Comparison of three-dimensional printed resin crowns and preformed stainless steel crowns for primary molar restorations: a randomized controlled trial.

The importance of aesthetics in children has increased over time. Therefore, this multicenter randomized clinical trial aimed to analyze and compare three-dimensional (3D)-printed resin crowns (RCs) as a potential alternative to stainless-steel crowns (SSCs) for restoring primary molars with extensive carious lesions. According to the null hypothesis, no statistically significant difference was observed in restoration failure between RC and SSC groups. A total of 56 primary molars after pulp treatment at two dental hospitals were included. After pulp treatment, the teeth were randomly divided into two groups: SSCs (n = 28) and RCs (n = 28). At 1 week and 3, 6 and 12 months, the Quigley-Hein plaque index (QHI), gingival index (GI), occlusal wear, and survival rate were assessed by examination, radiography and alginate impressions. No significant difference in QHI was observed between the two groups. However, the GI at 12 months and occlusal wear in the RC group were significantly higher than those in the SSC group (p < 0.05). The survival rates were 100% in the SSC group and 82.1% in the RC group (p = 0.047). Cracks and discoloration were also observed in the RCs. Within the limitations of this study, 3D-printed RCs are aesthetically superior to SSCs and clinically easy to repair. However, if clinical effectiveness and safety are improved, RCs could potentially become a viable aesthetic alternative in the future.

Influence of limited mouth opening in children on intraoral scanning accuracy: An in vitro study.

BACKGROUND: Although intraoral scanning is highly reliable, little is known about its accuracy in young children with limited mouth-opening ability. AIM: To determine the accuracy of intraoral scans based on the degree of mouth opening. DESIGN: To simulate mouth opening in children with primary dentition, three groups (n = 5 per group) were allocated by maximum mouth opening of 30, 37 and 40 mm. After the primary dentition model was connected to a dental phantom, intraoral scanning was performed using iTero and TRIOS4. The scanned files were digitally evaluated. Root mean square values were calculated to assess trueness and precision. RESULTS: iTero showed deviations of three-dimensional trueness of 0.067 ± 0.008, 0.063 ± 0.001 and 0.065 ± 0.005 mm, and TRIOS4 of 0.07 ± 0.002, 0.064 ± 0.003 and 0.066 ± 0.002 mm in the 30, 37 and 40 mm groups, respectively. There were no significant differences in either mouth opening (p > .017) or the intraoral scanners (p > .05). The same statistical results were obtained for precision, with the exception of the 30 mm of mouth opening. CONCLUSIONS: Within the limits of this study, limited mouth opening hardly influenced the accuracy of intraoral scanning.

Effect of Topical Programmed Death-Ligand1 on Corneal Epithelium in Dry Eye Mouse.

Dry eye disease (DED) is a growing health concern that impacts millions of individuals every year, and is associated with corneal injury, excessive oxidative stress and inflammation. Current therapeutic strategies, including artificial tears and anti-inflammatory agents, are unable to achieve a permanent clinical cure due to their temporary nature or adverse side effects. Therefore, here, we investigated the effectiveness of the topical administration of programmed death-ligand 1 (PD-L1) in the mouse model of DED. The model was generated in C57BL/6 mice by excising the extra orbital lacrimal gland and causing desiccation stress with scopolamine injections. Subsequently, either phosphate-buffered saline (3 µL/eye) or PD-L1 (0.5 µg/mL) was topically administered for 10 days. Tear volume was evaluated with phenol red thread, and corneal fluorescein staining was observed to quantify the corneal epithelial defect. Corneas were collected for histological analysis, and the expression levels of inflammatory signaling proteins such as CD4, CD3e, IL-17, IL-1ß, pIkB-α, pNF-kB and pERK1/2 were assessed through immunofluorescence and Western blot techniques. Our results demonstrate that desiccating stress-induced corneal epithelial defect and tear secretion were significantly improved by topical PD-L1 and could reduce corneal CD4+ T cell infiltration, inflammation and apoptosis in a DED mouse model by downregulating IL-17 production and ERK1/2-NFkB pathways.

Effect of orodispersible hyaluronic acid film on palatal mucosa wound healing.

