Immunological link between periodontitis and type 2 diabetes deciphered by single-cell RNA analysis.

BACKGROUND: Type 2 diabetes mellitus (DM) is a complex metabolic disorder that causes various complications, including periodontitis (PD). Although a bidirectional relationship has been reported between DM and PD, their immunological relationship remains poorly understood. Therefore, this study aimed to compare the immune response in patients with PD alone and in those with both PD and DM (PDDM) to expand our knowledge of the complicated connection between PD and DM. METHODS: Peripheral blood mononuclear cells were collected from 11 healthy controls, 10 patients with PD without DM, and six patients with PDDM, followed by analysis using single-cell RNA sequencing. The differences among groups were then compared based on intracellular and intercellular perspectives. RESULTS: Compared to the healthy state, classical monocytes exhibited the highest degree of transcriptional change, with elevated levels of pro-inflammatory cytokines in both PD and PDDM. DM diminished the effector function of CD8+ T and natural killer (NK) cells as well as completely modified the differentiation direction of these cells. Interestingly, a prominent pathway, RESISTIN, which is known to increase insulin resistance and susceptibility to diabetes, was found to be activated under both PD and PDDM conditions. In particular, CAP1+ classical monocytes from patients with PD and PDDM showed elevated nuclear factor kappa B-inducing kinase activity. CONCLUSIONS: Overall, this study elucidates how the presence of DM contributes to the deterioration of T/NK cell immunity and the immunological basis connecting PD to DM.

Experimental animal models for development of human enterovirus vaccine.

Enterovirus infections induce infectious diseases in young children, such as hand, foot, and mouth disease which is characterized by highly contagious rashes or blisters around the hands, feet, buttocks, and mouth. This predominantly arises from enterovirus A71 or coxsackievirus A16 infections and in severe cases, they can lead to encephalitis, paralysis, pulmonary edema, or even fatality, representing a global health threat. Due to the absence of effective therapeutic strategies for these infections, various experimental animal models are being investigated for the development of vaccines. During the early stages of research on enterovirus infections, non-human primate infections exhibited symptoms like those in humans, leading to their utilization as model animals. However, due to economic and ethical considerations, their current usage is limited. While enterovirus infections do not readily occur in mice, an infection model with mouse-adapted strain in neonatal mice has been employed. Cellular receptors have been identified in human cells, and genetically modified mice expressing these receptors have been used. Most recently, the utilization of Mongolian gerbil model is actively being considered and should be pursued for further animal model development. So, herein, we provide a summarized overview of the current portfolio of available enterovirus infection models, emphasizing their respective advantages and limitations.

Differential microbiota network in gingival tissues between periodontitis and periodontitis with diabetes.

Periodontitis and diabetes mellitus (DM) have a bidirectional relationship. Periodontitis is initiated by dysbiosis of oral microorganisms, and in particular, the characteristics of the microorganisms that have penetrated the tissue are directly related to the disease; therefore, we investigated the effect of DM on intragingival microbial profiling of patients with periodontitis. A total of 39 subjects were recruited and divided into three groups in this case control study as follows: healthy (NA, 10), periodontitis only (PD, 18), and periodontitis with DM (PD_DM, 11). Gingival tissue was collected, DNA was extracted, and whole-genome sequencing was performed. PD and PD_DM showed different characteristics from NA in diversity and composition of the microbial community; however, no difference was found between the PD nad PD_DM. PD_DM showed discriminatory characteristics for PD in the network analysis. PD showed a network structure in which six species were connected, including three red complex species, and PD_DM's network was more closely connected and expanded, with six additional species added to the PD network. Although DM did not significantly affect α- and ß-diversity or abundance of phyla and genera of microbiota that invaded the gingival tissue of patients with periodontitis, DM will affect the progression of periodontitis by strengthening the bacterial network in the gingival tissue.

Neural network ensemble model for prediction of erythrocyte sedimentation rate (ESR) using partial least squares regression.

