Prosthesis

15 pages, 1364 KB

Open AccessArticle

Neuromuscular Control of Overground Walking in Transtibial Amputees: Endoskeletal vs. Exoskeletal Prostheses

by Arunee Promsri

Prosthesis 2026, 8(2), 21; https://doi.org/10.3390/prosthesis8020021 - 20 Feb 2026

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Background: Transtibial prostheses are commonly classified as endoskeletal or exoskeletal and differ in weight, adaptability, and mechanical response, which may influence gait performance. This study examined whether prosthesis type affects overground walking movement structure and neuromuscular control and assessed the relationship between walking [...] Read more.

Background: Transtibial prostheses are commonly classified as endoskeletal or exoskeletal and differ in weight, adaptability, and mechanical response, which may influence gait performance. This study examined whether prosthesis type affects overground walking movement structure and neuromuscular control and assessed the relationship between walking speed and neuromuscular control. Methods: Principal component analysis (PCA) was applied to kinematic marker data from 20 unilateral transtibial amputees using either endoskeletal (n = 10; 54.7 ± 6.1 years) or exoskeletal prostheses (n = 10; 57.9 ± 8.7 years) during self-selected overground walking. Principal movements (PMs) were extracted to represent functionally meaningful gait components. Movement structure was evaluated using the relative explained variance of PM positions (rVAR), whereas neuromuscular control was quantified using the root mean square of PM accelerations (RMS; acceleration magnitude) and the number of zero crossings (N; regularity/predictability). Group differences were examined using covariate-adjusted analyses, controlling for preferred walking speed. Results: No significant differences in walking movement structure were found between prosthetic types. Unadjusted analyses suggested greater swing-phase acceleration (PM₂) and lower neuromuscular variability across PM₁–PM₄ in the endoskeletal group; however, these effects were no longer significant after adjusting for BMI and walking speed. Walking speed showed strong associations with neuromuscular control (p ≤ 0.003), with faster speeds linked to greater swing-phase acceleration and reduced variability. Conclusions: Walking movement structure and neuromuscular control were comparable between prosthetic types, while walking speed emerged as a key factor in gait evaluation among transtibial amputees. Full article

(This article belongs to the Section Bioengineering and Biomaterials)

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16 pages, 4282 KB

Open AccessCase Report

Implant Treatment Combining Interpositional and Strip Gingival Grafts in Post-Traumatic Sites of the Aesthetic Region: A 6-Year Case Report and Mini-Review

by Koji Naito, Akiyoshi Funato, Tsutomu Tanno and Keisuke Seki

Prosthesis 2026, 8(2), 20; https://doi.org/10.3390/prosthesis8020020 - 20 Feb 2026

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Abstract

In implant treatment in the aesthetic zone, high aesthetic quality is required in addition to functionality and long-term stability when reconstructing defects in peri-implant tissues. Post-traumatic cases often present with extensive loss of both hard and soft tissues, making the selection of an [...] Read more.

In implant treatment in the aesthetic zone, high aesthetic quality is required in addition to functionality and long-term stability when reconstructing defects in peri-implant tissues. Post-traumatic cases often present with extensive loss of both hard and soft tissues, making the selection of an appropriate grafting method essential. This report describes a case in which an interpositional gingival graft (IGG) and a strip gingival graft (SGG) were combined to regenerate peri-implant soft tissue following guided bone regeneration (GBR), maintaining favorable tissue morphology and aesthetics for six years. The patient was a 53-year-old woman who suffered trauma after falling down stairs, resulting in a fractured bridge in the right maxillary canine region and crown fracture. The traumatized tooth was extracted, and GBR was performed to restore hard tissue volume. Subsequently, IGG and SGG were used to improve soft tissue thickness, interproximal papilla height, and a healthy mucogingival junction (MGJ). A cantilever implant prosthesis was selected as the final restoration. Over six years, no gingival recession or marginal bone loss was observed, and excellent aesthetic stability was maintained. A mini-review of published reports on IGG and SGG demonstrated their efficacy in enhancing soft tissue volume. The findings of this case suggest that a comprehensive approach—including bone augmentation, soft tissue grafting, and prosthetic design—can provide predictable, long-term aesthetic and functional outcomes in complex post-traumatic cases (223). Full article

