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Effect of Dark Aging on Zirconium Silicate Nanoparticle–Reinforced Maxillofacial Silicone -
Forces Transmitted to Abutment Teeth in Distal Extension Removable Partial Denture—Impact of Indirect Retention -
Integration of EMG and Machine Learning for Real-Time Control of a 3D-Printed Prosthetic Arm -
Effect of Framework Orientation at a Selective Laser Melting Building Platform on Removable Partial Denture Fit
Journal Description
Prosthesis
Prosthesis
is an international peer-reviewed open access journal on rehabilitation medicine published monthly online by MDPI. The Italian Society of Odontostomatological Surgery (SIDCO) is affiliated with Prosthesis and its members receive discounts on the article processing charges.
- Open Access—free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, ESCI (Web of Science), and other databases.
- Journal Rank: JCR - Q2 (Materials Science, Biomaterials) / CiteScore - Q1 (Oral Surgery)
- Reliable Service: rigorous peer review and professional production.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 23.9 days after submission; acceptance to publication is undertaken in 5.8 days (median values for papers published in this journal in the second half of 2025).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
Impact Factor:
4.5 (2024);
5-Year Impact Factor:
4.0 (2024)
Latest Articles
Assessment of the Effect of Denture-Wearing and Periodontal Disease on the Microbial Load of Respiratory Pathogens
Prosthesis 2026, 8(2), 19; https://doi.org/10.3390/prosthesis8020019 - 18 Feb 2026
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
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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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Open AccessReview
Factors Affecting the Implant Supracrestal Complex: A Consensus Paper from the Global Consensus Meeting Organized by the Osstem Implant Community
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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
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
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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
Open AccessCase Report
Minimally Invasive Rehabilitation of a Missing Maxillary Lateral Incisor Using a Lithium Disilicate Cantilever Resin-Bonded Prosthesis: A Clinical Case Report
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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
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
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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)
Open AccessArticle
A Proof-of-Concept Framework Integrating ML-Based MRI Segmentation with FEM for Transfemoral Residual Limb Modelling
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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
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
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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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Open AccessArticle
Step Across the Border: A Comparative Analysis of Two Centers Performing Targeted Muscle Reinnervation
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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
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
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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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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
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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
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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.
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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
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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
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
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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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Open AccessArticle
Effects of Over-the-Counter Whitening Products on Microhardness, Gloss Retention, and Surface Roughness of Z350 XT Universal Restorative Composite Resin
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Mashael Binhasan, Sadeem Alkhamees, Reem Alkhraiyef, Shahad Alsumikhi, Sara Shabib, Nourah Shono, Haifa Barakah and Nassr Al-Maflehi
Prosthesis 2026, 8(1), 12; https://doi.org/10.3390/prosthesis8010012 - 22 Jan 2026
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Objectives: This study investigated the effects of three over-the-counter (OTC) whitening products, whitening pen (WP, Dazzling White Instant Whitening Pen, Dazzling White, Grand Rapids, MI, USA), whitening mouthwash (MW, Colgate Optic White, Colgate-Palmolive, New York, NY, USA), and whitening toothpaste (TP, Crest
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Objectives: This study investigated the effects of three over-the-counter (OTC) whitening products, whitening pen (WP, Dazzling White Instant Whitening Pen, Dazzling White, Grand Rapids, MI, USA), whitening mouthwash (MW, Colgate Optic White, Colgate-Palmolive, New York, NY, USA), and whitening toothpaste (TP, Crest 3D White, Procter & Gamble, Cincinnati, OH, USA), on the microhardness, gloss retention, and surface roughness of a nanofilled resin composite (Filtek Z350 XT Universal Restorative, 3M ESPE). Methods: Composite resin specimens were prepared and subjected to treatment with WP, MW, or TP. Microhardness, gloss retention, and surface roughness were measured before and after treatment. Data were subjected to statistical analysis, with normality assessed by Shapiro–Wilk testing. Parametric data were summarized as mean ± SD, and differences were evaluated using paired t-tests and one-way ANOVA with a significance level of p ≤ 0. 05. Results: All whitening products significantly altered the tested surface properties. Microhardness decreased in all groups (MD [95% CI]: 2.28 [1.84–2.71] for WP, 5.05 [4.22–5.88] for MW, and 3.09 [2.35–3.83] for TP; p < 0.001), with the greatest reduction observed in the MW group. Gloss retention also declined significantly (MD [95% CI]: 9.52 [6.28–12.76] for WP, 17.97 [14.92–21.01] for MW, and 18.92 [15.64–22.21] for TP; p < 0.001), with TP and MW showing greater loss compared to WP. Surface roughness increased significantly within each group (MD [95% CI]: −0.07 [–0.10 to −0.04] for WP, −0.23 [–0.30 to −0.16] for MW, and −0.25 [–0.38 to −0.13] for TP; p < 0.001), although no significant differences were found among groups in post-treatment values. Conclusions: OTC whitening products adversely affected the optical and mechanical properties of Z350 XT universal composite resin. Whitening MW caused the most pronounced microhardness reduction, while MW and TP induced greater gloss loss than WP. Clinicians should consider the potential impact of whitening products on resin composite restorations when advising patients on their use.
