare the combined mean scores among the VAs, and the combined mean scores of all questions were evaluated to determine variability if any among different VA's responses to the investigators. RESULTS: Among the four VAs, VA4 (1.32 ± 0.57) had significantly the lowest (best) score, followed by VA2 (1.55 ± 0.78), VA1 (2.67 ± 1.49), and VA3 (3.52 ± 0.50) (P value <.001). There were no significant differences in how the VAs: VA3 (P value = .46), VA4 (P value = .45), and VA2 (P value = .44) responded to each of the investigators except VA1 (P value = .003). CONCLUSION AND RELEVANCE: The VAs responded to the queries related to OGS, with VA4 displaying the best quality response, followed by VA2, VA1, and VA3. Technology companies and clinical organizations should partner for an intelligent VA with evidence-based responses specifically curated to educate patients.

Does distraction osteogenesis improve the airway volume and quality of life of obstructive sleep apnoea patients secondary to temporomandibular joint ankylosis?

Temporomandibular joint (TMJ) ankylosis leads to mandibular micrognathia that severely collapses the upper airway causing obstructive sleep apnoea (OSA), resulting in deterioration and compromise in the quality of life (QoL) of patients. In this study, we aimed to calculate airway volume changes, apnoea-hypopnoea index (AHI), and improvement in quality of life before and after distraction osteogenesis (DO). Fourteen Patients with OSA secondary to TMJ ankylosis at a mean (SD) age of 17.5 (5.43) years were enrolled in this prospective study. Multivector mandibular distractors were used in all patients following the standard Ilizarov distraction protocol with a mean (SD) anteroposterior distraction of 16.21 (4.37) mm and a consolidation period of 116.92 (14.35) days. The patients were followed up for six months. A polysomnography test (PSG) was done to quantify AHI and a low-dose computed tomographic scan was done to calculate airway volume using Dolphin medical imaging software pre and post-DO. The QoL of the patients was calculated using the OSA-18 questionnaire. Results analysis depicted that the mean (SD) preoperative AHI was 51.44 (37.99)/h which was improved to 9.57 (9.74)/h (p = 0.001) after DO. Airway volume was calculated on Dolphin software before and after DO showed a significant improvement in airway volume by 121.12% (98.30)%. Similarly, the OSA-18 questionnaire showed significant improvement in QoL from severe to normal. This study suggested that DO increases the corpus length of the mandible, leading to an increment in airway volume, which improves the QoL.

Dental caries, tobacco usage and associated risk factor of dental caries in patients visiting a government hospital in Western, Nepal.

BACKGROUND: This study was conducted to assess the prevalence of dental caries, tobacco usage, and associated risk factors for dental caries in patients who visited a government hospital in Western, Nepal. METHODS: This analytical cross-sectional study was conducted from January to April 2022. Patients above 18 years visiting the dental OPD of a government hospital, and who had provided informed consent were enrolled in the study using a convenience sampling technique. As the study also involved an illiterate population, in that case, informed consent was obtained from their respective legal guardian as well. A pretested standardized, close-ended questionnaire was administered by researchers to gather information regarding the associated risk factors and oral hygiene practices. Clinical examination was done for dental caries according to the criteria by the World Health Organization (WHO) using the "DMFT" index (WHO modification 1987). Bivariate and multivariable logistic regression was done and the odds ratio and p-value was calculated. For all tests, statistical significance was set at p < 0.05. RESULTS: A total of 219 participants completed the study with a mean age of 31.73 ± 12.46. The prevalence of dental caries and tobacco was found to be 80.36% and 5.02% respectively. Participants without health insurance had 2.35 times higher odds of dental caries (95% CI: 1.03-5.36). Not rinsing the mouth after eating sweets was associated with 3.07 times higher odds of dental caries (95% CI: 1.31-7.18). Those who hadn't visited a dentist in the past 12 months had lower odds (0.42; 95% CI: 0.18-0.94). Eating fresh fruit daily showed statistically higher odds (2.70; 95% CI: 1.04-6.99) of dental caries. Non-tobacco users had higher odds (14.19; 2.55-78.99) of dental caries. CONCLUSION: Dental caries is highly prevalent, while tobacco usage is relatively low. Factors associated with dental caries included lack of health insurance coverage, consumption of fruits once daily, recent dental visits within the past year, not rinsing the mouth with water after consuming sweets, and non-tobacco users.

Evaluation of scientific quality of YouTube video content related to orthodontic pain management.

INTRODUCTION: With the abundant use of the internet, patients undergoing or interested in orthodontic treatment try to use it to obtain information on pain during treatment. However, YouTube™ is unregulated and may potentially contain inaccurate information. OBJECTIVES: Thus, this study aimed to evaluate the scientific quality of the videos on YouTube™ related to orthodontic pain management. METHODS: A total of 62 videos related to orthodontic pain management were included in the study. All videos were evaluated by two experienced orthodontists. The video uploader, content, length, upload date, time since upload, number of views, comments, likes, dislikes, Interaction index, and Viewing rate of the videos were recorded and evaluated. The videos were scored using the Quality Criteria for Consumer Health Information (DISCERN), Global Quality Scale (GQS), and Audio-Visual Quality (AVQ), and divided into two groups: Doctors and Non-doctors. RESULTS: The mean DISCERN score was 2.56 ± 0.91, the GQS score was 2.56 ± 1.06, and AVQ was 2.48 ± 0.68. A statistically significant difference was found in DISCERN score of videos uploaded by Doctors compared to Non-doctors, but no statistically significant difference was found in GQS and AVQ scores between both groups (p> 0.05). CONCLUSIONS: The videos uploaded by Doctors were better in terms of quality and reliability, as compared to Non-doctors; and the AVQ of the videos uploaded by both groups was adequate. Despite that, both groups did not serve as a good source of information. YouTube™ cannot be considered a reliable source of information in terms of quality and reliability on videos related to orthodontic pain management.