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11 pages, 518 KB

Open AccessArticle

Assessment of the Effect of Denture-Wearing and Periodontal Disease on the Microbial Load of Respiratory Pathogens

by Gabrielle Beatrice Cui Batiller, Yeuk Ying Wong, Akhila Pudipeddi and Tong Wah Lim

Prosthesis 2026, 8(2), 19; https://doi.org/10.3390/prosthesis8020019 - 18 Feb 2026

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Abstract

Objective: This study aimed to quantitatively evaluate five opportunistic respiratory pathogens among individuals, with or without dentures, who have either healthy or diseased periodontal conditions. Methods: Saliva samples were obtained from 24 older adults. DNA extraction was performed, followed by a [...] Read more.

Objective: This study aimed to quantitatively evaluate five opportunistic respiratory pathogens among individuals, with or without dentures, who have either healthy or diseased periodontal conditions. Methods: Saliva samples were obtained from 24 older adults. DNA extraction was performed, followed by a quantitative Polymerase Chain Reaction targeting five opportunistic respiratory pathogens, namely Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pyogenes, Klebsiella pneumoniae, and Streptococcus agalactiae. The abundance of opportunistic pathogens among the four groups [denture-wearing with active periodontal disease (DAP), non-denture-wearing with active periodontal disease (NDAP), denture-wearing with stable periodontal health (DSP), and non-denture-wearing with stable periodontal health (NDSP)] were compared. Results: Saliva samples of all participants (100%) carried at least one opportunistic respiratory pathogen. Of the five pathogens, S. aureus, P. aeruginosa, K. pneumoniae, and S. agalactiae were present in more than 50% of the samples. A significant difference in the bacterial load of K. pneumoniae and P. aeruginosa was observed (p < 0.05). The quantity of P. aeruginosa in the NDAP group was significantly lower than the DSP group. However, for K. pneumoniae, no significant differences between the groups were detected. Conclusions: In this small pilot cohort, a relatively high prevalence and substantial microbial load of opportunistic respiratory pathogens were identified in the saliva of older adults. On the basis of these preliminary findings, optimal oral and denture hygiene care is suggested as a potential approach to reduce the presence and burden of respiratory pathogens in this population, although larger studies are required to confirm these associations and determine their clinical significance. Full article

(This article belongs to the Section Prosthodontics)

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15 pages, 305 KB

Open AccessReview

Factors Affecting the Implant Supracrestal Complex: A Consensus Paper from the Global Consensus Meeting Organized by the Osstem Implant Community

by Marco Tallarico, Francesco Grande, Gianluca Fortunato, Carlotta Cacciò, Soo-young Lee, Young-jin Cho, Kwan-tae Noh, Chikahiro Ohkubo, Felipe Aguirre, Recep Uzgur, Gaetano Noè, Santo Catapano and Gabriele Cervino

Prosthesis 2026, 8(2), 18; https://doi.org/10.3390/prosthesis8020018 - 18 Feb 2026

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Abstract

Aim: To develop clear, evidence-based, and standardized guidelines for the design, selection, and clinical use of implant abutments and prosthetic components in order to optimize the biological, mechanical, and esthetic performance of the implant supracrestal complex. Methods: A panel of 10 expert [...] Read more.

Aim: To develop clear, evidence-based, and standardized guidelines for the design, selection, and clinical use of implant abutments and prosthetic components in order to optimize the biological, mechanical, and esthetic performance of the implant supracrestal complex. Methods: A panel of 10 expert clinicians and researchers in prosthodontics participated in the Osstem Global Consensus Meeting. For the present consensus meeting, a scoping review was performed in advance and discussed among the participants. A comprehensive search of the literature was performed up to June 2025. Two reviewers (M.T. and F.G.) independently conducted screening, data extraction, and quality assessment using the Newcastle–Ottawa Scale. The evidence was synthesized and discussed by the panel of expert clinicians during the consensus meeting. After that, guidelines were developed using a 14-question questionnaire to formulate consensus-based clinical recommendations. The participants answered structured questions and discussed discrepancies to achieve a consensus. Results: The panel of expert clinicians reached a consensus on several prosthetic key points. Concave abutment profiles and emergence angles <30° promoted peri-implant tissue stability, while convex designs and wider angles increased risks of bone loss and peri-implantitis. Titanium remains the reference abutment material in posterior sites, while zirconia provides superior esthetics anteriorly, and hybrid abutments balance strength and esthetics. Conclusions: Prosthetic design and abutment material selection critically affect peri-implant tissue stability and esthetic outcomes. The evidence supports screw-retained designs, platform switching, and the “one abutment–one time” approach for predictable long-term success. Full article