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Open AccessArticle
Surface Modification of Zirconia with Thick Hydroxyapatite Film Using RF Magnetron Sputtering Technique
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Ihab Nabeel Safi, Hasanain K. A. Alalwan, Mustafa S. Tukmachi, Dhuha H. Mohammed and Maryam Sinan Abdulaali Al-Yasari
Prosthesis 2026, 8(1), 11; https://doi.org/10.3390/prosthesis8010011 - 19 Jan 2026
Abstract
Background/Objectives: The use of zirconia implants is gaining traction as a potential alternative to titanium. Although having excellent properties, the zirconia surface has limited osteogenic potential. The purpose of this study was to produce, for the first time, mechanically stable, thick micron-scale
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Background/Objectives: The use of zirconia implants is gaining traction as a potential alternative to titanium. Although having excellent properties, the zirconia surface has limited osteogenic potential. The purpose of this study was to produce, for the first time, mechanically stable, thick micron-scale hydroxyapatite coatings on zirconia implant material using radiofrequency (RF) magnetron sputtering. Methods: Zirconia samples were coated with HA using an RF magnetron sputtering device at a temperature of 125 °C for 20 h with 155 W of power. The procedure included rotating the substrate at a speed of 10 rpm while an argon gas flow was maintained continuously. Field emission scanning electron microscopy (FESEM), energy-dispersive X-ray (EDX) analysis, atomic force microscopy, and Vickers hardness measurements were used to evaluate the coat’s characteristics. Results: A smooth hydroxyapatite coating layer that was consistent and free of cracks was observed in all FESEM pictures. The EDX study revealed that the substrate surface contains HA particles, and the ratio of calcium (Ca) to phosphorus (P) was 16.58 to 11.31, which is very close to the ratio in original HA. FESEM cross-section pictures showed good adhesion between the coating and substrate without any gaps, and the coating thickness was 5 µm on average. A statistically significant difference was found in the roughness analysis between the samples of uncoated Zr and HA-coated Zr (p-value < 0.05). Conclusions: Zirconia implant material can be coated with a uniform layer of HA, displaying good adhesion and a thickness of a few micrometers when using magnetron sputtering for an extended period of time.