OBJECTIVE: The objective of the study was to evaluate the healing effect of hyaluronic acid films on palatal wounds. MATERIALS AND METHODS: After making 5-mm diameter palatal wounds, 72 rats were randomly assigned to three groups: control, hyaluronic acid gel, and hyaluronic acid film. The animals were sacrificed at 3, 7, and 21 days after the experiment. Clinical, histological, and RT-PCR analyses were performed. Human ex vivo oral mucosa models were used. Histological analysis and pan-cytokeratin staining were performed at 5 days after wound creation. RESULTS: In rat model, both gels and films showed favorable healing on Days 3 and 7 compared with healing in the control (p < 0.05). Film showed remarkable VEGF and α-SMA expression than did the others (p < 0.05). Immunohistochemical analysis showed that film exhibited significantly lower CD68 and greater α-SMA and vimentin expression levels than those in the others (p < 0.05). In human model, re-epithelialization rate of film group was significantly higher than that of the others. Complete epithelial regeneration was confirmed only in film group using pan-cytokeratin staining. CONCLUSIONS: Within the limits of this study, hyaluronic acid film outperformed gels in terms of palatal wound healing in both models.

Effect of intra-alveolar delivery of Frondoside A on inflammatory response of delayed tooth replantation.

BACKGROUND/AIM: Frondoside A is a sea cucumber extract which is well known for its anti-inflammatory and immunomodulatory properties. The purpose of this study was to evaluate the effect of Frondoside A application in the alveolar socket on inflammatory responses after delayed replantation in rat teeth. MATERIALS AND METHODS: Human periodontal ligament cells were cultured and exposed to Frondoside A. Cell-counting kit-8 assay was performed to evaluate the cell viability and nitric oxide assay was performed to assess the anti-inflammatory effect of Frondoside A. Molars were extracted from 32 Sprague-Dawley rats and randomly divided into control and Frondoside A groups. After 30 min of extra-oral dry time, molars were replanted. In the Frondoside A group, Frondoside A solution was applied in the alveolar socket before replantation. The animals were sacrificed after 28 days and histologically and immunohistochemically evaluated. RESULTS: 0.5 µM Frondoside A showed higher cellular viability at 6 h and lower production of nitric oxide compared with other Frondoside A solutions (p < .05). The Frondoside A group demonstrated lower inflammatory resorption scores in both middle 1/3 and apical 1/3 of root compared to the control group (p < .05). The Frondoside A group showed lower levels of expression in both cathepsin K and CD45 compared with the control group (p < .05). CONCLUSIONS: Within the limits of this study, intra-alveolar delivery of Frondoside A alleviates inflammatory root resorption in delayed replantation of rat teeth.

Three-dimensional analysis of the alveolar ridge profiles of maxillary central incisors in children for autotransplantation.

BACKGROUND: Sufficient alveolar housing is fundamental to ensure the favorable prognosis of autotransplanted teeth. However, little is known about the alveolar ridge profiles of the anterior maxilla in children. Therefore, this study aimed to investigate the alveolar ridge profiles of the anterior maxilla in growing children. METHODS: A total of 169 Korean children aged 10-13 years old were included in this retrospective study. Demographic data and cone-beam computed tomography scans of 244 maxillary central incisors were collected. For each tooth, the alveolar ridge thickness was determined at 1-, 3-, and 5-mm levels below the cemento-enamel junction. The alveolar process height and labial concavity were also evaluated. Statistical analyses were performed to evaluate differences according to age and sex. RESULTS: The alveolar ridge thickness did not differ according to age. The alveolar ridge thickness in males was significantly greater than that in females among those aged 10 and 11 years. The average alveolar process height was 17.43 ± 2.22 mm. The alveolar process height hardly changed with age from 10-13 years, whereas the alveolar process height of males was significantly greater compared with that of females among those aged 10 years. The labial concavity was approximately 150˚, with no significant differences between age and sex. CONCLUSIONS: Within the limits of this study, the anatomy of the alveolar ridge in the maxillary central incisors showed sufficient capacity as a recipient site for autotransplantation using mandibular premolars, especially in males. These findings serve as a valuable resource for facilitating autotransplantation in children.

Biocompatibility and Transplantation Efficacy of the C-Clear Artificial Cornea in a Rabbit Chemical Burn Model.