The erythrocyte sedimentation rate (ESR) is a non-specific blood test for determining inflammatory conditions. However, the long measurement time (60 min) to obtain ESR is an obstacle for a prompt evaluation. In this study, to reduce the measurement time of ESR, deep neural networks (DNNs) were applied to the sedimentation tendency of blood samples. DNNs using multilayer perceptron (MLP), long short-term memory (LSTM), and gated recurrent unit (GRU) were assessed and compared to determine a suitable length of time for the input sequence. To avoid overfitting, a stacking ensemble learning was adopted, which combines multiple models by using a meta model. Four meta models were compared: mean, median, least absolute shrinkage and selection operator, and partial least squares regression (PLSR) schemes. From the empirical results, LSTM and GRU models have better prediction than MLP over sequence lengths of 5 to 20 min. The decrease in [Formula: see text] and [Formula: see text] of GRU and LSTM was attenuated after a sequence length of 15 min, so the input sequence length is determined as 15 min. In terms of the meta model, the statistical comparison suggests that GRU combined with PLSR (GRU-PLSR) is the best case. Then, the GRU-PLSR was tested for prediction of ESR data obtained from periodontitis patients to check its applicability to a specific disease. The Bland-Altman plot shows acceptable agreement between measured and predicted ESR values. Based on the results, the GRU-PLSR can predict ESR with improved performance within 15 min and has potential applicability to ESR data with inflammatory and non-inflammatory conditions.

Emerging Japanese Encephalitis Virus Genotype V in Republic of Korea.

Japanese encephalitis (JE) is a vaccine-preventable mosquito-borne disease caused by infection with the Japanese encephalitis virus (JEV). JEV has five genotypes, including genotype V (GV), which is considered ancestral to the other genotypes. The first GV strain, GV Muar, was isolated from a Malayan patient in 1952 and GV did not reappear for 57 years until GV XZ0934 was isolated from a mosquito sample in China. Since 2010, 21 GV strains have been identified in Republic of Korea (ROK). Both GV Muar and GV XZ0934 are more pathogenic than other GI/GIII strains and are serologically distinct. However, because the ROK's GV strains have not been experimentally tested, their characteristics are not known. Characterization of the ROK's isolates is needed to enable development of effective GV strain-based vaccines to protect against GV infections.

Quantitative study for control of air-liquid segmented flow in a 3D-printed chip using a vacuum-driven system.

The formation of droplets or bubbles in a microfluidic system is a significant topic requiring device miniaturization and a small volume of samples. Especially, a two-phase segmented flow can be applied to micro-mixing for chemical reactions and the treatment of heat and mass transfer. In this study, a flow of liquid slugs and bubbles was generated in a 3D-printed chip and controlled by a single pump creating a vacuum at the outlet. The pump and chip device were integrated to form a simple and portable system. The size and flow rate of liquid slugs, obtained through image processing techniques, were analyzed considering several parameters related to hydraulic resistance and pressure drop. In addition, the effect of segmentation on mixing was observed by measuring the intensity change using two different colored inks. The hydraulic resistance of air and liquid flows can be controlled by changing the tube length of air flow and the viscosity of liquid flow. Because the total pressure drop along the channel was produced using a single pump at the outlet of the channel, the size and flow rate of the liquid slugs showed a near linear relation depending on the hydraulic resistances. In contrast, as the total pressure varied with the flow rate of the pump, the size of the liquid slugs showed a nonlinear trend. This indicates that the frequency of the liquid slug formation induced by the squeezed bubble may be affected by several forces during the development of the liquid slugs and bubbles. In addition, each volume of liquid slug segmented by the air is within the range of 10-1 to 2 µL for this microfluidic system. The segmentation contributes to mixing efficiency based on the increased homogeneity factor of liquid. This study provides a new insight to better understand the liquid slug or droplet formation and predict the segmented flow based on the relationship between the resistance, flow rate, and pressure drop.