Full article
(This article belongs to the Collection Oral Implantology: Current Aspects and Future Perspectives)
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Open AccessArticle
How Many Teeth Are Needed to Maintain Healthy Oral Function in Older Adults? A Cross-Sectional Analysis
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Ketsupha Suwanarpa, Yoko Hasegawa, Jarin Paphangkorakit, Atthasit Kanwiwatthanakun, Kazuhiro Hori and Takahiro Ono
Prosthesis 2026, 8(1), 10; https://doi.org/10.3390/prosthesis8010010 - 14 Jan 2026
Abstract
Background/Objectives: Oral function impairment negatively impacts nutrition, health, and quality of life in older adults. While retaining ≥20 natural teeth is often recommended for maintaining oral function, its validity is uncertain, particularly for those who adapt to tooth loss with dentures. This study
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Background/Objectives: Oral function impairment negatively impacts nutrition, health, and quality of life in older adults. While retaining ≥20 natural teeth is often recommended for maintaining oral function, its validity is uncertain, particularly for those who adapt to tooth loss with dentures. This study aimed to determine the minimum number of remaining functional teeth necessary to prevent oral hypofunction in older adults, focusing on two diagnostic criteria: decreased masticatory function and reduced occlusal force. Methods: A total of 154 participants (≥60 years) were included. Oral examination assessed the number of remaining functional teeth. To assess masticatory function, masticatory performance was objectively measured using a visual scoring method of gummy jelly, and occlusal force was quantified with pressure-sensitive film. Pearson’s correlation analyzed relationships among variables, while receiver operating characteristic (ROC) analysis identified optimal tooth number cut-offs for detecting decreased masticatory function (score ≤ 2) and reduced occlusal force (<500 N). Results: Significant positive correlations were found between the number of remaining functional teeth and both masticatory performance (r = 0.591, p < 0.001) and occlusal force (r = 0.453, p < 0.001). ROC indicated that 17 teeth was the optimal threshold for identifying both decreased masticatory performance and reduced occlusal force, with sensitivities of 0.79 and 0.72 and specificities of 0.93 and 0.88, respectively. Conclusions: Retention of 17 or more remaining functional teeth may be sufficient to maintain adequate masticatory performance and occlusal force. These findings serves as a preliminary guide for treatment planning and targeted interventions focused on preserving tooth retention and improving oral function in aging populations.
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(This article belongs to the Special Issue Maintaining Oral Function in Ageing Populations: Evidence-Based Strategies in Removable Prosthodontics)
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Open AccessArticle
Adaptive Myoelectric Hand Prosthesis Using sEMG—SVM Classification
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Forbes Kent, Amelinda Putri, Yosica Mariana, Intan Mahardika, Christian Harito, Grasheli Kusuma Andhini and Cokisela Christian Lumban Tobing
Prosthesis 2026, 8(1), 9; https://doi.org/10.3390/prosthesis8010009 - 9 Jan 2026
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Background/Objectives: An individual with a hand disability, whether caused by an accident, disease, or congenital condition, may have significant problems with their daily activities, self-perception, and ability to work. Prosthetic hands can be used to restore essential hand functions, and features such
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Background/Objectives: An individual with a hand disability, whether caused by an accident, disease, or congenital condition, may have significant problems with their daily activities, self-perception, and ability to work. Prosthetic hands can be used to restore essential hand functions, and features such as adaptive grasps can enhance their usability. Due to noise in the sEMG signal and hardware limitations in the system, reliable myoelectric control remains a challenge for low-cost prosthetics. ESP32 microcontrollers are used in this study to develop an SVM-based sEMG classifier that addresses these issues and improves responsiveness and accuracy. A 3D-printed mechanical structure supports the prosthesis, reducing production costs and making it more accessible. Methods: The prosthetic hand is developed using an ESP32 as the microcontroller, a Myoware Muscle Sensor to detect muscle activity, and an ESP32-based control system that integrates sEMG acquisition, SVM classification, and finger actuation with FSR feedback. A surface electromyography (sEMG) method is paired with a Support Vector Machine (SVM) algorithm to help classify signals from the sensor to improve the user’s experience and finger adaptability. Results: The SVM classifier achieved 89.10% accuracy, an F1-score of 0.89, and an AUC of 0.92, with real-time testing demonstrating that the ESP32 could reliably distinguish flexion and extension signals and actuate the servo, accordingly, producing movements consistent with the kinematic simulations. Complementing this control performance, the prosthetic hand was constructed using a coupled 4 bar linkage mechanism fabricated in PLA+, selected for its superior factor of safety compared to the other tested materials, ensuring sufficient structural reliability during operation. Conclusions: The results demonstrate that SVM-based sEMG classification can be effectively implemented on low-power microcontrollers for intuitive, low-cost prosthetic control. Further work is needed to expand beyond two-class detection and increase robustness against muscle fatigue and sensor placement variability.
