BACKGROUND: A pneumatic tourniquet is commonly used in orthopedic surgery. However, neuromuscular blocking agent can be sequestered in the isolated limb and be reabsorbed into the systemic circulation after tourniquet release, potentially delaying extubation. To investigate the change in the train-of-four (TOF) ratio after tourniquet release and correlate the TOF ratio change with the extubation time. METHODS: Forty patients undergoing unilateral total knee arthroplasty were enrolled. Before and after the pneumatic tourniquet release, 10 measurements of the TOF ratio were averaged and compared. Additionally, we investigated the correlation between the percentage change in the TOF ratio before and after tourniquet release and the extubation time. RESULTS: Among the 40 patient subjects, 30 showed a TOF ratio before tourniquet release and 10 showed only a TOF count. Of the 30 patients with a TOF ratio, 21 showed a TOF ratio increase after tourniquet release and 9 showed a TOF decrease; both increase and decrease were statistically significant (P < 0.001 and P = 0.008, respectively). The extubation time showed a weak negative correlation with the percentage change in the TOF ratio after tourniquet release (P = 0.004). CONCLUSIONS: In orthopedic surgery using a pneumatic tourniquet, neuromuscular function monitoring may be required to monitor the change in the effect of neuromuscular blocking agent before and after tourniquet release, which may help to improve anesthesia safety.
Anesthesia ; Arthroplasty* ; Extremities ; Humans ; Knee* ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Neuromuscular Monitoring ; Orthopedics ; Tourniquets*

Objective: To propose the utilization of virtual tooth models (VTMs) created by combining tooth root data from cone-beam computed tomography (CBCT) and crown data gathered through intraoral scanning to assess inter-root distance and angulation during orthodontic treatment when repeated radiographic monitoring becomes necessary. Methods: Patients with planned dental implant placement in edentulous areas during or after orthodontic treatment and who underwent intraoral and CBCT scans at the pretreatment and posttreatment stages were selected. Tooth models were fabricated by merging intraorally scanned crowns with the corresponding CBCT-scanned roots from the pretreatment. Tooth positions posttreatment was estimated by integrating models into posttreatment intraoral scans. Moreover, the actual positions were obtained from posttreatment CBCTs. Discrepancies in the estimated and actual tooth positions, including interradicular distances and inter-root angulations, were compared. Results: The minimum inter-radicular distance between two adjacent teeth demonstrated no significant difference between the estimated and actual tooth positions. The difference in inter-root angulation was not statistically significant. Most interradicular distances measured at each landmark revealed no significant differences between the estimated and actual tooth positions, except at the buccolingual midpoint of the cemento-enamel junction, where a slight discrepancy was observed. Conclusions The tooth position of VTMs demonstrated clinically acceptable accuracy compared to CBCT scans. Additionally, VTMs can benefit both clinicians and patients by enabling accurate assessment of the inter-radicular space for dental implant placement without repeated CBCT scans.

Objective: To propose the utilization of virtual tooth models (VTMs) created by combining tooth root data from cone-beam computed tomography (CBCT) and crown data gathered through intraoral scanning to assess inter-root distance and angulation during orthodontic treatment when repeated radiographic monitoring becomes necessary. Methods: Patients with planned dental implant placement in edentulous areas during or after orthodontic treatment and who underwent intraoral and CBCT scans at the pretreatment and posttreatment stages were selected. Tooth models were fabricated by merging intraorally scanned crowns with the corresponding CBCT-scanned roots from the pretreatment. Tooth positions posttreatment was estimated by integrating models into posttreatment intraoral scans. Moreover, the actual positions were obtained from posttreatment CBCTs. Discrepancies in the estimated and actual tooth positions, including interradicular distances and inter-root angulations, were compared. Results: The minimum inter-radicular distance between two adjacent teeth demonstrated no significant difference between the estimated and actual tooth positions. The difference in inter-root angulation was not statistically significant. Most interradicular distances measured at each landmark revealed no significant differences between the estimated and actual tooth positions, except at the buccolingual midpoint of the cemento-enamel junction, where a slight discrepancy was observed. Conclusions The tooth position of VTMs demonstrated clinically acceptable accuracy compared to CBCT scans. Additionally, VTMs can benefit both clinicians and patients by enabling accurate assessment of the inter-radicular space for dental implant placement without repeated CBCT scans.

Objective: To propose the utilization of virtual tooth models (VTMs) created by combining tooth root data from cone-beam computed tomography (CBCT) and crown data gathered through intraoral scanning to assess inter-root distance and angulation during orthodontic treatment when repeated radiographic monitoring becomes necessary. Methods: Patients with planned dental implant placement in edentulous areas during or after orthodontic treatment and who underwent intraoral and CBCT scans at the pretreatment and posttreatment stages were selected. Tooth models were fabricated by merging intraorally scanned crowns with the corresponding CBCT-scanned roots from the pretreatment. Tooth positions posttreatment was estimated by integrating models into posttreatment intraoral scans. Moreover, the actual positions were obtained from posttreatment CBCTs. Discrepancies in the estimated and actual tooth positions, including interradicular distances and inter-root angulations, were compared. Results: The minimum inter-radicular distance between two adjacent teeth demonstrated no significant difference between the estimated and actual tooth positions. The difference in inter-root angulation was not statistically significant. Most interradicular distances measured at each landmark revealed no significant differences between the estimated and actual tooth positions, except at the buccolingual midpoint of the cemento-enamel junction, where a slight discrepancy was observed. Conclusions The tooth position of VTMs demonstrated clinically acceptable accuracy compared to CBCT scans. Additionally, VTMs can benefit both clinicians and patients by enabling accurate assessment of the inter-radicular space for dental implant placement without repeated CBCT scans.

