Prosthesis, Volume 7, Issue 3 (June 2025) – 11 articles

Background/Objective: Changes in limb volume affect prosthetic socket fit and limb health, which in turn affects the comfort, stability, and usability of a prosthesis. The objective of this research was to identify and evaluate residual limb fluid volume metrics that could be used to identify the need for a prosthetic socket modification or replacement. Methods: A prospective observational study was conducted with transtibial prosthesis users undergoing socket modification or replacement. Participants performed a morning and afternoon 20 min structured activity protocol and self-reported their average socket comfort and other health outcomes before and after their socket was modified or replaced. Limb fluid volume changes across the protocol were recorded using bioimpedance analysis. Results: Anterior region residual limb fluid volume loss was low when the socket comfort score was high. Participants with ESCS_ave increases of ≥2 points pre- to post-modification experienced less limb fluid volume loss post-modification minus pre-modification (mean +0.6%) compared to participants with ESCS_ave increases of <2 points (mean −0.9%) (p = 0.0002). Conclusions: The percentage of fluid volume in the anterior limb may be a useful quantitative metric to explore for the application of bioimpedance monitoring in clinical care, helping to identify when sufficient change has occurred such that a new socket is warranted. Full article

Objectives: Traditional 2D cell cultures on flat surfaces fail to replicate 3D environments, affecting cellular morphology and function. Various 3D techniques (e.g., spheroids, organoids, organs-on-chips, 3D bioprinting) have been used for disease modelling and drug testing, but their application in hard tissues remains challenging. This study aimed to develop a biocompatible 3D culture method for bone tissue organoids using human bone marrow-derived stem cells (hBMSCs) and hydrogels. Methods: hBMSCs were isolated from human jawbone marrow. The control group was cultured under 2D conditions, whereas the experimental group was cultured in a 3D hydrogel environment. In vitro analyses, including flow cytometry and RNA sequencing, were performed. Quantitative data were statistically analysed at a 0.05 level of significance. Results: hBMSCs cultured in 3D hydrogel conditions indicated enhanced reproducibility, increased cell viability, and significant osteogenic differentiation. Genes such as MMP-13, LPL, and SP7 showed substantially higher expression in 3D cultures, with protein-level confirmation by Western blot. These findings suggest that 3D culture more effectively supports the natural growth and differentiation of hBMSCs. Conclusions: Culturing hBMSCs in a 3D environment more closely mimics in vivo conditions, thus promoting the expression and activity of critical proteins involved in hBMSC differentiation. Full article

Background: Nanomaterial-based biosensors represent a transformative advancement in oral health diagnostics and therapeutics, offering superior sensitivity and selectivity for early disease detection compared to conventional methods. Their applications span prosthetic dentistry, where they enable the precise monitoring of dental implants, and theranostics for conditions such as dental caries, oral cancers, and periodontal diseases. These innovations promise to enhance proactive oral healthcare by integrating detection, treatment, and preventive strategies. Objectives: This review comprehensively examines the role of nanomaterial-based biosensors in dental theranostics, with a focus on prosthetic applications. It emphasizes their utility in dental implant surveillance, the early identification of prosthesis-related complications, and their broader implications for personalized treatment paradigms. Methods: A systematic literature search was conducted across PubMed, Scopus, and Web of Science for studies published between 2010 and early 2025. Keywords included combinations of “nanomaterials”, “biosensors”, “dentistry”, “oral health”, “diagnostics”, “therapeutics”, and “theranostics”. Articles were selected based on their relevance to nanomaterial applications in dental biosensors and their clinical translation. Results: The review identified diverse classes of nanomaterials—such as metallic nanoparticles, carbon-based structures, and quantum dots—whose unique physicochemical properties enhance biosensor performance. Key advancements include the ultra-sensitive detection of biomarkers in saliva and gingival crevicular fluid, the real-time monitoring of peri-implant inflammatory markers, and cost-effective diagnostic platforms. These systems demonstrate exceptional precision in detecting early-stage pathologies while improving operational efficiency in clinical settings. Conclusions: Nanomaterial-based biosensors hold significant promise for revolutionizing dental care through real-time implant monitoring and early complication detection. Despite challenges related to biocompatibility, scalable manufacturing, and rigorous clinical validation, these technologies may redefine oral healthcare by extending prosthetic device longevity, enabling personalized interventions, and reducing long-term treatment costs. Future research must address translational barriers to fully harness their potential in improving diagnostic accuracy and therapeutic outcomes. Full article