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Open AccessArticle
SEM-Based Evaluation and Quantitative Validation of ICON Resin Infiltration in Sound Enamel: A Microinvasive Preventive Strategy in Orthodontics
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Alexandra Ecaterina Saveanu, Catalina Iulia Saveanu, Oana Dragos, Maria Sophia Saveanu and Daniela Anistoroaei
Prosthesis 2026, 8(1), 8; https://doi.org/10.3390/prosthesis8010008 - 9 Jan 2026
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Background: Resin infiltration has emerged as a micro-invasive strategy for managing enamel porosities, offering both therapeutic and aesthetic benefits. ICON® (DMG, Hamburg, Germany) is the most widely used system; however, evidence on its penetration behavior in sound enamel remains limited. Objectives: This
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Background: Resin infiltration has emerged as a micro-invasive strategy for managing enamel porosities, offering both therapeutic and aesthetic benefits. ICON® (DMG, Hamburg, Germany) is the most widely used system; however, evidence on its penetration behavior in sound enamel remains limited. Objectives: This in vitro study aimed to evaluate the penetration depth and morphological pattern of ICON resin infiltration in sound human enamel, using quantitative morphometric analysis and scanning electron microscopy (SEM). Methods: Fourteen freshly extracted, caries-free anterior teeth were sectioned longitudinally. ICON® resin infiltrate was applied to the buccal enamel surfaces according to the manufacturer’s protocol, while the lingual/palatal surfaces served as internal controls. Penetration depth was measured quantitatively on both mesial (surface A) and distal (surface B) halves, and SEM was used to assess resin–enamel interface morphology. Statistical analysis included the Shapiro–Wilk test, paired t-test, Pearson correlation, and percentage difference calculation. Results: The mean difference in penetration depth between surfaces A and B was −21.29 µm (p = 0.525), indicating no statistically significant variation. A strong positive correlation was observed between surfaces (r = 0.783, p = 0.001). The mean percentage difference was −3.57% (SD = 18.61%), suggesting minimal directional bias. SEM images confirmed continuous and homogeneous resin infiltration within enamel prisms. Post-hoc power analysis indicated 15.2% power, reflecting the impact of the limited sample size typical for SEM-based exploratory studies. Conclusions: Within the limitations of this in vitro investigation, ICON resin infiltration demonstrated uniform and consistent penetration in sound enamel, supported by both quantitative and SEM analyses. These findings validate its potential as a reliable preventive and micro-invasive biomaterial in dental practice, particularly for protecting enamel surfaces prior to orthodontic bracket bonding. Further clinical research with larger cohorts is recommended to confirm its long-term stability and prophylactic performance.
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Open AccessTechnical Note
The Design of a Multi-Finger Actuated Breathing-Powered Upper Limb Prosthesis
by
Iñigo De La Joya, Jhonatan da Ponte Lopes and Jeroen H. M. Bergmann
Prosthesis 2026, 8(1), 7; https://doi.org/10.3390/prosthesis8010007 - 6 Jan 2026
Abstract
Upper limb deficiencies can limit the range of tasks children can perform. Current prosthetics provide overall good performance to increase the activities that users can complete, but challenges remain. Body- or electrically powered prostheses struggle to restore the full range of motion needed
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Upper limb deficiencies can limit the range of tasks children can perform. Current prosthetics provide overall good performance to increase the activities that users can complete, but challenges remain. Body- or electrically powered prostheses struggle to restore the full range of motion needed for specific tasks. Currently, these systems do not allow for controlled hand closure or opening across all possible postures. A breathing-powered prototype named Airbender, which extracts energy from a breathing input by means of a Tesla turbine, provides the possibility of operation in any position. This paper introduces a novel design for a multi-finger actuated breathing-powered upper limb prosthetic concept and analyses its performance through a series of lab-based experiments. Results show that such a design could provide a fully controllable system. The final assembled design is capable of achieving full actuation under a flow rate of 340 Ls/min. The results obtained demonstrate that a functional multi-finger actuated breathing-powered upper limb prosthesis could be feasible and opens a path for future research in the field, with the ultimate goal of reducing the minimum flow rate required and actuation time to further improve its functionality.