15 pages, 1951 KB

Open AccessCase Report

Minimally Invasive Rehabilitation of a Missing Maxillary Lateral Incisor Using a Lithium Disilicate Cantilever Resin-Bonded Prosthesis: A Clinical Case Report

by Mohanned M. Toras, Ossama Raffa, Hanaa Ashkar, Faris Alsufi and Loai Alsofi

Prosthesis 2026, 8(2), 17; https://doi.org/10.3390/prosthesis8020017 - 17 Feb 2026

Viewed by 741

Abstract

This case report describes the esthetic and functional rehabilitation of a 45-year-old male patient presenting with a missing maxillary right lateral incisor (#12). Due to persistent insufficiency of alveolar ridge width following multiple augmentation procedures, implant placement was contraindicated. A minimally invasive prosthetic [...] Read more.

This case report describes the esthetic and functional rehabilitation of a 45-year-old male patient presenting with a missing maxillary right lateral incisor (#12). Due to persistent insufficiency of alveolar ridge width following multiple augmentation procedures, implant placement was contraindicated. A minimally invasive prosthetic approach was therefore selected, consisting of a single-retainer lithium disilicate resin-bonded fixed dental prosthesis (RBFDP) combined with laminate veneers to optimize anterior esthetics. The cantilever design and adhesive protocol were selected based on biomechanical principles aimed at minimizing interfacial stresses and preserving enamel structure. The prosthesis was fabricated using a fully digital workflow, and adhesive bonding was performed following established ceramic and enamel surface conditioning protocols. The restoration fulfilled the patient’s esthetic and functional expectations, and clinical follow-up at 18 months demonstrated stable bonding, healthy peri-abutment tissues, and absence of technical or biological complications. This case highlights the role of lithium disilicate cantilever RBFDPs as a minimally invasive and clinically viable treatment option for the replacement of maxillary lateral incisors when implant therapy is contraindicated, with outcomes limited to short- to medium-term observation. Full article

(This article belongs to the Special Issue Digital and 3D-Printed Dental Appliances: Materials, Design, and Clinical Applications)

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23 pages, 2606 KB

Open AccessArticle

A Proof-of-Concept Framework Integrating ML-Based MRI Segmentation with FEM for Transfemoral Residual Limb Modelling

by Ryota Sayama, Yukio Agarie, Hironori Suda, Hiroshi Otsuka, Kengo Ohnishi, Shinichiro Kon, Akihiko Hanahusa, Motoki Takagi and Shinichiro Yamamoto

Prosthesis 2026, 8(2), 16; https://doi.org/10.3390/prosthesis8020016 - 13 Feb 2026

Viewed by 614

Abstract

Background: Accurate evaluation of pressure distribution at the socket–limb interface is essential for improving prosthetic fit and comfort in transfemoral amputees. This study aimed to develop a proof-of-concept framework that integrates machine learning–based segmentation with the finite element method (FEM) to explore the [...] Read more.