We investigated the bioavailability and stability of a C-Clear artificial cornea in a rabbit chemical burn model. Thirty-six rabbits were divided into a control group (n = 16) and a chemical burn group that used NaOH solution (n = 20). After lamellar dissection, the central posterior lamella was excised using a 3 mm diameter trephine, and an artificial cornea was transplanted into the lamellar pocket. After 2 weeks, the central anterior lamella was excised using a 3 mm diameter trephine to secure a clean visual axis. We examined the anterior segment of the eyes weekly for 12 weeks after transplantation. Successful subjects whose artificial corneas were maintained stably for 12 weeks were euthanized and underwent histologic examinations. Artificial corneas remained stable for up to 12 weeks in 62.5 and 50% of rabbits in the control and chemical burn groups, respectively. Two rabbits in the chemical burn group showed the formation of a retroprosthetic membrane, and one rabbit with visual axis blockage underwent membrane removal using a Nd:YAG laser. In histologic examinations, adhesion between artificial cornea and peripheral corneal stoma was observed. In conclusion, we confirmed structural stability and biocompatibility of the C-Clear artificial cornea for up to 12 weeks after implantation in control and chemical burn groups.

Short-term clinical outcomes after implantation of monofocal intraocular lens with enhanced intermediate function in eyes with epiretinal membrane.

Our study evaluated the clinical outcomes after implantation of a monofocal intraocular lens (IOL) with enhanced intermediate function in eyes with epiretinal membrane (ERM). Patients with preexisting ERM who underwent cataract surgery with implantation of monofocal IOL with enhanced intermediate function were included retrospectively. According to the ERM grade and central subfield thickness (CST) obtained from preoperative optical coherence tomography, patients were divided into non-fovea-involving and fovea-involving ERM groups. At 1 month after surgery, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), contrast sensitivity, defocus curve, and satisfaction questionnaire were evaluated. Postoperative clinical findings were compared with age-matched controls without ERM. A total of 50 patients' eyes (28 and 22 in the non-fovea-involving and fovea-involving ERM groups, respectively) were compared with 42 control eyes. One month post-surgery, significant differences in UDVA, CDVA, and CST (corrected P was < 0.001, = 0.001, and < 0.001, respectively) were observed between the fovea-involving ERM and control group; however, no significant differences in UIVA and UNVA were observed between the two groups. Contrast sensitivity showed inferior results in the fovea-involving group without significance. Photic phenomena were reported less in the fovea-involving group than in the non-fovea-involving group. More than 70% of patients in both ERM groups were satisfied. Implantation of monofocal IOL with enhanced intermediate function could be a good option for patients with ERM that need intermediate vision.

Biocompatibility and mineralization potential of new calcium silicate cements.

Background/purpose: As calcium silicate cements (CSCs) have been successfully used in various types of vital pulp therapy, many new CSC products have been developed. The aim of this study was to evaluate the biocompatibilities and mineralization potential of new CSC. The experimental materials were NeoMTA Plus and EndoSequence Root Repair Material-Fast Set Putty (ERRM-FS) which were compared to ProRoot MTA. Materials and methods: In vitro, the effects of the new CSC on stem cells were evaluated. Each CSC was prepared for cell viability testing, alkaline phosphatase (ALP) assay, and calcium ion release assay. In vivo, the exposed pulp model was used for the partial pulpotomy procedure. Thirty-six teeth were treated with three materials: ProRoot MTA, NeoMTA Plus, or ERRM-FS. After four weeks, the teeth were extracted and processed for histologic analysis. Dentin bridge formation, pulp inflammation, and odontoblastic cell layer were evaluated and the area of newly formed calcific barrier of each group was measured. Results: Three CSCs demonstrated similar cell viability on stem cells and the levels of ALP and calcium release were not significantly different between tested materials. ProRoot MTA and ERRM-FS showed better tissue healing process than NeoMTA Plus after partial pulpotomy, in terms of quality of calcific barrier and pulp inflammation. The outcomes from measuring newly formed calcific area demonstrated no significant differences between the materials. Conclusion: NeoMTA Plus and ERRM-FS displayed similar biocompatibilities and mineralization potential compared to ProRoot MTA. Therefore, these new CSCs can be used as desirable alternatives to ProRoot MTA.