Is it worth applying self-irrigation after third molar extraction? A randomised controlled trial.

In this study, we aimed to examine the effectiveness of self-irrigation following the extraction of mandibular third molars. A randomised controlled clinical trial was conducted with 155 patients who had undergone extraction of a mandibular third molar. The irrigation group was instructed to self-irrigate the extraction socket with tap water using a syringe three times a day, starting seven days after the tooth extraction. The incidence of complications and mouth opening, halitosis, plaque/gingival index, and oral health-related quality of life (OHRQoL) were measured. The irrigation group showed a lower incidence of complications than the non-irrigation group. The halitosis, plaque, and gingival scores were lower by mean (SD) 19.66 (5.19), 0.58 (0.06), and 0.62 (0.08), respectively, in the irrigation group than in the non-irrigation group (p = 0.0001). A greater amount of food packing was associated with higher halitosis, plaque, and gingival scores and poorer OHRQoL (p < 0.05). Further, more frequent irrigation was associated with lower halitosis, plaque, and gingival scores and better OHRQoL (p ≤ 0.016). Self-irrigation of the extraction socket using a syringe containing tap water is a very effective method for keeping the extraction socket clean. This technique reduced halitosis, improved plaque and gingival indices, and increased OHRQoL.

Correlation between Electrodiagnostic Study and Imaging Features in Patients with Suspected Carpal Tunnel Syndrome.

Electrodiagnostic studies (EDXs) are the confirmative diagnostic tool for carpal tunnel syndrome (CTS). Previous studies have evaluated the relationship between EDXs and ultrasonography (US) but not with X-rays. Recently, many studies on the diagnostic value of X-rays in various diseases have been reported, but data on CTS are lacking. We evaluated the relationship between electrodiagnostic parameters and roentgenographic and ultrasonographic features in CTS and investigated the usefulness of X-rays and US for CTS. This retrospective study included 97 wrists of 62 patients. All patients with suspected CTS underwent EDXs, wrist US, and wrist X-rays. The CTS patients were classified into mild, moderate, and severe groups. The roentgenographic features included the ulnar variance (UV) and the anteroposterior diameter of the wrist (APDW), and the ultrasonographic features included the flattening ratio (FR) and the thickest anteroposterior diameter of the median nerve (TAPDM). Most EDX parameters showed significant correlations with roentgenographic and US features. The electrodiagnostic severity was also correlated with all imaging features. Therefore, both wrist X-rays and wrist US can be useful for the diagnosis of CTS as supplements to EDXs.

Optimal application of compressive palatal stents following mesiodens removal in pediatric patients: A Randomized Controlled Trial / Aplicación óptima de stents palatinos de compresión después de la extracción del mesiodens en pacientes pediátricos: un ensayo controlado aleatorio

Background: There is no scientific evidence supporting the choice of a palatal stent in patients who underwentremoval of an impacted supernumerary tooth. We aimed to investigate the effects of palatal stents in patients whounderwent supernumerary tooth removal through a palatal approach and to suggest the optimal stent thicknessand material.Material and Methods: We recruited 144 patients who underwent extraction of a supernumerary tooth between themaxillary anterior teeth. Subjects were assigned to a control group (CG) or one of four compressive palatal stentgroups (CPSGs) classified by the thickness and material of the thermoplastic acrylic stent used. Palatal gingivalswelling and objective indices (healing, oral hygiene, gingival, and plaque) were evaluated before surgery and onpostoperative days (PODs) 3, 7, and 14; pain/discomfort and the Child Oral Health Impact Profile (COHIP) wereassessed as subjective indices of the effects of the stent.Results: The CPSGs showed faster healing than did the CG on PODs 7 (P<0.001) and 14 (P=0.043); swelling wasmeasured by 1.64±0.88 mm and 4.52±0.39 mm, respectively. Although swelling was least in the 4-mm hard group(0.92±0.33 mm), the difference compared with that in the 2-mm hard group (1.01±0.18 mm) was not significant(P=0.077). The CPSGs showed better COHIP (P<0.001-0.036) and pain scores (P<0.001) than did the CG onPODs 1-3. Conclusions: Compressive palatal stents reduce discomfort by decreasing pain and alleviating swelling. Althougha stent is effective regardless of its thickness and material, 2-mm hard stents maximized such positive effects withminimal discomfort.(AU)

Parenteral, non-live rotavirus vaccine: recent history and future perspective.