Background: Accurate evaluation of pressure distribution at the socket–limb interface is essential for improving prosthetic fit and comfort in transfemoral amputees. This study aimed to develop a proof-of-concept framework that integrates machine learning–based segmentation with the finite element method (FEM) to explore the feasibility of an initial workflow for residual-limb analysis during socket application. Methods: MRI data from a transfemoral amputee were processed using a custom image segmentation algorithm to extract adipose tissue, femur, and ischium, achieving high F-measure scores. The segmented tissues were reconstructed into 3D models, refined through outlier removal and surface smoothing, and used for FEM simulations in LS-DYNA. Pressure values were extracted at nine sensor locations and compared with experimental measurements to provide a preliminary qualitative assessment of model behaviour. Results: The results showed consistent polarity between measured and simulated values across all points. Moderate correspondence was observed at eight low-pressure locations, whereas a substantial discrepancy occurred at the ischial tuberosity (IS), the primary load-bearing site. This discrepancy likely reflects the combined influence of geometric deviation in the reconstructed ischium and the non-physiological medial boundary condition required to prevent unrealistic tissue displacement. This limitation indicates that the current formulation does not support reliable quantitative interpretation at clinically critical locations. Conclusions: Overall, the proposed framework provides an initial demonstration of the methodological feasibility of combining automated anatomical modeling with FEM for exploratory pressure evaluation, indicating that such an integrated pipeline may serve as a useful foundation for future development. While extensive refinement and validation are required before any quantitative or clinically meaningful application is possible, this work represents an early step toward more advanced computational investigations of transfemoral socket–limb interaction. Full article

(This article belongs to the Special Issue Finite Element Analysis in Prosthesis and Orthosis Research)

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13 pages, 1956 KB

Open AccessArticle

Step Across the Border: A Comparative Analysis of Two Centers Performing Targeted Muscle Reinnervation

by Gunther Felmerer, Edward de Keating-Hart, Jérôme Pierrart, Claire Bonamici, Guillaume Bokobza, Marta Da Costa, Silvio Bagnarosa, Alperen Sabri Bingoel, Daniela Wüstefeld, Erik Andres, Wolfgang Lehmann and Jonathan Frederic Götz

Prosthesis 2026, 8(2), 15; https://doi.org/10.3390/prosthesis8020015 - 11 Feb 2026

Viewed by 550

Abstract

Background: Targeted muscle reinnervation (TMR) is increasingly used to enhance prosthetic control and to reduce post-amputation pain. Its implementation across new centers raises questions about the reproducibility of outcomes and the impact of surgical experience. Methods: We compared the first three [...] Read more.

Background: Targeted muscle reinnervation (TMR) is increasingly used to enhance prosthetic control and to reduce post-amputation pain. Its implementation across new centers raises questions about the reproducibility of outcomes and the impact of surgical experience. Methods: We compared the first three TMR patients treated in a newly established center in Nantes, France, with three patients treated in a high-volume center in Göttingen, Germany. Functional outcomes were measured using the Box and Block test (BBT), and operative time was recorded. Two French cases were performed with the assistance of a Göttingen-based surgeon. Conclusions: The functional outcomes showed a similar trend in both groups. The mean BBT scores were equivalent, suggesting reliable reinnervation and prosthetic integration even in early cases. Operative times were longer in Nantes, but did not impact outcomes. TMR appears not to have a pronounced learning curve, particularly regarding functional success in early cases under guided protocols. Factors such as assistance from experienced surgeons and favorable donor-to-recipient nerve ratios likely contribute to consistent outcomes. These findings support the reproducibility of TMR across institutions. Results: Within the first two years of rehabilitation we observed improvements in both functional performance and patient-reported quality of life. All six patients across both centers in-creased in BBT scores. All the patients reported an increase in social relationships and psychological health, and two of three patients reported an increase in physical health. Importantly, all six patients discontinued the use of pain medication at 2 years fol-lowing TMR. Furthermore, the French patients reported a decrease from 65–82 mm to 0–31 mm across the patients’ Visual Analog Scale (VAS) pain scores. Full article

(This article belongs to the Special Issue Innovation in Prosthetic Solutions: Bridging Neuroscience and Engineering for Next-Generation Prosthetic Systems)

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20 pages, 1191 KB

Open AccessArticle

Recycling of Medical Waste in the Circular Economy: LCA Analysis of the Production of Bone Allografts from Femoral Heads Used in Dental Implantology

by Szidonia Krisztina Veress, Bálint Botond Bögözi, Lajos Csönge, Bernadette Kerekes-Máthé and Melinda Székely

Prosthesis 2026, 8(2), 14; https://doi.org/10.3390/prosthesis8020014 - 6 Feb 2026

Cited by 1 | Viewed by 717

Abstract

Background/Objectives: Bone grafting is fundamental in oral implantology in order to achieve appropriate esthetic and functional results. One of the options for bone grafting is the use of allografts, which can be produced using femoral heads removed during orthopedic surgeries in accordance [...] Read more.