Introduction: Intertrochanteric femoral fractures (IFFs) are the most common traumatic injuries in elderly people and significantly impact the patient’s health status. The current evidence indicates that short intramedullary nails may be a better choice than dynamic hip screws in IFF management, being less invasive and biomechanically superior, providing a buttress to limit fracture collapse. On the other hand, an unstable fracture may collapse even after adequate reduction and fixation. This paper aims to describe the surgical complexity of the nail-to-total hip arthroplasty (THA) conversion, focusing on the restoration of normal hip geometry. Material and Methods: Patients referred to our level I trauma center with failed cephalomedullary nailing following IFFs and managed with the nail-to-THA conversion were retrospectively recruited. The anteroposterior postoperative pelvis radiographs were analyzed to establish whether the normal biomechanics of the involved hip were restored. The following radiographic parameters were recorded and compared to the contralateral unaffected side: hip offset, cervical–diaphyseal angle, and limb length discrepancy. Clinical assessment was performed using the following scores: the Harris hip score (HHS) and the visual analog scale for pain (VAS). The independent samples t-test and the Pearson correlation test were performed. The tests were two-tailed; a p < 0.05 was considered significant. Results: A total of 31 patients met the inclusion and exclusion criteria (10 males and 21 females; mean age: 76.2 years; range: 66–90 years) and were included in this study. The modes of trochanteric nail failure included the following: cut-out in 22 cases (70.97%), non-union in 4 cases (12.9%), peri-implant fracture in 1 case (3.23%), cut-through in 2 cases (6.45%), and femoral head avascular necrosis (HAN) in 2 cases (6.45%). Long stems were used in 21 patients out of 31 (67.74%), while dual-mobility cups were implanted in 24 patients out of 31 (77.41%). A significant mean neck shaft angle (NSA) increase (p < 0.001) and a significant mean femoral offset reduction (FO, p 0.001) compared to the contralateral hip were recorded; a mean limb length discrepancy (LLD) of 8.35 mm was observed. A significant correlation between HHS and ∆NSA (p = 0.01) and ∆FO (p = 0.003) was recorded. Conclusions: Conversion from a cephalomedullary nail to THA is a complex procedure that should be considered a revision surgery, rather than a primary surgery. Surgeons must be aware that normal hip geometry may not be obtained during this surgical procedure; thus, a patient undergoing the nail-to-THA conversion for intertrochanteric fixation failure may have an increased risk of implant-related complications. Full article

Background/Objective: Research indicates that sport is a useful avenue in rehabilitation for redeveloping identity for people with a limb amputation. However, the available research focusses on Paralympians or elite athletes with disabilities. By contrast, this study aimed to explore the experience of sport participation and identity in lay members of the public who had undergone limb amputation. Methods: Semi-structured interviews took place with nine people who had undergone amputation and participated in sport. The interviews were recorded, transcribed, and analysed using interpretative phenomenological analysis. Results: Four themes were developed from the data: (1) enabling a feeling of normality and equality; (2) becoming a better person; (3) belonging and connection; and (4) experiencing and responding to the gaze of others. The findings highlight the role of sport in facilitating personal growth through a desire to help and inspire others. Conclusions: Rehabilitation professionals involved in care following amputation could offer person-centred therapies to those who may be reluctant to participate in sport in a way that makes use of a person’s values and facilitates personal growth. Full article

Background/Objectives: Using chemical disinfectants to clean the base of heat-cured acrylic dentures has several negative effects, including toxicity. On the other hand, therapeutic herbs have fewer adverse effects. This study intended to determine how the antibacterial efficacy and the surface roughness of the heat-cured acrylic material used to fabricate dentures were affected by the use of Cordia myxa fruit (CMF) extract as a disinfection solution for dentures using the immersion technique. Methods: Heat-cured acrylic specimens were prepared (N = 110; 55 specimens) for each test; each group contained five specimens. Three CMF extract concentrations (50, 100, and 150 mg/mL) were made and examined for three immersion times (5, 10, and 15 min). The results were compared to the first control group, which used distilled water, and the second group, which used 2% glutaraldehyde for ten minutes, in accordance with the guidelines. One way analysis of variance ANOVA and Games–Howell post hoc test were employed in SPSS (Statistical Package for the Social Sciences) program for statistical analysis. Results: The results for the antibacterial test revealed that CMF solutions had a statistically significant difference in all test groups in comparison with the first control group and non-significant differences with (H p = 0.92; J p = 0.278; K p = 0.303) groups in comparison with the second control group (Glutaraldehyde 2%). For the surface roughness test, the effect was not statistically significant for all groups compared to the first and second control groups. Conclusions: It can be concluded that immersing the heat-cure acrylic samples in a solution of 100 mg/mL CMF extract for 15 min, and 150 mg/mL for 10 and 15 min, has an antibacterial effect similar to that of the Glutaraldehyde 2% antiseptic and no negative effect on surface roughness. Full article