Full article
(This article belongs to the Section Orthopedics and Rehabilitation)
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Open AccessCase Report
Surgical Procedures to Enhance Prosthetic Prognosis in the Rehabilitation of a Maxillectomy Defect Due to Sinonasal Carcinoma: A Case Report
by
Armando Crupi, Giancarlo Pecorari, Vincenzo Ronsivalle and Marco Cicciù
Prosthesis 2026, 8(1), 6; https://doi.org/10.3390/prosthesis8010006 - 30 Dec 2025
Abstract
Background: Rehabilitation of head and neck cancer patients with acquired intraoral defects is challenging and requires multidisciplinary collaboration. This case report describes an integrated surgical and prosthetic approach in which palatal obturator rehabilitation is used to restore palatal integrity, speech, swallowing, aesthetics,
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Background: Rehabilitation of head and neck cancer patients with acquired intraoral defects is challenging and requires multidisciplinary collaboration. This case report describes an integrated surgical and prosthetic approach in which palatal obturator rehabilitation is used to restore palatal integrity, speech, swallowing, aesthetics, and overall quality of life after maxillectomy. The objective is to show how careful surgical planning to optimize prosthetic prognosis, combined with a precisely designed obturator prosthesis, can achieve satisfactory functional rehabilitation. Methods: A man in his 50s with sinonasal carcinoma underwent partial left maxillectomy followed by radiotherapy and chemotherapy. The defect was classified as Aramany class I and Brown class 2b, and the surgical resection was planned to preserve structures favorable to prosthetic support. Prosthetic management included fabrication of a removable partial denture incorporating a hollow-bulb obturator. Results: During trial and delivery, the patient demonstrated improved speech and swallowing, enhanced denture stability, and favorable aesthetics. The patient reported satisfaction with functional and cosmetic outcomes and was provided with instructions for use and cleaning, with a plan for regular follow-up. Conclusions: Palatal obturator prostheses remain a gold standard for unilateral maxillectomy rehabilitation when adequate retention is achievable. Surgical-prosthetic collaboration permits restoring palatal contours, and dentition can normalize speech and swallowing, and substantially improve the quality of life.
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(This article belongs to the Special Issue Prosthesis: Spotlighting the Work of the Editorial Board Members)
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Open AccessArticle
Subischial vs. Ischial Containment Sockets: A Multicenter Randomized Crossover Trial to Assess Comfort and Mobility in Daily Life Situations
by
Isabelle Loiret, Clément Duraffourg, Iris Permentiers, Pascal Barbazanges, Guillaume Bokobza, Marta Da Costa, Estelle Elie, Nicolas Fons, Christophe Popineau, Sandrine Rey, Ghislaine Roche, Yoann Ronzi, Marie Thomas-Pohl, Rémi Klotz and Laurine Calistri
Prosthesis 2026, 8(1), 5; https://doi.org/10.3390/prosthesis8010005 - 30 Dec 2025
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Background: Various socket designs exist, linking the residual limb together with the prosthetic components to restore the ability to walk; however, lack of socket comfort is a frequent complaint. Objective: To evaluate the impact of socket design on end-user comfort and mobility. Methods:
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Background: Various socket designs exist, linking the residual limb together with the prosthetic components to restore the ability to walk; however, lack of socket comfort is a frequent complaint. Objective: To evaluate the impact of socket design on end-user comfort and mobility. Methods: A randomized crossover trial was set to compare comfort and mobility of above-knee amputees (AKAs) wearing an ischial containment (IC) or subischial (I-SUB) socket. Patients actively wearing IC sockets were recruited from 10 rehabilitation centers across the country. They were then fitted for an I-SUB socket by Certified Prosthetists (CPs) as an alternate socket. Participants were randomly assigned to start with one or the other socket. After a minimum of 2 weeks, each participant evaluated the Socket Comfort Score (SCS) (primary outcome) in various situations, performed the 2-min walk test, and answered the PLUS-M questionnaire (secondary outcomes). Results: A total of 25 participants were included, of whom 23 completed the study with full (n = 21) or partial data (n = 2). SCS were improved with I-SUB compared with IC in all situations, with significant differences in general, when sitting on a rigid chair, sitting in a car, and standing. The differences in self-reported mobility and walking distance at the 2-min walk test were not significant. At the end of the study, more than 80% of the participants chose to keep the I-SUB socket for their daily use. Conclusions: For the first time, this study supports that the subischial suction socket improves comfort in daily life without negatively impacting user mobility in a group of individuals with AKA.
