This case report describes the use of CAD-based digital tooth arrangement to overcome the limitations of conventional methods in a patient with a maxillary arch wider than the average Korean morphology. In such wide arches, average-based tooth arrangement often restricts the ability to adjust the occlusal plane and cusp positions, thereby limiting functional and esthetic reproduction.In this case, virtual tooth arrangement and occlusal analysis were performed using CAD software, and a putty index was fabricated on a 3D-printed reference model to guide the final arrangement. The fabricated maxillary cast metal complete denture and mandibular distal extension removable partial denture successfully achieved bilateral balanced occlusion, and the patient reported high satisfaction in both functional and esthetic aspects. This case highlights the clinical utility of digital tooth arrangement in atypically wide arches and suggests that CAD-assisted workflows can enhance accuracy and reproducibility in clinical prosthodontics.

With the advancement of digital technology, the clinical application of CAD-CAM systems in dentistry has been expanding. CAD-CAM technology is now being utilized not only for fixed dental prostheses but also in the fabrication of removable dentures. However, its use in removable partial dentures has primarily focused on fabricating metal frameworks, with insufficient research on intraoral fitness and long-term prognosis. Recently, CAD-CAM technology has enabled the fabrication of customized artificial teeth, offering several advantages such as the establishment of precise occlusal relationships, reduced laboratory time, and ease of reproduction. This case reports on a patient who presented with discomfort due to mobility of the mandibular anterior teeth and multiple missing posterior teeth. Given the patient’s economic and systemic conditions, fabrication of a mandibular removable partial denture was chosen as the treatment option.Clinical examination revealed occlusal wear and supraeruption in the maxillary dentition, resulting in an uneven occlusal plane. To achieve a more precise occlusal relationship and accurate tooth arrangement, customized artificial teeth were fabricated using CAD-CAM technology. Despite the uneven and non-ideal occlusal plane, a removable partial denture incorporating these CAD-CAM customized artificial teeth was successfully delivered, resulting in satisfactory functional and esthetic outcomes.

The integration of cone beam computed tomography (CBCT) and intraoral scanner (IOS) data through superimposition enables comprehensive evaluation of hard and soft tissue anatomy. While this technique has demonstrated clinical efficacy for implant and orthognathic surgery planning, its implementation in prosthetic treatment design and diagnosis remains limited. Through precise registration of CBCT and IOS data sets, clinicians can quantitatively assess alveolar bone dimensions, interproximal bone levels, and soft tissue biotype. This information enables establishment of patient-specific design criteria for prosthetic contours and interproximal contact areas. Additionally, this integrated approach facilitates evaluation of midline discrepancies, jaw asymmetries, and available restorative space for long-span fixed dental prostheses. Furthermore, the immediate gingival displacement that occurs following removal of the provisional prostheses necessitates standardized protocols for precise transfer of the subgingival emergence profile established by provisional prostheses to definitive prostheses. This clinical report describes CBCT-IOS superimposition-based digital analysis for anterior esthetic restorations, with successful transfer of subgingival emergence profile from the provisional to the definitive prostheses.

This case report describes a customized PEEK healing abutment fabricated using CAD-CAM technology to ensure the aesthetics of an anterior implant prosthesis.A 3-dimensional surgical guide was designed and printed to plan the ideal placement of implant, and the healing abutment was designed by CAD software to ensure the appropriate peri-gingival tissue at that location. The CAD-CAM Ti-base PEEK abutment was tightened right after the installation of implant fixture. After approximately 2 ‒ 3 months of observation, soft tissue healing and implant fixture stability were confirmed. The intraoral scanning before removing a healing abutment, after removing it which is for sub-gingival tissue, and with scan body were performed separately for the final prosthesis and all scan files were superimposed to design and fabricate the final prosthesis to ensure both aesthetic and functional performance. The final prosthesis fit comfortably without compressing the surrounding soft tissue, and the patient was functionally and esthetically satisfied with the outcome.