Purpose: The aim of this study was to evaluate the color stability of 3D printed resin disks using spectral reflectance data obtained at different time periods after immersion in various staining solutions. The color stability of 3D-printed temporary crowns is clinically important, as it directly affects the esthetic outcome and patient satisfaction during the provisional phase of treatment. Materials and methods: Forty identical round disk specimens measuring 10 mm in diameter and 2 mm in thickness were fabricated using CAD/CAM 3D printing resin (shade B1). Half of the specimens (n = 20) were polished using an acrylic bur and medium pumice. The remaining specimens were unpolished (n = 20). Each group of disks was then immersed in one of the following immersion solutions: artificial saliva, black tea, carrot juice, and red wine. Color difference ΔE was evaluated using the spectrophotometer, a spectral reflectance instrument, at baseline, day 1, week 1, week 2 and week 3, against a white background. Comparisons between polished and unpolished disks at each time point were conducted using Mann–Whitney tests. Differences among the staining solutions at each time point for both polished and unpolished disks were analyzed using a one-way ANOVA with Tukey’s post hoc test. Results: Color difference ΔE was measured using the CIELAB formula. The mean ΔE values of each group were calculated. The greatest difference in color was observed in the unpolished and polished disks immersed in red wine. Polished disks showed less color difference when compared to unpolished disks. Significant differences in ΔE were detected between polished and unpolished disks immersed in red wine at week 1 (p = 0.0159), week 2 (p = 0.0079) and week 3 (p = 0.0079) and in carrot juice at week 3 (p = 0.0317). Conclusions: Immersion of 3D printed disks in different staining solutions caused detectable color difference in the tested materials, which was relative to the immersion duration and the staining solution used. The color of the 3D printed resins is influenced by the surface finishing, which may result in visually perceptible color differences. The color stability of 3D printied materials should be improved to provide long-term esthetics. Full article

Purpose: The aim of this study was to evaluate the long-term clinical results of two different implant–abutment connection types (screw-retained/Morse locking taper), marginal bone loss, and complications in prosthetic restorations. Materials and Methods: In 2017–2018, 579 implants and 242 implant-supported restorations applied to 137 patients were included in the study. Patients were recalled every six months, clinical evaluations were accomplished, and complications were recorded. When examining the distribution of prosthetic restorations by type, it was determined that 38 (15.70%) were single crowns, 136 (56.19%) were fixed partial cement-retained bridge restorations, 53 (21.90%) were fixed partial screw-retained bridge restorations, and 15 (6.19%) were overdenture prostheses. Findings: Overall, complications included eighteen (21.68%) retention losses, nineteen (22.89%) instances of screw loosening, twenty-one (25.30%) veneer ceramic fractures, three (3.61%) acrylic base fractures, fourteen (16.87%) cases of peri-implantitis, and eight (9.64%) implant losses. Conclusions: Differences in complication rates were observed between implants with different implant–abutment connection designs. While no significant differences were found regarding annual mesial and distal marginal bone loss for implants with conical locking connections, a significant difference was detected in those with screw-retained connections. In both implant groups, mesial and distal marginal bone loss progressed gradually over the follow-up period. Full article

Background: Total hip arthroplasty (THA) is a widely adopted surgical intervention for restoring mobility and reducing pain in patients with severe hip joint conditions, such as osteoporosis. However, traditional titanium implants often lead to stress shielding and subsequent bone resorption due to the mismatch in stiffness between the implant and bone. Objectives: This study computationally investigates the biomechanical performance of femoral implants made from composite materials, specifically polyether-ether-ketone (PEEK) and polylactic acid (PLA) reinforced with hydroxyapatite (HA), compared to conventional titanium stems. Methods: Using finite element (FE) modeling, physiological loading during walking was simulated, and the strain energy density (SED) was analyzed to assess stress distribution and the potential for stress shielding across different Gruen zones. Results: The results indicate that both the PEEK and PLA composites exhibited more physiological load transfer, particularly in Gruen zones 1 and 7, reducing stress shielding and supporting bone preservation. Conclusions: These findings suggest that PEEK and PLA composites may offer improved implant stability and bone integration. Despite highlighting the promise of biomimetic materials in orthopedics, this study is limited to computational analysis and requires experimental validation. It emphasizes the need for further investigation using patient-specific geometries and a variety of loading scenarios to confirm these benefits and optimize femoral implant design. Full article