Relationship between insomnia and working from home among Korean domestic workers: results from the 5th Korean working condition survey.

BACKGROUND: Social distancing has been increasingly implemented following the COVID-19 pandemic and more people have been working from home. Consequently, the screen time has increased, which can disrupt the natural sleep-wake cycle and delay sleep onset. Given that studies on the health of employees who work from home remain insufficient, particularly with respect to the risk of sleep disorders including insomnia, this study aimed to assess the relationship between working from home and insomnia among workers using data from the 5th Working Conditions Survey conducted in Korea. METHODS: Of 30,108 wage workers, we enrolled 818 employees who worked from home and 4,090 employees who worked from the office, a 1:5 pair sample based on sex and occupational group. Personal and occupational characteristics, working from home, and insomnia were included in the analysis. Age, education, employment status, working years, working hours per week, work-life balance, self-perceived health, depression, and anxiety were all adjusted as potential confounding variables. Conditional logistic regression analysis was performed using working from home as an independent variable and insomnia as a dependent variable to determine the correlation between working from home and insomnia. RESULTS: Working from home was associated with sleep onset latency disorder, OR = 3.23 (95% CI: 2.67-3.91), sleep maintenance disorder, OR = 3.67 (95% CI: 3.02-4.45), and non-restorative sleep, OR = 3.01 (95% CI: 2.46-3.67); working from home had a statistically significant relationship with all three types of insomnia. CONCLUSIONS: Within the limits of the study, these findings can be used as a fundamental basis for the implementation of policies and guidelines to prevent insomnia in workers who work from home.

Bisphenol A release from commercially available 3-dimensionally printed resins and human cell apoptosis to bisphenol A: an in-vitro study.

Bisphenol A (BPA) from dental materials may be linked to children's health issues. This study aimed to assess the release of BPA from commercially available 3-dimensional (3D)-printed resin materials and evaluate BPA-related apoptotic effects on human periodontal ligament cells and gingival fibroblasts. Commercially available 3D-printed resin materials for prosthodontic use were selected as follows: NextDent C&B MFH (3D Systems, Rock Hill, SC, USA), DIOnavi-P. MAX (Dio Co., Busan, Korea), and DIOnavi-Denture02 (Dio Co., Busan, Korea). Identical cuboidal samples (1 cm × 1 cm × 0.5 cm) were printed from the materials and cured. BPA release was assessed using liquid chromatography/mass spectrometry (LC/MS). In addition, human gingival fibroblasts and periodontal ligament cells were exposed to various BPA solutions based on the LC/MS results. Cell Counting kit-8 (CCK-8) and real-time polymerase chain reaction analyses were performed to evaluate BPA-related apoptotic effects. The LC/MS analysis confirmed that none of the 3D-printed resin materials released BPA after curing. Both human gingival fibroblasts and periodontal ligament cells showed lower viability after BPA exposure. Regarding apoptosis-related gene expression, Caspase10 (CASP10) expression in periodontal ligament cells was significantly different in the BPA solutions (p < 0.05). The expression of BAX and Capspase8 (CASP8) in gingival fibroblasts was significantly increased by BPA in a dose-dependent manner (p < 0.05). Within the limitations of this study, the 3D-printed resin materials were not found to release BPA. This finding implies that 3D-printed resin materials are not associated with potential BPA-related risks in children.

Oral characteristics and dietary habits of preterm children: A retrospective study using National Health Screening Program for Infants and Children.

The rate of preterm birth is increasing worldwide and preterm infants are susceptible to oral health problems. Hence, this study aimed to investigate the effect of premature birth on dietary and oral characteristics as well as dental treatment experiences of preterm infants using a nationwide cohort study. Data was retrospectively analyzed from National Health Screening Program for Infants and Children (NHSIC) of the National Health Insurance Service of Korea. 5% sample of children born between 2008 and 2012 who completed first or second infant health screening were included and divided into full-term and preterm-birth groups. Clinical data variables such as dietary habits, oral characteristics, and dental treatment experiences were investigated and comparatively analyzed. Preterm infants showed significantly lower rates of breastfeeding at 4-6 months (p<0.001), delayed start of weaning food at 9-12 months (p<0.001), higher rates of bottle feeding at 18-24 months (p<0.001), poor appetite at 30-36 months (p<0.001) and higher rates of improper swallowing and chewing function at 42-53 months (p = 0.023) than full-term infants. Preterm infants also had eating habits leading to poor oral conditions and higher percentage of absence of dental visit compared to full-term infants (p = 0.036). However, dental treatments including 1-visit pulpectomy (p = 0.007) and 2-visit pulpectomy (p = 0.042) significantly decreased when oral health screening was completed at least once. The NHSIC can be an effective policy for oral health management in preterm infants.