In patients with differentiated thyroid cancer (DTC), initial recurrence risk stratification based on clinical, histopathological, and perioperative data remains the key determinant for guiding management strategies during the first 1-2 years post-treatment. However, the adoption of ongoing risk stratification (ORS), which dynamically reassesses risk by integrating longitudinal clinical data and treatment response, enables more precise long-term prognostic assessment and facilitates highly individualized management. Building upon recent guidelines, the 2026 KTA guideline has been further refined by incorporating robust evidence from large-scale national cohorts and comprehensive systematic reviews. These updated recommendations outline contemporary concepts of ORS, risk-adapted TSH suppression targets, optimized surveillance modalities for recurrence detection, and disease-specific long-term follow-up strategies. Reflecting the paradigm shift toward de-escalated treatment, this revision integrates evolved perspectives on TSH suppression intensity, the clinical interpretation of thyroglobulin levels, and tailored follow-up intervals. These evidence-based recommendations aim to minimize unnecessary treatment and excessive surveillance in the large proportion of patients with excellent prognosis after initial therapy, while ensuring that each patient receives appropriately tailored and effective long-term management.

Purpose: This study aimed to evaluate the role of hepatic resection in patients with objective responses after combined transarterial chemoembolization (TACE) and radiotherapy (RT) for hepatocellular carcinoma (HCC) with macroscopic vascular invasion (MVI). Materials and Methods: We retrospectively reviewed the patients treated with combined TACE and RT for HCC with MVI between 2010 and 2015. Some of the patients with objective responses underwent hepatic resection or liver transplantation; to investigate the impact of surgery, patients with objective responses who did not undergo surgery were selected as the control group. Survival outcomes were compared using a propensity score–based stabilized inverse probability of treatment weighting method. Results: Out of the 170 patients with objective responses after combined TACE and RT, 41 patients underwent surgery, including eight liver transplantations. The unweighted surgery group was younger and had a higher proportion of solitary tumors and unilateral vascular involvement. After adjustment, the 3-year overall survival (OS) rates were 61.0% and 28.6% in the surgery and non-surgery groups, respectively. The most important prognostic factor for OS was surgery (adjusted Cox hazard ratio [HR], 0.28; 95% confidence interval [CI], 0.17 to 0.46; p < 0.001). Complete response after TACE and RT (vs. partial response) was also a significant prognostic factor for OS (adjusted HR, 0.41; 95% CI, 0.27 to 0.61; p < 0.001). There was no surgical mortality. Four patients (9.8%) required additional surgery due to bleeding or graft failure. Conclusion Hepatic resection was significantly associated with improved OS in patients who showed objective responses after receiving combined TACE and RT for HCC with MVI.

The optimal frequency for hemodialysis in older adults with end-stage kidney disease (ESKD) has not been established. This study aims to investigate whether a twice-weekly dialysis schedule using an incremental approach can reduce hospitalization rates in the elderly with incident dialysis, compared with conventional thrice-weekly dialysis. Methods: We have designed a pragmatic randomized controlled trial to compare the effects of twice-weekly versus thrice-weekly hemodialysis in 428 ESKD individuals (dropout rate 20%) aged 60 years or older with residual kidney function (urine output, >500 mL/ day). The trial will be conducted across 18 referral hospital-based dialysis centers in Korea. Individual participants will be randomized to either a twice-weekly (with incremental approach) or thrice-weekly dialysis group and will be followed up for 24 months. The primary outcome of the study is all-cause hospitalization rate, while secondary outcomes include dialysis-specific hospitalization rates, mortality, quality of life, frailty, and cost-effectiveness. Participants have the flexibility to transfer to other dialysis centers as needed. The decision to increase dialysis frequency will be made by the treating physicians. The study is ongoing and will be completed in May 2026. Conclusion: This study will provide valuable insights into the benefits and risks of twice-weekly dialysis with an incremental approach in elderly with residual kidney function compared to thrice-weekly dialysis.