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Open AccessArticle
Bactericidal Titanium Oxide Nanopillars for Intersomatic Spine Screws
by
Mariano Fernández-Fairén, Luis M. Delgado, Matilde Roquette and Javier Gil
Prosthesis 2026, 8(1), 4; https://doi.org/10.3390/prosthesis8010004 - 26 Dec 2025
Abstract
Background: Postoperative infections remain a major complication in spinal surgeries involving intersomatic screws, often compromising osseointegration and long-term implant stability. Questions/Purposes: This study evaluated a nanotextured titanium oxide surface with nanopillar-like morphology designed to reduce bacterial colonization while preserving mechanical integrity
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Background: Postoperative infections remain a major complication in spinal surgeries involving intersomatic screws, often compromising osseointegration and long-term implant stability. Questions/Purposes: This study evaluated a nanotextured titanium oxide surface with nanopillar-like morphology designed to reduce bacterial colonization while preserving mechanical integrity and promoting bone integration. Methods: Ti6Al4V screws were studied in three batches: control, passivated with HCl and acid mixture treatment to obtain nanotopographies on the surfaces. To create the nanotopographies, the screws were treated with a 1:1 (v/v) sulfuric acid–hydrogen peroxide solution for 2 h. Surface morphology, roughness, wettability, and surface energy were analyzed by SEM, confocal microscopy, and contact angle measurements. Corrosion and ion release were assessed electrochemically and by ICP-MS, respectively. Mechanical behavior, cytocompatibility, mineralization, and antibacterial efficacy were evaluated in vitro. Osseointegration was analyzed in rabbit tibiae after 21 days by histology and bone–implant contact (BIC). Results: The treatment produced uniform nanopillars (Ra = 0.12 µm) with increased hydrophilicity (49° vs. 102° control) and higher surface energy. Mechanical properties and fatigue resistance (~600 N, 10 million cycles) were unaffected. Corrosion currents and Ti ion release remained low. Nanopillar surfaces enhanced osteoblast adhesion and mineralization and reduced bacterial viability by >60% for most strains. In vivo, Bone Index Contact (BIC) was higher for nanopillars (52.0%) than for HCl-treated (43.8%) and control (40.1%) screws, showing a positive osseointegration trend (p > 0.005). Conclusions: The proposed acid-etching process generates a stable, scalable nanotopography with promising antibacterial and osteogenic potential while maintaining the alloy’s mechanical and chemical integrity. Clinical relevance: This simple, scalable, and drug-free surface modification offers a promising approach to reduce postoperative infections and promote bone integration in spinal implants.
