Objective: To assess the success rate and proximity of miniscrews to the root using surgical guides produced by integrating data obtained from conebeam computed tomography and intraoral scanned models. Methods: This retrospective study involved 113 patients (224 miniscrews) who underwent miniscrew placement as part of their orthodontic treatment. Two operators placed miniscrews between the buccal alveolar bone of each patient and assessed initial stability by measuring the Periotest value (PTV) and insertion torque (IT). Patients were divided into two groups based on the miniscrew insertion method: manual group (MG) and surgical guide group (SG). Root proximity was assessed using periapical radiography, and miniscrews that remained in place for over 6 months were considered successful. Results: There was a statistically significant difference in the Kaplan–Meier survival curves between the groups (P < 0.05). The success rates of the miniscrews were 79.1% and 90.5% for the MG and SG, respectively (P < 0.05). The root contact rate also differed significantly between the groups (MG, 17.5%; SG, 0.1%; P < 0.001). However, the PTV and IT did not show significant differences between the groups. Conclusions Proximity to the root and utilization of surgical guides have the most direct impact on the success rate of miniscrews. Root proximity can be effectively reduced using surgical guides. Therefore, the use of a miniscrew surgical guide is recommended to increase the success rate of miniscrews as stable anchorage devices, particularly in cases with narrow interradicular space.

Objective: To assess the success rate and proximity of miniscrews to the root using surgical guides produced by integrating data obtained from conebeam computed tomography and intraoral scanned models. Methods: This retrospective study involved 113 patients (224 miniscrews) who underwent miniscrew placement as part of their orthodontic treatment. Two operators placed miniscrews between the buccal alveolar bone of each patient and assessed initial stability by measuring the Periotest value (PTV) and insertion torque (IT). Patients were divided into two groups based on the miniscrew insertion method: manual group (MG) and surgical guide group (SG). Root proximity was assessed using periapical radiography, and miniscrews that remained in place for over 6 months were considered successful. Results: There was a statistically significant difference in the Kaplan–Meier survival curves between the groups (P < 0.05). The success rates of the miniscrews were 79.1% and 90.5% for the MG and SG, respectively (P < 0.05). The root contact rate also differed significantly between the groups (MG, 17.5%; SG, 0.1%; P < 0.001). However, the PTV and IT did not show significant differences between the groups. Conclusions Proximity to the root and utilization of surgical guides have the most direct impact on the success rate of miniscrews. Root proximity can be effectively reduced using surgical guides. Therefore, the use of a miniscrew surgical guide is recommended to increase the success rate of miniscrews as stable anchorage devices, particularly in cases with narrow interradicular space.

Objective: To assess the success rate and proximity of miniscrews to the root using surgical guides produced by integrating data obtained from conebeam computed tomography and intraoral scanned models. Methods: This retrospective study involved 113 patients (224 miniscrews) who underwent miniscrew placement as part of their orthodontic treatment. Two operators placed miniscrews between the buccal alveolar bone of each patient and assessed initial stability by measuring the Periotest value (PTV) and insertion torque (IT). Patients were divided into two groups based on the miniscrew insertion method: manual group (MG) and surgical guide group (SG). Root proximity was assessed using periapical radiography, and miniscrews that remained in place for over 6 months were considered successful. Results: There was a statistically significant difference in the Kaplan–Meier survival curves between the groups (P < 0.05). The success rates of the miniscrews were 79.1% and 90.5% for the MG and SG, respectively (P < 0.05). The root contact rate also differed significantly between the groups (MG, 17.5%; SG, 0.1%; P < 0.001). However, the PTV and IT did not show significant differences between the groups. Conclusions Proximity to the root and utilization of surgical guides have the most direct impact on the success rate of miniscrews. Root proximity can be effectively reduced using surgical guides. Therefore, the use of a miniscrew surgical guide is recommended to increase the success rate of miniscrews as stable anchorage devices, particularly in cases with narrow interradicular space.