Objective: To propose the utilization of virtual tooth models (VTMs) created by combining tooth root data from cone-beam computed tomography (CBCT) and crown data gathered through intraoral scanning to assess inter-root distance and angulation during orthodontic treatment when repeated radiographic monitoring becomes necessary. Methods: Patients with planned dental implant placement in edentulous areas during or after orthodontic treatment and who underwent intraoral and CBCT scans at the pretreatment and posttreatment stages were selected. Tooth models were fabricated by merging intraorally scanned crowns with the corresponding CBCT-scanned roots from the pretreatment. Tooth positions posttreatment was estimated by integrating models into posttreatment intraoral scans. Moreover, the actual positions were obtained from posttreatment CBCTs. Discrepancies in the estimated and actual tooth positions, including interradicular distances and inter-root angulations, were compared. Results: The minimum inter-radicular distance between two adjacent teeth demonstrated no significant difference between the estimated and actual tooth positions. The difference in inter-root angulation was not statistically significant. Most interradicular distances measured at each landmark revealed no significant differences between the estimated and actual tooth positions, except at the buccolingual midpoint of the cemento-enamel junction, where a slight discrepancy was observed. Conclusions The tooth position of VTMs demonstrated clinically acceptable accuracy compared to CBCT scans. Additionally, VTMs can benefit both clinicians and patients by enabling accurate assessment of the inter-radicular space for dental implant placement without repeated CBCT scans.

Objective: To propose the utilization of virtual tooth models (VTMs) created by combining tooth root data from cone-beam computed tomography (CBCT) and crown data gathered through intraoral scanning to assess inter-root distance and angulation during orthodontic treatment when repeated radiographic monitoring becomes necessary. Methods: Patients with planned dental implant placement in edentulous areas during or after orthodontic treatment and who underwent intraoral and CBCT scans at the pretreatment and posttreatment stages were selected. Tooth models were fabricated by merging intraorally scanned crowns with the corresponding CBCT-scanned roots from the pretreatment. Tooth positions posttreatment was estimated by integrating models into posttreatment intraoral scans. Moreover, the actual positions were obtained from posttreatment CBCTs. Discrepancies in the estimated and actual tooth positions, including interradicular distances and inter-root angulations, were compared. Results: The minimum inter-radicular distance between two adjacent teeth demonstrated no significant difference between the estimated and actual tooth positions. The difference in inter-root angulation was not statistically significant. Most interradicular distances measured at each landmark revealed no significant differences between the estimated and actual tooth positions, except at the buccolingual midpoint of the cemento-enamel junction, where a slight discrepancy was observed. Conclusions The tooth position of VTMs demonstrated clinically acceptable accuracy compared to CBCT scans. Additionally, VTMs can benefit both clinicians and patients by enabling accurate assessment of the inter-radicular space for dental implant placement without repeated CBCT scans.

A novel robotic mirror therapy system was recently developed to provide proprioceptive stimulus to the hemiplegic arm during a mirror therapy. Validation of the robotic mirror therapy system was performed to confirm its synchronicity prior to the clinical study. The mean error angle range between the intact arm and the robot was 1.97 to 4.59 degrees. A 56-year-old male who had right middle cerebral artery infarction 11 months ago received the robotic mirror therapy for ten 30-minute sessions during 2 weeks. Clinical evaluation and functional magnetic resonance imaging (fMRI) studies were performed before and after the intervention. At the follow-up evaluation, the thumb finding test score improved from 2 to 1 for eye level and from 3 to 1 for overhead level. The Albert's test score on the left side improved from 6 to 11. Improvements were sustained at 2-month follow-up. The fMRI during the passive motion revealed a considerable increase in brain activity at the lower part of the right superior parietal lobule, suggesting the possibility of proprioception enhancement. The robotic mirror therapy system may serve as a useful treatment method for patients with supratentorial stroke to facilitate recovery of proprioceptive deficit and hemineglect.
Arm ; Brain ; Clinical Study ; Exoskeleton Device ; Follow-Up Studies ; Hemiplegia ; Humans ; Infarction, Middle Cerebral Artery ; Magnetic Resonance Imaging ; Male ; Methods ; Middle Aged ; Neurological Rehabilitation ; Parietal Lobe ; Pilot Projects* ; Proprioception* ; Stroke ; Thumb ; Upper Extremity*

There are limited data on the impact of diabetes control on the risk of subclinical coronary atherosclerosis.