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(This article belongs to the Special Issue Managing the Challenge of Periprosthetic Joint Infection)
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Open AccessArticle
Evaluation of Zirconium Oxide Nanoparticle-Reinforced Pigmented Maxillofacial Silicone Mimicking Human Skin Tone: Effects on Color Stability and Surface Roughness After Accelerated Aging
by
Soz Grundig, Kawan Othman and Bruska Azhdar
Prosthesis 2026, 8(1), 3; https://doi.org/10.3390/prosthesis8010003 - 25 Dec 2025
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Background/Objectives: This in vitro study examined the potential enhancement in resistance to accelerated aging in room-temperature vulcanized (RTV) maxillofacial silicone, intrinsically pigmented in two skin tones, through the use of zirconium oxide (ZrO2) nanoparticles. Methods: A total of 128 disc-shaped specimens
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Background/Objectives: This in vitro study examined the potential enhancement in resistance to accelerated aging in room-temperature vulcanized (RTV) maxillofacial silicone, intrinsically pigmented in two skin tones, through the use of zirconium oxide (ZrO2) nanoparticles. Methods: A total of 128 disc-shaped specimens were created in rose silk and soft brown shades, each containing zirconium oxide concentrations of 0%, 1%, 2%, and 3% by weight. Color variation (ΔE*) was assessed initially and following 252, 750, and 1252 h of artificial aging, tested with a colorimeter. Surface roughness characteristics (Ra, Rq, Rt) were evaluated before and after 1252 h using atomic force microscopy (AFM). Structural, vibrational, and morphological characteristics were analyzed through X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and field emission scanning electron microscopy (FESEM). Results: Non-parametric tests (Friedman, Kruskal–Wallis, and Bonferroni-adjusted paired testing; p < 0.05) indicated that accelerated aging significantly increased ΔE* in all specimens. The addition of ZrO2 reduced these changes; however, the optimal concentration differed by pigment: 1% for rose silk and 3% for soft brown. The effect on surface roughness depended on pigment type. Higher nanoparticle concentrations generally improved post-aging smoothness in soft brown samples, whereas rose silk showed a more variable response. XRD and FTIR analyses confirmed successful nanoparticle incorporation without altering the fundamental silicone structure, while FESEM demonstrated improved filler–matrix interaction in modified groups. Conclusions: Adjusting ZrO2 concentration according to pigment type can improve the future color retention and surface characteristics of maxillofacial silicone.
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Open AccessArticle
Development and Validation of a Questionnaire Comparing the Role of Conventional Versus Digital Technologies as an Innovating Tool in Prosthodontics
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Valentin Lamasanu, Dragos Ioan Virvescu, Ionut Luchian, Gabriel Rotundu, Oana-Maria Butnaru, Dana Gabriela Budala, Florin Razvan Curca, Florinel Cosmin Bida, Carina Balcos, Zinovia Surlari and Monica Silvia Tatarciuc
Prosthesis 2026, 8(1), 2; https://doi.org/10.3390/prosthesis8010002 - 23 Dec 2025
Abstract
Background/Objectives: The rapid evolution of digital technologies has significantly transformed prosthodontic workflows, improving clinical precision, communication, and patient satisfaction. However, the extent to which dental professionals perceive, integrate, and evaluate these technologies remains insufficiently standardized. This study aimed to develop and validate
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Background/Objectives: The rapid evolution of digital technologies has significantly transformed prosthodontic workflows, improving clinical precision, communication, and patient satisfaction. However, the extent to which dental professionals perceive, integrate, and evaluate these technologies remains insufficiently standardized. This study aimed to develop and validate a questionnaire for assessing perceptions, attitudes, perceived advantages, barriers, and future intentions regarding the use of digital technologies in prosthodontic practice. Methods: A cross-sectional survey was conducted among 420 dental professionals (305 dentists and 115 dental technicians) from Northeastern Romania. The 27-item questionnaire, structured on five theoretical dimensions, was distributed online via the Survio platform. Internal consistency was assessed using Cronbach’s Alpha, and construct validity was analyzed through Exploratory Factor Analysis (Principal Component Analysis with Varimax rotation). Conclusions: Cronbach’s Alpha coefficients ranged from 0.700 to 0.799 across the five dimensions, indicating acceptable to very good internal reliability. The Kaiser–Meyer–Olkin value (0.646) and Bartlett’s Test of Sphericity (p < 0.001) confirmed data suitability for factor analysis. The validated questionnaire represents a reliable and conceptually coherent tool for evaluating professional perspectives on digitalization in prosthodontics. Its application can inform educational strategies, guide institutional investments, and support a balanced transition toward integrated digital workflows in clinical and laboratory settings.