Evaluation of scientific quality of YouTube video content related to orthodontic pain management

ABSTRACT Introduction: With the abundant use of the internet, patients undergoing or interested in orthodontic treatment try to use it to obtain information on pain during treatment. However, YouTube™ is unregulated and may potentially contain inaccurate information. Objectives: Thus, this study aimed to evaluate the scientific quality of the videos on YouTube™ related to orthodontic pain management. Methods: A total of 62 videos related to orthodontic pain management were included in the study. All videos were evaluated by two experienced orthodontists. The video uploader, content, length, upload date, time since upload, number of views, comments, likes, dislikes, Interaction index, and Viewing rate of the videos were recorded and evaluated. The videos were scored using the Quality Criteria for Consumer Health Information (DISCERN), Global Quality Scale (GQS), and Audio-Visual Quality (AVQ), and divided into two groups: Doctors and Non-doctors. Results: The mean DISCERN score was 2.56 ± 0.91, the GQS score was 2.56 ± 1.06, and AVQ was 2.48 ± 0.68. A statistically significant difference was found in DISCERN score of videos uploaded by Doctors compared to Non-doctors, but no statistically significant difference was found in GQS and AVQ scores between both groups (p> 0.05). Conclusions: The videos uploaded by Doctors were better in terms of quality and reliability, as compared to Non-doctors; and the AVQ of the videos uploaded by both groups was adequate. Despite that, both groups did not serve as a good source of information. YouTube™ cannot be considered a reliable source of information in terms of quality and reliability on videos related to orthodontic pain management.

RESUMO Introdução: Com o uso abundante da Internet, os pacientes em tratamento ortodôntico, ou interessados em fazê-lo, tentam usá-la para obter informações sobre a dor durante o tratamento. Entretanto, o YouTube™ não é regulamentado e pode conter informações imprecisas. Objetivos: Esse estudo teve como objetivo avaliar a qualidade científica de vídeos no YouTube™ relacionados ao controle da dor ortodôntica. Métodos: No total, 62 vídeos relacionados ao controle da dor ortodôntica fora incluídos nesse estudo. Todos os vídeos foram avaliados por dois ortodontistas experientes. O responsável pela postagem do vídeo, seu conteúdo, sua duração, data de postagem, tempo decorrido desde a postagem, o número de visualizações, os comentários, os likes, os deslikes, o índice de interação e a taxa de visualização dos vídeos foram registrados e avaliados. Os vídeos foram pontuados usando os Critérios de Qualidade para Informações sobre Saúde do Consumidor (DISCERN), a Escala de Qualidade Global (GQS) e a Qualidade Audiovisual (AVQ), e divididos em dois grupos: Doutores e Não Doutores. Resultados: A pontuação DISCERN média foi de 2,56 ± 0,91, a pontuação GQS foi de 2,56 ± 1,06 e a AVQ foi de 2,48 ± 0,68. Foi encontrada uma diferença estatisticamente significativa na pontuação DISCERN dos vídeos postados por Doutores, em comparação com os Não Doutores, mas não foi encontrada diferença estatisticamente significativa nas pontuações GQS e AVQ entre os dois grupos (p> 0,05). Conclusões: Os vídeos postados pelos Doutores foram melhores em termos de qualidade e confiabilidade, em comparação com os Não Doutores, e o AVQ dos vídeos postados por ambos os grupos foi adequado. Apesar disso, ambos os grupos não serviram como uma boa fonte de informações. Em termos de qualidade e confiabilidade dos vídeos relativos ao manejo da dor ortodôntica, o YouTube™ não pode ser considerado uma fonte confiável de informações.

Does the Retromandibular Transparotid Approach Provide Quicker Access to Fracture of Mandibular Subcondyle Compared With the Retromandibular Transmasseteric Anterior Parotid Approach?

PURPOSE: Limited studies are available in the literature comparing various surgical approaches for the management of condylar fractures, and those comparing different types of retromandibular approaches are even fewer in number. This study aimed to compare the efficacy of 2 variants of the retromandibular approach-retromandibular transmasseteric anterior parotid (RMTMAP) and retromandibular transparotid (RMTP) in terms of exposure time, blood loss, facial nerve palsy, sialoceles or parotid fistula formation, infection, and esthetics of scar tissue. PATIENTS AND METHODS: A randomized controlled trial was designed in patients with mandibular subcondylar fractures requiring operative intervention. Patients were randomized into 2 groups based on a computer-generated randomization table. Group A included 37 cases, treated with the RMTMAP approach, and group B included 38 cases treated with the RMTP approach. The primary outcome variable was exposure time. Secondary outcome variables were blood loss during exposure, complications like facial nerve palsy, sialocele formation, surgical site infection, and scar esthetics. All patients were followed for 3 months. Collected data were analyzed using the χ2 and analysis of variance tests. RESULTS: The mean exposure time for fractures treated with the RMTMAP approach and RMTP approach was 21.08 ± 9.18 and 13.57 ± 6.09, respectively (P < .05). The mean blood loss for RMTMAP and RMTP approach was 11.75 ± 5.11 and 9.9 ± 3.77 mL, respectively (P = .078). No facial nerve injury was seen in patients treated with the RMTMAP approach, whereas 3 (7.8%) patients in the RMTP group had transient facial nerve injury (P = .08). CONCLUSIONS: This study concludes that the RMTP approach provides quicker access to the condyle as compared with the RMTMAP approach. However, the incidence of transient facial nerve injury was more in the RMTP approach. Except for reduced blood loss in the RMTP approach, all other parameters were comparable in both the approaches.