Background/Objectives: Bone grafting is fundamental in oral implantology in order to achieve appropriate esthetic and functional results. One of the options for bone grafting is the use of allografts, which can be produced using femoral heads removed during orthopedic surgeries in accordance with the principles of the circular economy. The aim of this study is to examine the environmental impacts of the production of cancellous block and granulates of bone graft materials produced in this way. Methods: The cradle-to-gate life cycle assessment was performed at the Petz Aladár University Teaching Hospital Tissue Bank Department, Győr, Hungary, with the system boundaries defined and the bone graft material produced during a production process defined as a functional unit. The environmental impacts were determined with the OpenLCA v2.5.0. software, using the ReCiPe v1.03 2016 midpoint (H) and endpoint (H) assessment methods. Results: During the production process, 500 g of bone graft material is produced in both forms, packaged as 1 g. The carbon footprint of the production of the cancellous bone block was 88,972 kgCO₂-Eq, while that of the bone granulates was 100,033 kgCO₂-Eq, to which the chemicals used for the degreasing and deantigenization of the bone tissue contributed the most. Within the impact categories, the material resources of metals–minerals, terrestrial ecotoxicity and climate change contributed the most to the environmental impacts. Within most impact categories, electricity was the most significant influencing factor. Conclusions: The environmental impact of the production of bone substitute granulates is greater than that of the bone block, to which the packaging of the products contributes primarily. Full article

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20 pages, 9590 KB

Open AccessArticle

Computer-Guided Flapless Immediate Function Dental Implants for Full-Arch Rehabilitations Using the All-on-4 Concept: A 12-Year Clinical and 10-Year Radiographic Retrospective Study

by Miguel de Araújo Nobre, Armando Lopes, Carolina Antunes and Francisco Salvado

Prosthesis 2026, 8(2), 13; https://doi.org/10.3390/prosthesis8020013 - 26 Jan 2026

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Abstract

Background/Objectives: Implant-supported rehabilitations using the All-on-4 concept represent a viable treatment option for completely edentulous patients. The guided surgery software allows for the performance of a flapless computer-guided surgery with similar results to those achieved through a flap surgery. This study aimed to [...] Read more.

Background/Objectives: Implant-supported rehabilitations using the All-on-4 concept represent a viable treatment option for completely edentulous patients. The guided surgery software allows for the performance of a flapless computer-guided surgery with similar results to those achieved through a flap surgery. This study aimed to evaluate the long-term outcomes of complete edentulous implant-supported rehabilitations using an All-on-4 arrangement, following a computer-guided protocol. Methods: A total of 111 patients (68 females, 43 males) with an average age of 60.9 years ± 9.67 years were treated. The primary outcome measures were implant and prosthetic survival. Secondary outcome measures were marginal bone loss (MBL) and the incidence of mechanical and biological complications. Results: Thirty-nine patients were lost to follow-up. Thirty-seven implants and five prostheses failed, rendering a 92.5% implant cumulative survival rate and a 96.2% prosthetic survival rate at 12 years. The average MBL per implant was 1.19 ± 1.16 mm, with 1.26 ± 1.33 mm for axial implants and 1.12 ± 0.95 mm for tilted implants at 10 years. The incidence rate of mechanical complications at the patient level was 90.1% for provisional prostheses and 55.9% for definitive prostheses. The rate of biological complications was 14.3% at the implant level. Conclusions: Full-arch rehabilitations following an All-on-4 implant arrangement and assisted by a computer-guided protocol may be a viable alternative for patients with edentulism/hopeless teeth in the long term. Full article

(This article belongs to the Collection Oral Implantology: Current Aspects and Future Perspectives)

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Prosthesis, Volume 8, Issue 2 (February 2026) – 9 articles

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