Since the widespread introduction of oral and live attenuated rotavirus vaccines around the world in 2009, the impacts of disease burden and the effects of disease reduction in developing countries have been proven. However, in low and middle-income countries, the vaccine efficacy is somewhat lower than in developed countries due to differences in nutritional conditions, microbial environments of individuals, and other factors. In addition, as oral, live vaccines have been found to be associated with rare but serious side effects, the development of a next-generation vaccine with safety, improved effectiveness, and ease of storage is currently underway. New vaccine strain developed by the Centers for Disease Control and Prevention in the United States are undergoing preclinical testing of efficacy, antigen dose, and administration route in the form of a heat-treated inactive vaccine, and a recombinant protein-based trivalent subunit vaccine developed by the Program for Appropriate Technology in Health is undergoing clinical trial in phase III. Several research groups are also developing non-replicating protein-based rotavirus vaccines using virus-like particles and nanoparticles. This review provides a brief overview of the development status and technology of parenteral, non-live rotavirus vaccines worldwide.

Evaluation of the antigenic stability of influenza virus like particles after exposure to acidic or basic pH.

PURPOSE: Virus-like particles (VLPs) are being developed as a promising vaccine platform and therapeutic delivery. Various strategies for effectively constructing VLPs have been studied, but relatively few studies have been done on various factors affecting storage. In this study, we investigated the antigenic changes of VLPs in an acidic or basic pH environment using influenza VLPs as an experimental model. MATERIALS AND METHODS: Influenza VLPs containing hemagglutination and M1 proteins were generated and their antigenicity and protective immunity in vitro and in vivo were evaluated after exposure to acidic (pH 4 and 5) or basic (pH 9 and 10) pH buffers. RESULTS: VLP exposed to basic pH showed similar levels of antigenicity to those stored in neutral pH, while antigenicity of VLP exposed to acidic pH was found to be significantly reduced compared to those expose neutral or basic pH. All groups of mice responded effectively to low concentrations of virus infections; however, VLP vaccine groups exposed to acid pH were found not to induce sufficient protective immune responses when a high concentration of influenza virus infection. CONCLUSION: In order for VLP to be used as a more powerful vaccine platform, it should be developed in a strategic way to respond well to external changes such as acidic pH conditions.

Hypomethylation of lncRNA H19 as a potential prognostic biomarker for oral squamous cell carcinoma.

OBJECTIVES: Dysregulated DNA methylation is common in cancers and is considered one of the most important triggers in cancer development and progression. The expression and promoter methylation status of long non-coding RNA (lncRNA) H19 play a key role in several cancers, but its role is unclear in oral cancer. The aim of this study was to evaluate the potential of lncRNA H19 as a prognostic biomarker for oral cancer. DESIGNS: The transcript levels and the methylation status of lncRNA H19 in OSCC cell lines and OSCC patient tissues were investigated by quantitative real-time RT-PCR (qRT-PCR) and methylation-specific PCR (MSP). Methylation ratio (%) were calculated from the intensity of the MSP in the gel image and Kaplan-Meier survival analysis of OSCC patient survival was performed for patients grouped according to the lncRNA H19 promoter methylation ratio. RESULTS: lncRNA H19 was highly expressed and its promoter region was hypomethylated in OSSC cell lines as compared to normal control. Almost all OSCC patients tissues (63 out of 65, 97 %) showed hypomethylation of lncRNA H19 compared to normal oral mucosa tissues. There was a significant correlation between methylation ratio and tumor histopathologic grade. OSCC patients with hypomethylation of lncRNA H19 had a significantly lower 5-year survival rate. CONCLUSIONS: Hypomethylation of lncRNA H19 may serve as a potential prognostic biomarker for oral cancer.

