Are There Differences in the Causes and Complications of Mandibular Third Molar Extraction in Older Patients Compared to Younger Patients?

BACKGROUND: Although most impacted third molars (ITMs) are extracted in the teens and early 20s, some undergo extractions after their 40s. It is unclear whether the reasons for extraction, the degree of impaction, and complications differ in patients in an older age group compared with a younger age group. PURPOSE: The purpose of this study was to measure the association between age and 1) reason for extraction and 2) postoperative complications. STUDY DESIGN, SETTING, SAMPLE: This was a retrospective cohort study of patients who had undergone surgical extraction of at least one mandibular ITM at a single institution. We excluded 1) age under 20 years, 2) follow-up period of less than 1 week, and 3) tooth extraction under general anesthesia. PREDICTOR VARIABLE: The primary predictor variable was age, classified into 3 groups (20s:20-29; 30s:30-39; over 40s: 40 and greater). MAIN OUTCOME VARIABLE(S): The primary outcome variables were the reason for extraction (prophylactic or symptomatic) and the presence of complications. The secondary outcome variable was type of complication (postoperative infection, dry socket, neurosensory disturbance, presenting pain over 1 month, retained root requiring secondary treatment). COVARIATES: The covariates were sex, laterality of ITM, and difficulty of extraction as measured by the difficulty index, a measure based on depth, orientation, and ramus relationship/space available, with a higher score indicating greater difficulty. ANALYSES: χ2 test was performed to analyze the association of categorical outcome variables and covariates. Level of statistical significance was set at P < .05. RESULTS: Of a total of 831 eligible subjects, there were 555 (66.8%), 159 (19.1%), and 117 (14.1%) in the 20s, 30s, and over 40s age groups, respectively. The percentage of symptomatic extraction of ITM was significantly higher in the over-40 age group compared with the 20s group (92.3 vs 69.4%, (P < .001). Complication rate also significantly differed between over 40s group and the 20s group (7.7 vs 1.8%, P < .001). Difficulty index and indications for ITM extraction were significantly different between groups (P < .001). CONCLUSION AND RELEVANCE: Symptoms, difficulty, and complications related to ITM increase at over 40 years of age. This should be taken into consideration during the joint clinical decision-making process with patients with ITM.

Association Between Ursodeoxycholic Acid and Clinical Outcomes in Patients With COVID-19 Infection: Population-Based Cohort Study.

BACKGROUND: Several studies have investigated the relationship between ursodeoxycholic acid (UDCA) and COVID-19 infection. However, complex and conflicting results have generated confusion in the application of these results. OBJECTIVE: We aimed to investigate whether the association between UDCA and COVID-19 infection can also be demonstrated through the analysis of a large-scale cohort. METHODS: This retrospective study used local and nationwide cohorts, namely, the Jeonbuk National University Hospital into the Observational Medical Outcomes Partnership common data model cohort (JBUH CDM) and the Korean National Health Insurance Service claim-based database (NHIS). We investigated UDCA intake and its relationship with COVID-19 susceptibility and severity using validated propensity score matching. RESULTS: Regarding COVID-19 susceptibility, the adjusted hazard ratio (aHR) value of the UDCA intake was significantly lowered to 0.71 in the case of the JBUH CDM (95% CI 0.52-0.98) and was significantly lowered to 0.93 (95% CI 0.90-0.96) in the case of the NHIS. Regarding COVID-19 severity, the UDCA intake was found to be significantly lowered to 0.21 (95% CI 0.09-0.46) in the case of JBUH CDM. Furthermore, the aHR value was significantly lowered to 0.77 in the case of NHIS (95% CI 0.62-0.95). CONCLUSIONS: Using a large-scale local and nationwide cohort, we confirmed that UDCA intake was significantly associated with reductions in COVID-19 susceptibility and severity. These trends remained consistent regardless of the UDCA dosage. This suggests the potential of UDCA as a preventive and therapeutic agent for COVID-19 infection.

Sensory change after implant surgery: related factors for recovery.

Objectives: This retrospective study aimed to analyze data on nerve damage in patients who complained of sensory changes after dental implant surgery, the clinical results according to proximity of the implant fixture to the inferior alveolar nerve (IAN) canal, and the factors affecting recovery of sensation. Materials and Methods: The electronic medical records of 64 patients who had experienced sensory change after implant surgery were reviewed. Patients were classified by sex, age, implant installation sites, recovery rate and the distance between the implant fixture and IAN canal on computed tomography (CT). The distance was classified into Group I (D>2 mm), Group II (2 mm≥D>0 mm), and Group III (D≤0 mm). Results: The 64 patients were included and the mean age was 57.3±7.3 years. Among the 36 patients who visited our clinic more than two times, 21 patients (58.3%) reported improvement in sensation, 13 patients (36.1%) had no change in sensation, and 2 patients (5.6%) reported worsening sensation. In Group II, symptom improvement was achieved in all patients regardless of the removal of the implant fixture. In Group III, 8 patients (40.0%) had reported symptom improvement with removal of the implant fixture, and 2 patients (33.3%) of recovered patients showed improvement without removal. Removal of the implant fixture in Group III did not result in any significant difference in recovery (P=0.337), although there was a higher possibility of improvement in sensation in removal cases. Conclusion: Clinicians first should consider removing the fixture when it directly invades the IAN canal. However, in cases of sensory change after dental implant surgery where the drill or implant fixture did not invade the IAN canal, other indirect factors such as flap elevation and damage due to anesthesia should be considered as causes of sensory change. Removal of the implant should be considered with caution in these situations.

Flexible Hard Coating: Glass-Like Wear Resistant, Yet Plastic-Like Compliant, Transparent Protective Coating for Foldable Displays.

A flexible hard coating for foldable displays is realized by the highly cross-linked siloxane hybrid using structure-property relationships in organic-inorganic hybridization. Glass-like wear resistance, plastic-like flexibility, and highly elastic resilience are demonstrated together with outstanding optical transparency. It provides a framework for the application of siloxane hybrids in protective hard coatings with high scratch resistance and flexibility for foldable displays.

Flexible transparent conducting composite films using a monolithically embedded AgNW electrode with robust performance stability.

We report on the performance of an all-in-one flexible hybrid conducting film employing a monolithically embedded AgNW transparent electrode and a high-performance glass-fabric reinforced composite substrate (AgNW-GFRHybrimer film). Specifically, we perform in-depth investigations on the stability of the AgNW-GFRHybrimer film against heat, thermal oxidation, and wet chemicals to demonstrate the potential of the hybrid conducting film as a robust electrode platform for thin-film optoelectronic devices. With the ease of large-area processability, smooth surface topography, and robust performance stability, the AgNW-GFRHybrimer film can be a promising platform for high-performance optoelectronic devices.