Scleral Lens Applications Focused on Korean Patients with Various Corneal Disorders.

PURPOSE: We aimed to report on the clinical outcomes of scleral lens applications in Korean patients with various corneal disorders. METHODS: This retrospective review was conducted for 62 eyes of 47 patients who had been fitted with scleral lenses for various corneal disorders. The patients were referred for inadequate spectacle-corrected visual acuity and rigid gas permeable (RGP) or soft contact lens intolerance. Uncorrected visual acuity, habitually corrected visual acuity, best lens-corrected visual acuity, topographic indices, keratometry indices, and lens parameters were evaluated. RESULTS: Twenty-six eyes of 19 patients with keratoconus were enrolled. Other conditions included corneal scar (13 eyes of 12 patients), phlyctenules (three eyes), laceration (four eyes), chemical burn (one eye), keratitis (one eye), Peters' anomaly (one eye), fibrous dysplasia (one eye), ocular graft-versus-host disease (two eyes of one patient), irregular astigmatism (18 eyes of 12 patients), and corneal transplant status (five eyes of four patients). The mean topographic values of the eyes include flat keratometric value (43.0 ± 6.1 diopters [D]), steep keratometric value (48.0 ± 7.4 D), and astigmatism (4.9 ± 3.6 D). Of the eyes fitted with scleral lenses, best lens-corrected visual acuity (0.10 ± 0.22 logarithm of the minimum angle of resolution [logMAR]) was significantly better than the habitually corrected visual acuity (0.59 ± 0.62 logMAR, p < 0.001). CONCLUSIONS: Scleral contact lenses are a good alternative for patients with corneal abnormalities and those who are intolerable to RGP contact lenses, resulting in both successful visual outcomes and patient satisfaction, especially concerning keratoconus, corneal scar, and corneal transplant status.

Differentiating Multiple Myeloma and Osteolytic Bone Metastases on Contrast-Enhanced Computed Tomography Scans: The Feasibility of Radiomics Analysis.

Osteolytic lesions can be seen in both multiple myeloma (MM), and osteolytic bone metastasis on computed tomography (CT) scans. We sought to assess the feasibility of a CT-based radiomics model to distinguish MM from metastasis. This study retrospectively included patients with pre-treatment thoracic or abdominal contrast-enhanced CT from institution 1 (training set: 175 patients with 425 lesions) and institution 2 (external test set: 50 patients with 85 lesions). After segmenting osteolytic lesions on CT images, 1218 radiomics features were extracted. A random forest (RF) classifier was used to build the radiomics model with 10-fold cross-validation. Three radiologists distinguished MM from metastasis using a five-point scale, both with and without the assistance of RF model results. Diagnostic performance was evaluated using the area under the curve (AUC). The AUC of the RF model was 0.807 and 0.762 for the training and test set, respectively. The AUC of the RF model and the radiologists (0.653-0.778) was not significantly different for the test set (p ≥ 0.179). The AUC of all radiologists was significantly increased (0.833-0.900) when they were assisted by RF model results (p < 0.001). In conclusion, the CT-based radiomics model can differentiate MM from osteolytic bone metastasis and improve radiologists' diagnostic performance.

Evaluation of delphinidin as a storage medium for avulsed teeth.