Recruitment and Retention Strategies Among Racial and Ethnic Minorities in Web-Based Intervention Trials: Retrospective Qualitative Analysis.

BACKGROUND: Racial and ethnic minority groups are underrepresented in health research, contributing to persistent health disparities in the United States. Identifying effective recruitment and retention strategies among minority groups and their subpopulations is an important research agenda. Web-based intervention approaches are becoming increasingly popular with the ubiquitous use of the internet. However, it is not completely clear which recruitment and retention strategies have been successful in web-based intervention trials targeting racial and ethnic minorities. OBJECTIVE: This study aims to describe lessons learned in recruiting and retaining one of the understudied ethnic minority women-Korean Americans-enrolled in a web-based intervention trial and to compare our findings with the strategies reported in relevant published web-based intervention trials. METHODS: Multiple sources of data were used to address the objectives of this study, including the study team's meeting minutes, participant tracking and contact logs, survey reports, and postintervention interviews. In addition, an electronic search involving 2 databases (PubMed and CINAHL) was performed to identify published studies using web-based interventions. Qualitative analysis was then performed to identify common themes addressing recruitment and retention strategies across the trials using web-based intervention modalities. RESULTS: A total of 9 categories of recruitment and retention strategies emerged: authentic care; accommodation of time, place, and transportation; financial incentives; diversity among the study team; multiple, yet standardized modes of communication; mobilizing existing community relationships with efforts to build trust; prioritizing features of web-based intervention; combined use of web-based and direct recruitment; and self-directed web-based intervention with human support. Although all the studies included in the analysis combined multiple strategies, prioritizing features of web-based intervention or use of human support were particularly relevant for promoting recruitment and retention of racial and ethnic minorities in web-based intervention trials. CONCLUSIONS: The growing prevalence of internet use among racial and ethnic minority populations represents an excellent opportunity to design and deliver intervention programs via the internet. Future research should explore and compare successful recruitment and retention methods among race and ethnic groups for web-based interventions. TRIAL REGISTRATION: ClinicalTrials.gov NCT03726619; https://clinicaltrials.gov/ct2/show/NCT03726619.

Comparison of time and cost between conventional surgical planning and virtual surgical planning in orthognathic surgery in Korea.

BACKGROUND: The purpose of this study was to measure the time of the conventional surgical planning (CSP) and virtual surgical planning (VSP) in orthognathic surgery and to compare them in terms of cost. MATERIAL AND METHOD: This is a retrospective study of the patients who underwent orthognathic surgery at the OOOOO University Dental Hospital from December 2017 to August 2018. All the patients were analyzed through both CSP and VSP, and all the surgical stents were fabricated through manual and 3-dimensional (3D) printing. The predictor variables were the planning method (CSP vs. VSP) and the surgery type (group I: Le Fort I osteotomy+bilateral sagittal split osteotomy [LFI+BSSO] or group II: only bilateral sagittal split osteotomy [BSSO]), and the outcomes were the time and cost. The results were analyzed using paired t test. RESULTS: Thirty patients (12 females, 18 males) met the inclusion criteria, and 17 patients were excluded from the study due to missing or incomplete data. There were 20 group I patients (LFI+BSSO regardless of genioplasty) and 10 group II patients (BSSO regardless of genioplasty). The average time of CSP for group I was 385±7.8 min, and that for group II was 195±8.33 min. The time reduction rate of VSP compared with CSP was 62.8% in group I and 41.5% in group II. On the other hand, there was no statistically significant cost reduction. CONCLUSIONS: The time investment in VSP in this study was significantly smaller than that in CSP, and the difference was greater in group I than in group II.

Primary repair of untreated cleft palate in an elderly patient: a case report.