Objective: To assess the success rate and proximity of miniscrews to the root using surgical guides produced by integrating data obtained from conebeam computed tomography and intraoral scanned models. Methods: This retrospective study involved 113 patients (224 miniscrews) who underwent miniscrew placement as part of their orthodontic treatment. Two operators placed miniscrews between the buccal alveolar bone of each patient and assessed initial stability by measuring the Periotest value (PTV) and insertion torque (IT). Patients were divided into two groups based on the miniscrew insertion method: manual group (MG) and surgical guide group (SG). Root proximity was assessed using periapical radiography, and miniscrews that remained in place for over 6 months were considered successful. Results: There was a statistically significant difference in the Kaplan–Meier survival curves between the groups (P < 0.05). The success rates of the miniscrews were 79.1% and 90.5% for the MG and SG, respectively (P < 0.05). The root contact rate also differed significantly between the groups (MG, 17.5%; SG, 0.1%; P < 0.001). However, the PTV and IT did not show significant differences between the groups. Conclusions Proximity to the root and utilization of surgical guides have the most direct impact on the success rate of miniscrews. Root proximity can be effectively reduced using surgical guides. Therefore, the use of a miniscrew surgical guide is recommended to increase the success rate of miniscrews as stable anchorage devices, particularly in cases with narrow interradicular space.

Objective: To assess the success rate and proximity of miniscrews to the root using surgical guides produced by integrating data obtained from conebeam computed tomography and intraoral scanned models. Methods: This retrospective study involved 113 patients (224 miniscrews) who underwent miniscrew placement as part of their orthodontic treatment. Two operators placed miniscrews between the buccal alveolar bone of each patient and assessed initial stability by measuring the Periotest value (PTV) and insertion torque (IT). Patients were divided into two groups based on the miniscrew insertion method: manual group (MG) and surgical guide group (SG). Root proximity was assessed using periapical radiography, and miniscrews that remained in place for over 6 months were considered successful. Results: There was a statistically significant difference in the Kaplan–Meier survival curves between the groups (P < 0.05). The success rates of the miniscrews were 79.1% and 90.5% for the MG and SG, respectively (P < 0.05). The root contact rate also differed significantly between the groups (MG, 17.5%; SG, 0.1%; P < 0.001). However, the PTV and IT did not show significant differences between the groups. Conclusions Proximity to the root and utilization of surgical guides have the most direct impact on the success rate of miniscrews. Root proximity can be effectively reduced using surgical guides. Therefore, the use of a miniscrew surgical guide is recommended to increase the success rate of miniscrews as stable anchorage devices, particularly in cases with narrow interradicular space.

The authors report a case of newly manifested severe junctional bradycardia following dexmedetomidine administration during spinal anesthesia in a polypharmacy patient. A 77-year-old woman receiving multiple medications, including a beta-blocker and a calcium channel blocker, underwent right total knee arthroplasty. After spinal anesthesia, intravenous dexmedetomidine was initiated as a sedative; her heart rate decreased, followed by junctional bradycardia (heart rate, 37–41 beats/min). Dexmedetomidine was discontinued, and a dopamine infusion was initiated. Seven hours after surgery, junctional bradycardia persisted; a temporary transvenous pacemaker was inserted, and the beta-blocker and calcium channel blocker were discontinued. The patient was discharged on postoperative day 11 without any sequelae. Anesthesiologists should be aware of dexmedetomidine’s inhibitory effects on the cardiac conduction system, especially in geriatric patients taking medications with negative chronotropic effects and in combination with neuraxial anesthesia.