BACKGROUND: Delphinidin (DP), an anthocyanidin found in blueberries, has antioxidant and anti-inflammatory effects. This study aimed to investigate the efficacy of DP as a storage medium for avulsed teeth. METHODS: Human periodontal ligament cells were cultured and exposed to DP solution (10, 50, and 100 µM), Dulbecco's modified Eagle's medium, Hank's balanced salt solution and tap water. Cell counting kit-8 assays were performed after 0.5, 1, 6, and 24 h to measure the cell viability. Nitric oxide assays and gelatin zymography were performed to evaluate the anti-inflammatory effects of DP. Reverse transcription-polymerase chain reaction was used to determine the expression levels of inflammatory cytokines. RESULTS: The viability of periodontal ligament cells was greatest at 100 µM DP. At 1 h, 100 µM DP decreased nitric oxide synthesis (p < .0167). Matrix metallopeptidase-9 activity was inhibited by DP in a dose-dependent manner (p < .0167). Moreover, treatment with 100 µM DP decreased the expression levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-8 in periodontal ligament cells (p < .0167). CONCLUSIONS: Within the limits of this study, DP preserved the viability and suppressed the inflammatory response of periodontal ligament cells. These findings suggest that DP could be promising for preservation of avulsed teeth.

Determination of the range of intervention timing for supernumerary teeth using the Korean health insurance review and assessment service database.

This study aimed to identify the frequency of complications during the diagnosis, observation, and treatment of supernumerary teeth or odontomas and evaluate the relationship between complications and the timing of surgical intervention. This study was conducted based on data from the Korea Health Insurance Review and Assessment Service between January 2008 and December 2019. A 2-year washout period was applied, and a follow-up period of at least 2 years was also included. During the observation period, the age at diagnosis of supernumerary teeth and odontomas was analyzed using major diagnostic codes, and the treatment codes were used to determine the interval between diagnosis and surgical intervention. The incidence rates of supernumerary teeth (1.21%) and odontomas (0.36%) were comparable to that reported in previous studies. The frequency of supernumerary teeth was the highest in the anterior region, followed by the premolar and molar regions. The average ages at diagnosis according to the location of the supernumerary teeth were 7.25, 13.98, and 16.11 years in the anterior, premolar, and molar regions, respectively. The age at diagnosis correlated with the maturity period of the teeth at the corresponding location. For the supernumerary tooth group, surgical intervention was more likely to occur when malocclusion (p < 0.0001) or tooth eruption disturbances (p < 0.0001) were present or dentigerous cysts were absent (p = 0.006). For the odontoma group, malocclusion (p = 0.251) was not correlated with surgical intervention. When tooth eruption disturbances (p = 0.002) and dentigerous cysts (p < 0.0001) were present, surgical intervention was more likely to occur. Pediatric dentists should conduct timely clinical checks and periodic follow-ups to prevent complications and unnecessary orthodontic treatments in patients with supernumerary teeth or odontomas.

Comparative gene expression analysis of stemness between periodontal ligament and umbilical cord tissues in humans.

Background/purpose: Due to their regenerative potential, periodontal ligament (PDL) and umbilical cord (UBC) tissues are an attractive potential mesenchymal stem cells (MSCs) source. This study compared the expression patterns of genes related to stemness between fresh PDL and UBC tissues. Materials and methods: PDL tissues were collected from 38 permanent premolars extracted for orthodontic purposes, and UBC tissues were obtained from three newborns. Each sample was immediately frozen to prevent RNA degradation. cDNA microarray analysis, quantitative real-time polymerase chain reaction (PCR), and immunohistochemical staining were performed. Gene expression patterns associated with dental stemness (DS) and induced pluripotent stemness (iPS) were compared between PDL and UBC tissues. Results: In the cDNA microarray analyses, the expressions of most iPS genes were greater in the PDL than in the UBC. Meanwhile, the expressions of most DS genes were greater in the UBC than in the PDL. Quantitative real-time PCR analyses showed that the expression levels of matrix metallopeptidase 13 (MMP13), ADAM metallopeptidase domain 22 (ADAM22), vascular cell adhesion protein 1 (VCAM1), and kruppel-like factor 4 (KLF4) genes were greater in the PDL than in the UBC, while the expressions of melanoma cell adhesion molecule (MCAM) and activated leukocyte cell adhesion molecule (ALCAM) were greater in the UBC than in the PDL. Conclusion: These results suggest that UBC and PDL tissues showed slightly different expression patterns of genes related to stemness, which warrants further investigation to use these tissues for future regeneration and implantation therapies.

Patients Report Infrequent Counseling by Physicians and Inadequate Knowledge about Inflammatory Bowel Disease and Reproductive Health Issues.