Untreated adult or elderly cleft lip and palate patients are rarely seen, but studies on delayed primary palatal closure have been performed in the less developed Asian and African countries, where access to medical care is difficult. A 64-year-old woman visited our clinic with untreated cleft palate with a 40×20-mm-wide defect in the medial palate. Two-flap palatoplasty under general anesthesia was performed to close the cleft palate. After 1 month, the result was favorable without any complications including oronasal fistula. Cleft palate primary repair in an elderly patient is rare and has some surgical problems that are associated with a wide range of defects, but good results can be obtained if surgery is performed well with appropriate considerations.

Comparative study of bone regeneration using fibrin sealant with xenograft in rabbit sinus: pilot study.

BACKGROUND: Stability of the grafted bone volume is one of the important factors to the success of alveolar bone grafts. For this, platelet-rich plasma (PRP) or fibrin sealant is mixed with the bone graft material. Bio-Oss® is a protein-free bovine mineral commonly used in bone graft procedures. The grafting particles are commonly combined with a standard fibrin sealant (Tisseel®) to fabricate a plastic implantable product. The purpose of this experiment was to evaluate the efficacy of fibrin sealant (Tisseel®) in bone regeneration performance in a rabbit maxillary sinus model. METHODS: A total of five 3.5 kg weight New Zealand white rabbits were used for the study. After elevating the sinus membrane in both maxillary sinus cavities, Bio-Oss® mixed with normal saline (group 1) was filled into the right side, and Tisseel® mixed Bio-Oss® (group 2) was inserted into the other side. The bone mineral density and bone volume were analyzed with microscopic computed tomography (micro-CT) and histomorphometric 12 weeks after application. RESULTS: Histologically, new bone formation rate was 14.8%, and grafted bone rate was 70.5% in group 1. In group 2, they were 18.5% and 60.4%, respectively. According to micro-CT analysis, bone mineral density (mg/cm3, BMD) was 2.5% larger in group 1. CONCLUSIONS: The findings from this study suggest that, although the difference in the bone formation between group 1 and group 2 appears to be insignificant, group 2 had an advantage in using smaller amount of bone substances to achieve the reliable bone formation.

Influence of temperature on the antigenic changes of virus-like particles.

PURPOSE: In this study, we investigated whether the antigenic changes of the virus-like particles (VLPs) are affected by the temperature during storage. MATERIALS AND METHODS: After exposing the recombinant influenza VLPs to various temperatures for a period, antigenic changes were examined through in vitro hemagglutination receptor binding assay and in vivo mouse experiments. RESULTS: Influenza VLPs were exposed at three different temperatures of low, middle, and high on a thermo-hygrostat. High temperature exposed influenza VLPs were showed significantly reduced HA activity and immunogenicity after mouse single immunization over time compared low and middle. When the VLPs exposed to the high temperature were inoculated once in the mice, it was found that the immunogenicity was significantly reduced compared to the VLPs exposed to the low temperature. However, these differences were almost neglected when mice were inoculated twice even with VLPs exposed to high temperatures. CONCLUSION: This study suggests that similar protective effects can be expected by controlling the number of vaccination and storage conditions, although the antigenic change in the VLP vaccines occurred when exposed to high temperature.

Automatic mandibular canal detection using a deep convolutional neural network.

The practicability of deep learning techniques has been demonstrated by their successful implementation in varied fields, including diagnostic imaging for clinicians. In accordance with the increasing demands in the healthcare industry, techniques for automatic prediction and detection are being widely researched. Particularly in dentistry, for various reasons, automated mandibular canal detection has become highly desirable. The positioning of the inferior alveolar nerve (IAN), which is one of the major structures in the mandible, is crucial to prevent nerve injury during surgical procedures. However, automatic segmentation using Cone beam computed tomography (CBCT) poses certain difficulties, such as the complex appearance of the human skull, limited number of datasets, unclear edges, and noisy images. Using work-in-progress automation software, experiments were conducted with models based on 2D SegNet, 2D and 3D U-Nets as preliminary research for a dental segmentation automation tool. The 2D U-Net with adjacent images demonstrates higher global accuracy of 0.82 than naïve U-Net variants. The 2D SegNet showed the second highest global accuracy of 0.96, and the 3D U-Net showed the best global accuracy of 0.99. The automated canal detection system through deep learning will contribute significantly to efficient treatment planning and to reducing patients' discomfort by a dentist. This study will be a preliminary report and an opportunity to explore the application of deep learning to other dental fields.