Background: To make good use of the prognostic value of arterial stiffness, it is important to identify the population with the greatest benefit. In this study, we compared the prognostic value of brachial-ankle pulse wave velocity (baPWV) according to various clinical characteristics. Methods: A total of 10,597 subjects who underwent baPWV measurement (mean age, 61.4 ± 9.5 years; female proportion, 42.5%) were retrospectively analyzed. Major adverse cardiovascular events (MACEs), defined as a composite of cardiac death, non-fatal myocardial infarction, coronary revascularization, and ischemic stroke were assessed during the clinical follow-up period. Results: In the multivariate analysis, clinical variables with more than 4,000 subjects were selected as grouping variables, which were sex (men and women), age (≥ 65 and < 65 years), body mass index (BMI) (≥ 25 and < 25 kg/m 2), hypertension (presence and absence), estimated glomerular filtration rate (≥ 90 and < 90 mL/min/1.73 m 2 ), and statin use (user and non-user). During the median clinical follow-up duration of 3.58 years (interquartile range, 1.43–5.38 years), there were 422 MACEs (4.0%). In total study subjects, baseline higher baPWV was associated with increased risk of MACE occurrence (hazard ratio for baPWV ≥ 1,800 cm/s compared to baPWV < 1,400 cm/s, 4.04; 95% confidence interval, 2.62–6.21; P < 0.001). The prognostic value of baPWV was statistically significant regardless of sex, age, BMI, hypertension, renal function, and statin use. Conclusion Our results suggest that baPWV is not only effective in specific clinical situations, but can be effectively applied to predict cardiovascular prognosis in various clinical situations.

Background and Objectives: This study aimed to investigate the association between cardiovascular events and 2 different levels of elevated on-treatment diastolic blood pressures (DBP) in the presence of achieved systolic blood pressure targets (SBP). Methods: A nation-wide population-based cohort study comprised 237,592 patients with hypertension treated. The primary endpoint was a composite of cardiovascular death, myocardial infarction, and stroke. Elevated DBP was defined according to the Seventh Report of Joint National Committee (JNC7; SBP <140 mmHg, DBP ≥90 mmHg) or to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) definitions (SBP <130 mmHg, DBP ≥80 mmHg). Results: During a median follow-up of 9 years, elevated on-treatment DBP by the JNC7 definition was associated with an increased risk of the occurrence of primary endpoint compared with achieved both SBP and DBP (adjusted hazard ratio [aHR], 1.14; 95% confidence interval [CI], 1.05–1.24) but not in those by the 2017 ACC/AHA definition. Elevated ontreatment DBP by the JNC7 definition was associated with a higher risk of cardiovascular mortality (aHR, 1.42; 95% CI, 1.18–1.70) and stroke (aHR, 1.19; 95% CI, 1.08–1.30). Elevated on-treatment DBP by the 2017 ACC/AHA definition was only associated with stroke (aHR, 1.10;95% CI, 1.04–1.16). Similar results were seen in the propensity-score-matched cohort. Conclusion Elevated on-treatment DBP by the JNC7 definition was associated a high risk of major cardiovascular events, while elevated DBP by the 2017 ACC/AHA definition was only associated with a higher risk of stroke. The result of study can provide evidence of DBP targets in subjects who achieved SBP targets.

The most feared complication of left ventricular thrombus (LVT) is the occurrence of systemic thromboembolic events, especially in the brain. Herein, we report a patient with severe sepsis who suffered recurrent devastating embolic stroke. Transthoracic echocardiography revealed apical ballooning of the left ventricle with a huge LVT, which had not been observed in chest computed tomography before the stroke. This case emphasizes the importance of serial cardiac evaluation in patients with stroke and severe medical illness.
Brain ; Echocardiography ; Heart Ventricles ; Humans ; Sepsis ; Shock, Septic* ; Stroke* ; Thorax ; Thrombosis*

The most feared complication of left ventricular thrombus (LVT) is the occurrence of systemic thromboembolic events, especially in the brain. Herein, we report a patient with severe sepsis who suffered recurrent devastating embolic stroke. Transthoracic echocardiography revealed apical ballooning of the left ventricle with a huge LVT, which had not been observed in chest computed tomography before the stroke. This case emphasizes the importance of serial cardiac evaluation in patients with stroke and severe medical illness.
Brain ; Echocardiography ; Heart Ventricles ; Humans ; Sepsis ; Shock, Septic ; Stroke ; Thorax ; Thrombosis