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(This article belongs to the Special Issue Biomimetics and Digital Workflows in Prosthodontics: Innovations, Materials, and Patient-Centered Outcomes)
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Open AccessArticle
Cross-Cultural Adaptation and Preliminary Validation of the Arabic Version of the Amputee Body Image Scale
by
Reem W. Massarweh and Mohammad M. D. Sobuh
Prosthesis 2026, 8(1), 1; https://doi.org/10.3390/prosthesis8010001 - 22 Dec 2025
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Background/Objectives: Amputation often leads to decreased body image satisfaction and self-acceptance, affecting mental health and social integration. The Amputee Body Image Scale (ABIS) is a validated tool designed to assess satisfaction and measure body image acceptance. The scale has been translated into
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Background/Objectives: Amputation often leads to decreased body image satisfaction and self-acceptance, affecting mental health and social integration. The Amputee Body Image Scale (ABIS) is a validated tool designed to assess satisfaction and measure body image acceptance. The scale has been translated into many languages to improve rehabilitation services for individuals with amputation worldwide; however, a validated Arabic version of this scale does not currently exist. The study aims to cross-culturally adapt and validate the ABIS for Arabic-speaking individuals with lower-limb amputation. Methods: A cross-cultural adaptation was performed according to the International Test Commission (ITC) guidelines. The adapted Arabic version of the scale was completed by 100 Jordanian individuals with lower-limb amputations. Their responses were then statistically analyzed using factor analysis to assess content and construct validity and Cronbach’s α to assess internal consistency (reliability). Results: The Arabic version of the ABIS demonstrated strong construct validity (KMO = 0.898; Bartlett’s test p < 0.001) and high internal consistency (Cronbach’s alpha = 0.92), while factor analysis suggested the multidimensionality of the scale after cross-cultural adaptation. Conclusions: The findings suggest the preliminary validity and reliability of the Arabic version of the ABIS, supporting its potential use in rehabilitation centres to assess body image satisfaction among Arabic-speaking individuals with amputation. Nevertheless, further improvements are warranted to adapt the scale to Arabic culture.
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Open AccessReview
The Use of the Flexible Thermoplastic Nylon-Based Dental Prostheses: A Literature Review
by
Saverio Ceraulo, Antonio Barbarisi, Zhong Hao Hu, Gianluigi Caccianiga, Dorina Lauritano and Francesco Carinci
Prosthesis 2025, 7(6), 169; https://doi.org/10.3390/prosthesis7060169 - 18 Dec 2025
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Background: Nylon-based removable partial dentures, such as Valplast® (Valplast International Corp, Westbury NY, USA), have been proposed as a valuable alternative to acrylic resin prostheses, particularly following oral surgical extractions and in patients with suspected methacrylate hypersensitivity. This review aimed to
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Background: Nylon-based removable partial dentures, such as Valplast® (Valplast International Corp, Westbury NY, USA), have been proposed as a valuable alternative to acrylic resin prostheses, particularly following oral surgical extractions and in patients with suspected methacrylate hypersensitivity. This review aimed to evaluate the clinical indications guiding the use of nylon-based prostheses after oral surgical extractions and to investigate their prevalence in patients with documented acrylic allergies. Methods: Following PRISMA 2020 guidelines, a comprehensive search was conducted in six databases (PubMed, Scopus, Embase, Google Scholar, LILACS, and Cochrane Library) for studies published between 2015 and 2025. Eligible studies were critically appraised using the Joanna Briggs Institute (IBI) tools. Results: Nine studies met the inclusion criteria, all of which were low-level evidence (six case reports and three case series), comprising a total of 11 patients (mean age 43 years). Nylon-based prostheses were used in both maxillary and mandibular arches, with rehabilitation motivated by esthetic and functional reasons. Outcomes were generally favorable, with patients reporting satisfaction in terms of comfort, function, and esthetics. Conclusions: Current evidence supporting the use of nylon-based removable partial dentures remains extremely limited and is based exclusively on case reports and small case series. While this type of prostheses represents a viable post-surgical rehabilitation option, primarily chosen for esthetic and functional benefits, evidence on their use in patients with documented acrylic hypersensitivity remains lacking. The low quality and limited number of studies highlight the need for prospective, controlled, and long-term research to clarify the role of nylon prostheses in post-surgical oral rehabilitation and to define their effectiveness in patients with material allergies.
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