A retrospective analysis of risk factors of oromaxillofacial infection in patients presenting to a hospital emergency ward.

BACKGROUND: The purpose of this study was to review the clinical features of oromaxillofacial infections in patients presenting to a hospital emergency ward, to identify the key factors affecting the requirement for hospitalization, and the potential risk factors predisposing to a prolonged length of hospital stay. METHODS: A retrospective medical record review of the 598 patients treated for oromaxillofacial infection from 2013 to 2017 at the oral and maxillofacial surgery department, Yangsan Pusan National University Hospital, was conducted. The following information was collected from each patient: sex, age, past medical history, site of infection, etiology, admission or outpatient care, level of C-reactive protein (mg/dL), fascial spaces involved, treatment method, and duration of hospitalization. Chi-squared tests were used to identify risk factors, which were further analyzed using multivariable logistic regression. RESULTS: A total of 606 patients were eligible for inclusion in the study, of which eight were excluded due to having incomplete charts; thus, 598 patients were included: 55% were male, mean patient age was 47.1 ± 19.9 years, and 12.9% of patients were diabetic. Furthermore, 71.2% of patients had infection originating in the mandible; the most common tooth of origin was lower posterior, and 29.8% of patients were hospitalized. Risk factors for hospital admission were elderly patients with concurrent disease, elevated C-reactive protein level, and multiple-space infection in the oromaxillofacial area. The duration of hospitalization was correlated with both diabetes and age. CONCLUSIONS: The requirement for hospital admission is determined by the severity of the infection; even severe infections, once treated with appropriate surgery, have no relation to the length of hospital stay. The important risk factors for increased duration of hospitalization are diabetes mellitus and older age. The understanding of risk factors associated with a prolonged hospital stay during the treatment of oromaxillofacial infection will aid in treatment planning as well as highlight the importance of adequate diabetes control in patients at risk of such infection.

Comparison of time and cost between conventional surgical planning and virtual surgical planning in orthognathic surgery in Korea.

BACKGROUND: The purpose of this study was to measure the time of the conventional surgical planning (CSP) and virtual surgical planning (VSP) in orthognathic surgery and to compare them in terms of cost. MATERIAL AND METHOD: This is a retrospective study of the patients who underwent orthognathic surgery at the Pusan National University Dental Hospital from December 2017 to August 2018. All the patients were analyzed through both CSP and VSP, and all the surgical stents were fabricated through manual and three-dimensional (3D) printing. The predictor variables were the planning method (CSP vs. VSP) and the surgery type (group I: Le Fort I osteotomy + bilateral sagittal split osteotomy [LFI+BSSO] or group II: only bilateral sagittal split osteotomy [BSSO]), and the outcomes were the time and cost. The results were analyzed using the paired t test. RESULTS: Thirty patients (12 females, 18 males) met the inclusion criteria, and 17 patients were excluded from the study due to missing or incomplete data. There were 20 group I patients (LFI+BSSO regardless of genioplasty) and 10 group II patients (BSSO regardless of genioplasty). The average time of CSP for group I was 385 ± 7.8 min, and that for group II was 195 ± 8.33 min. The time reduction rate of VSP compared with CSP was 62.8% in group I and 41.5% in group II. On the other hand, there was no statistically significant cost reduction. CONCLUSIONS: The time investment in VSP in this study was significantly smaller than that in CSP, and the difference was greater in group I than in group II.