Background: Obesity is a well-known risk factor for chronic kidney disease and its progression. However, the impact of obesity on the renal function of the elderly population is uncertain. We investigated the association between obesity and renal outcomes in the elderly. Methods: We analyzed 130,504 participants from the Korean National Health Insurance Service-Senior cohort. Obesity was classified according to body mass index (BMI), sex-specific waist circumference (WC), and the presence of metabolic syndrome. The primary outcome was renal function decline, defined as a decline in the estimated glomerular filtration rate (eGFR) of at least 50% from baseline or new-onset end-stage renal disease. Results: During a follow-up period of 559,531.1 person-years (median, 4.3 years), 2,486 participants (19.0%; incidence rate of 4.44 per 1,000 person-years) showed renal function decline. A multivariate Cox proportional hazards model revealed that BMI/WC was not associated with renal function decline. However, the group with metabolic syndrome had a significantly increased risk of renal function decline compared to the group without metabolic syndrome (adjusted hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.13–1.36). Compared with the non-metabolic syndrome group, the adjusted HRs (95% CI) for participants with one through five components were 0.96 (0.84–1.11), 1.10 (0.96–1.27), 1.24 (1.06–1.45), 1.37 (1.12–1.66), and 1.99 (1.42–2.79), respectively (p for trend < 0.001). Conclusion In elderly Korean adults, metabolic syndrome and the number of its components were associated with a higher risk of renal function decline, but BMI or WC was not significant.

Background: Excess intake of added sugars contributes to obesity, type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), and premature mortality. Sugar-sweetened beverages (SSBs), the main source of added sugars, are consistently linked to adverse outcomes. Artificially sweetened beverages (ASBs) have been suggested as short-term substitutes, but evidence regarding benefits and harms remains inconclusive, and guidance is lacking. Methods: This consensus statement draws on a structured evidence review combining two approaches: an updated meta-analysis of randomized controlled trials (RCTs) assessing short- to intermediate-term effects of replacing SSBs with ASBs on weight and metabolic outcomes; and an umbrella review of systematic reviews of cohort studies evaluating long-term associations of SSBs and ASBs with major outcomes, including mortality, CVD, and T2DM. Results: In 14 RCTs (3–76 weeks), replacing SSBs with ASBs produced modest reductions in body weight (–0.73 kg) and body fat (–0.72%), with inconsistent effects on glycemic and cardiometabolic markers. Evidence from 20 systematic reviews of cohorts (up to 34 years follow-up) showed that higher intake of both SSBs and ASBs was associated with increased risks of T2DM, CVD, and mortality, with relative risks for ASBs similar to those for SSBs. Conclusion ASBs may serve as a short-term substitution for individuals with high SSB intake, particularly those at elevated metabolic risk. However, regular or long-term use is not recommended due to uncertain safety and potential reinforcement of sweet preference. Public health strategies should emphasize reducing both SSBs and ASBs, prioritizing water and unsweetened beverages as the ultimate goal.

Background: As the global population ages, medical professionals are also aging. This study investigates the status of Korean anesthesiologists over the age of 60. Methods: Anesthesiologists aged 60 and older, residing and working in Korea, were invited to participate in this study via e-mail from February to March 2021 and by mail from June to August 2021. The survey consisted of 40 questions covering 10 topics, including health status, residence, work style, and economic status. Depending on the type of question, answers were ranked on a scale of 1, 2, and 3, with the most preferred response being selected. Results: A total of 63 responses were received, resulting in a response rate of 26.5%. Among the respondents, 56 were currently practicing as anesthesiologists and reported satisfaction with their clinical practice and life status. On average, they treated 24 patients per day without experiencing significant discomfort or inconvenience in their roles as senior physicians. Twenty-four respondents acknowledged physical discomfort related to aging, and nine expressed cautions regarding age-related changes. Fifty-two respondents indicated that reeducation for advanced medical practice as anesthesiologists was necessary. Conclusions Senior anesthesiologists in Korea are primarily working in secondary and tertiary hospitals and are satisfied with their current life status. A comprehensive evaluation of reeducation programs for advanced clinical practice and retirement strategies for senior anesthesiologists is needed to address the growing number of aging physicians in the workforce.