OBJECTIVE: Inflammatory bowel disease (IBD) reproductive health counseling is associated with higher knowledge, lower voluntary childlessness, greater medication adherence during pregnancy, and improved outcomes of pregnancy. Our aims were to assess counseling and knowledge about IBD and reproductive health in a tertiary care IBD patient population. STUDY DESIGN: We anonymously surveyed women and men ages 18 to 45 cared for at the Stanford IBD clinic about reproductive health and administered the CCPKnow questionnaire. STATA was used to summarize descriptive statistics and compare categorical variables using Fisher's exact test. RESULTS: Of the 100 patients (54% women) who completed the survey, only 33% reported prior reproductive health counseling. Both men and women considered not having a child due to IBD (31% women, 15% men) and most (83%) had no prior counseling. A minority of patients had an adequate (≥8/17) CCPKnow score (45% women, 17% men). The majority of women with prior pregnancy had pre-existing IBD (67%), yet many did not seek gastrointestinal (GI) care (38% preconception, 25% during pregnancy) and 33% stopped/changed medications, with 40% not discussing this with a physician. Prior counseling was significantly associated with education level (p = 0.013), biologic use (p = 0.003), and an adequate CCPKnow score (p = 0.01). Overall, 67% of people wanted more information on IBD and reproductive health. CONCLUSION: In an educated tertiary care cohort, the majority of patients had low CCPKnow scores and rates of IBD reproductive health counseling. Many patients with IBD prior to pregnancy reported no GI care preconception or during pregnancy and stopped/changed medications without consulting a physician. There is an urgent need for proactive counseling by gastroenterologists and obstetricians on IBD and reproductive health. KEY POINTS: · There is inadequate reproductive health counseling in IBD.. · Many IBD patients do not seek prenatal/perinatal GI care.. · Patients change medications without consultation.. · GIs and OBs should proactively counsel IBD patients..

Bilateral Multiple Retinal Detachments Associated with Diffuse Large B-Cell Lymphoma: Masquerading as Vogt-Koyanagi-Harada Disease.

PURPOSE: We report a case of intraocular involvement in diffuse large B-cell lymphoma masquerading as Vogt-Koyanagi-Harada disease. METHODS: A 48-year-old woman presented with blurred vision in both eyes, fever, and hearing disturbance and underwent a complete ophthalmologic and systemic evaluation. RESULTS: Ophthalmologic examination showed bilateral exudative retinal detachment and signs of Vogt-Koyanagi-Harada disease. However, considering her generalized symptoms, systemic evaluation was performed before administering systemic steroid pulse therapy. In a systemic investigation, the patient was diagnosed with intraocular involvement in diffuse large B-cell lymphoma. After systemic chemotherapy, her bilateral visual acuity improved to 20/25 and the bilateral serous retinal detachment resolved. CONCLUSION: In cases with prominent systemic symptoms, comprehensive systemic evaluation should be performed to rule out severe systemic conditions, such as malignancies.

Stress distribution in pediatric zirconia crowns depending on different tooth preparation and cement type: a finite element analysis.

BACKGROUND: In clinical settings, tooth preparation for prefabricated zirconia crowns (PZCs) in the primary dentition varies widely. However, knowledge about the biomechanical behavior of PZCs in various clinical settings is limited. This study was conducted to evaluate the biomechanical behavior of PZCs in different clinical settings using 3-dimensional finite element analysis. METHODS: 3-dimensional models of the PZC, cement, and tooth with six different conditions were simulated in primary molar teeth, incorporating cement thickness (100, 500, and 1000 µm) and cement type (resin-modified glass ionomer cement and resin cement). A total of 200 N of occlusal force was applied to the models, both vertically and obliquely as representative cases. A general linear model univariate analysis with partial eta-squared (ηp2) was performed to evaluate the relative effects of the variables. RESULTS: The overall stress of tooth was increased as the cement space increases under oblique loading. The von Mises stress values of the resin cements were significantly higher than those of the resin-modified glass ionomer cements for all cement thicknesses (p < .05). The effect size of the cement type (ηp2 = .519) was more dominant than the cement thickness (ηp2 = .132) in the cement layer. CONCLUSIONS: Within the limits of this study, cement type has a greater influence on the biomechanical behavior of PZCs than cement thickness.