Continuous Monitoring of Changes in Heart Rate during the Periprocedural Course of Carotid Artery Stenting Using a Wearable Device: A Prospective Observational Study.

This prospective observational study will evaluate the change in heart rate (HR) during the periprocedural course of carotid artery stenting (CAS) via continuous monitoring using a wearable device. The participants were recruited from our outpatient clinic between April 2020 and March 2023. They were instructed to continuously wear the device from the last outpatient visit before admission to the first outpatient visit after discharge. The changes in HR of interest throughout the periprocedural course of CAS were assessed. In addition, the Bland-Altman analysis was adopted to compare the HR measurement made by the wearable device during CAS with that made by the electrocardiogram (ECG). A total of 12 patients who underwent CAS were included in the final analysis. The time-series analysis revealed that a percentage change in HR decrease occurred on day 1 following CAS and that the most significant HR decrease rate was 12.1% on day 4 following CAS. In comparing the measurements made by the wearable device and ECG, the Bland-Altman analysis revealed the accuracy of the wearable device with a bias of -1.12 beats per minute (bpm) and a precision of 3.16 bpm. Continuous HR monitoring using the wearable device indicated that the decrease in HR following CAS could persist much longer than previously reported, providing us with unique insights into the physiology of carotid sinus baroreceptors.

Considerations for the selection of interim restoration materials using wear test results.

PURPOSE: The purpose of this study was to examine the wear of resin materials using two-body wear tests and to verify a selection method for optimal interim restoration materials from findings of a diagnostic occlusal device. METHODS: Specimens were prepared from nine different resins used for diagnostic occlusal devices (soft resin) and interim restorations. Wear tests were conducted using an abrasion testing machine. The resulting wear on resin specimens and antagonist stainless-steel styluses was measured using a laser confocal scanning microscope, and the surface conditions were observed through a scanning electron microscope. The data were analyzed with one-way ANOVA and Tukey's multiple comparison test. The findings of the previous study on diagnostic occlusal devices were referred to in order to verify the selection method of optimal interim restoration materials. RESULTS: The maximum wear depth of the soft resin specimens was significantly greater than that of the other specimens (p<0.05) and was equivalent to the wear depth of a diagnostic occlusal device used for 14 nights. The wear of bis-acryl resin material was shallower than that of the other materials (Polymethyl methacrylate and polyethyl methacrylate), and its antagonist stylus was significantly worn (p<0.05). CONCLUSION: The findings of the previous and present studies showed a relationship among the parameters of Electromyography, wear depth of the diagnostic occlusal device, and wear of materials used for interim restorations. Findings related to bruxism can guide in the selection of interim restoration material and the determination of a suitable duration of wear.

Evaluation of sleep bruxism with a novel designed occlusal splint.

PURPOSE: This report presents our evaluation system that assesses sleep bruxism. The characteristics and fabrication process of our novel designed splint, and the analysis process of our system are presented. METHODS: The subjects were 17 volunteers. The splint was fabricated with a self-curing resin compounded with an amino-acid powder for easy wear on the semi-adjustable articulator, and adjusted for a full-balanced occlusion. An impression of the splint, located on the cast, was taken before and after it was worn. The analytical casts were made and scanned via a dental 3D scanner. The datasets were superimposed using two kinds of regions of interest (palate and occlusal surface). The differences between the two datasets were quantitatively presented with pseudo-color mapping. The maximum differences in coronal and apical directions were calculated on the selected area in the occlusal surface when the occlusal surface was used as a region of interest for registration. The relationship between the EMG activities and the change of occlusal surface of the splint were investigated. RESULTS: In all subjects, deformation and wear facets on the splint were observed. The differences in the apical direction, which indicate wear depth, were correlated with the maximum muscle activity during sleep (p=0.036). CONCLUSION: From our results, it is suggested that we are not able to eliminate the influence of parafunction for the prosthesis only by designing the surface of occlusal splint using the semi-adjustable articulator. Our splint may have the potential to detect specific facets due to parafunctions as nocturnal bruxism.

Computer assisted mandibular reconstruction using a custom-made titan mesh tray and removable denture based on the top-down treatment technique.

PURPOSE: The purpose of this report is to propose a computer assisted mandibular reconstruction procedure, utilizing a custom-made Ti-mesh tray with particulate cancellous bone and marrow, and a removable denture. This procedure was based on the top-down treatment technique, and reviews the case of a representative patient with mandibular continuity defect. METHODS: The patient was a 74-year old female with a chief complaint of facial asymmetry and masticatory dysfunction. Due to gingival carcinoma, she underwent a segmental mandibulectomy on the left mandibule. On the VR space, using 3-D reconstructed computer tomography data, the residual right-side mandibular fragment was repositioned based on the condylar position and the occlusal relation. The mandibular fragment was then mirrored for a central sagittal plane. The position of the mirrored object was slightly arranged with the occlusal relation. Through the above operations, the landmark configuration, for the custom-made Ti-mesh tray as a virtual simulation model, was fabricated. On the physical model, we produced a custom-made Ti-mesh tray with a commercial Ti-mesh sheet. Surgical treatment was carried out using the tray. The denture pattern was designed by a dental technician on the VR space, fabricated using a 3D printer, and modified to create an impression tray with resin. Using the impression, the temporary removable denture was fabricated. CONCLUSIONS: We propose a computer assisted design for a custom-made Ti-mesh tray and a removable denture, based on the Top-down treatment concept. We feel this technique is advantageous in reconstructing functional occlusion, and in accurately regaining dental and facial esthetics.