Prosthesis

Background/Objectives: Autopolymerizing poly (methyl methacrylate) (PMMA) resin is widely used in provisional restorations; however, its inadequate mechanical properties represent a significant limitation. This study aimed to develop electrospun fibers with chemically reduced graphene oxide (rGO) and to evaluate the effect of fiber reinforcement on the mechanical and physical properties of a commercially available PMMA resin. Methods: Electrospinning was employed to produce nanofibers containing 0.02 wt% and 0.05 wt% rGO within a PMMA matrix. Fiber characterization was performed using SEM-EDS, XRD, TGA/DTG, and FTIR. Following characterization, the fibers were blended into PMMA resin at 1%, 2.5%, and 5% (by weight). The resulting fiber-reinforced composites were tested for flexural strength, elastic modulus, surface roughness, and Vickers microhardness. Results: The addition of 1% and 2.5% PMMA/rGO-0.02 fibers and 1% PMMA/rGO-0.05 fibers significantly improved the flexural strength of PMMA compared with the control group (p < 0.05). A statistically significant increase in elastic modulus was observed only in the group containing 1% PMMA/rGO-0.02 fibers (p < 0.05). However, there were no significant differences in surface roughness or microhardness between the control and experimental groups (p > 0.05). Conclusions: Incorporating electrospun PMMA-rGO fibers into PMMA resin enhances flexural properties at low concentrations without altering surface characteristics. These findings suggest that such fiber-reinforced systems hold promises for improving the mechanical performance and functional longevity of provisional dental restorations under clinical conditions. Full article

Objectives: This systematic review aimed to evaluate the cost, production time, clinical performance, and patient satisfaction of 3D printing workflows in prosthodontics compared to conventional and subtractive methods. Methods: Following PRISMA guidelines, a systematic search of electronic databases was performed to identify studies published between 2015 and 2025 that directly compared digital additive workflows with analogue or subtractive workflows. Studies were eligible if they included prosthodontic treatments such as dentures, crowns, or implant-supported prostheses and reported at least one relevant outcome. The primary outcomes were cost, time efficiency, clinical accuracy (e.g., marginal adaptation, fit), and patient satisfaction. Included studies were methodologically evaluated using MINORS scale and the risk of bias was assessed using ROBINS-I and RoB 2 tools. Results: Seven studies met the inclusion criteria. Overall, 3D printing workflows demonstrated reduced production time and cost in comparison to conventional or subtractive methods. Clinical outcomes were generally comparable or superior, particularly regarding adaptation and fit. Patient satisfaction was favourable in most studies, although reporting varied. Long-term follow-up was limited, which constrains the interpretation of sustained clinical performance. Conclusions: These findings suggest that 3D printing can serve as an efficient and cost-effective alternative in prosthodontic fabrication, with clinical results comparable to those already established. Further research is needed to assess long-term clinical performance and cost-effectiveness in various clinical scenarios. Full article

Background: Digital dental photography is increasingly essential for documentation and smile design. This study aimed to compare the linear measurement accuracy of various smartphones and a Digital Single-Lens Reflex (DSLR) camera against digital models obtained by intraoral and desktop scanners. Methods: Tooth height and width from six different casts were measured and compared using images acquired with a Canon EOS 250D DSLR, six smartphone models (iPhone 13, iPhone 15, Samsung Galaxy S22 Ultra, Samsung Galaxy S23 Ultra, Samsung Galaxy S24, and Vivo T2), and digital scans obtained from the Helios 500 intraoral scanner and the Ceramill Map 600 desktop scanner. All image measurements were performed using ImageJ software (National Institutes of Health, Bethesda, MD, USA), and statistical analysis was conducted using one-way analysis of variance (ANOVA) with Tukey’s post hoc test (α = 0.05). Results: The results showed no significant differences in measurements across most imaging methods (p > 0.05), except for the Vivo T2, which showed a significant deviation (p < 0.05). The other smartphones produced measurements comparable to those of the DSLR, even at distances as close as 16 cm. Conclusions: These findings preliminary support the clinical use of smartphones for accurate dental documentation and two-dimensional smile design, including the posterior areas, and challenge the previously recommended 24 cm minimum distance for mobile dental photography (MDP). This provides clinicians with a simplified and accessible alternative for high-accuracy dental imaging, advancing the everyday use of MDP in clinical practice. Full article

Background/Objectives: Guided implant surgery relies on the use of surgical templates to direct osteotomy drills, but guide design may influence irrigation efficiency, hence bone overheating, a critical factor in preventing thermal necrosis. This ex vivo study compared temperature changes when drilling using two guide designs: a closed-frame (occlusive structure) and an open-frame (non-occlusive design), evaluating their clinical relevance in mitigating overheating. Methods: Sixteen pig ribs were scanned, and implant osteotomies were planned via a guided surgery software. Two 3D-printed resin templates, one with a closed-frame design and one with an open-frame design, were tested (8 ribs per group, 24 implants per group). Drilling was performed sequentially (diameter of 1.9 mm, 3.25 mm, and 4.1 mm) at 800 rpm, while bone temperatures were recorded at depths of 3 mm and 10 mm using K-type thermo§s. Results: Significantly higher temperature rises were observed with the closed-frame guide. Drilling depth had also a significant influence, with higher temperatures at 3 mm than 10 mm (p < 0.001), suggesting that cortical bone density may amplify frictional heat. No significant effect of drill diameter was detected. Conclusions: Within the limitations of this ex vivo model, the open-frame design kept the maximal temperature rise about 0.67 °C lower than the closed-frame guide (1.22 °C vs. 0.55 °C), i.e., a 2.2-fold relative reduction was observed during the most demanding drilling step. This suggests a more efficient cooling capacity, especially in dense cortical bone, which offers a potential benefit for minimizing thermal risk in guided implant procedures. Full article

Purpose: The aim of this study was to compare the effect of rotary (air-driven, electric-driven) and oscillating (piezoelectric ultrasonic) handpieces on the quality of crown preparation, marginal integrity, and internal adaptation of monolithic zirconia crowns. Materials and Methods: Seventy-two standardized premolar preparations were performed using the air-driven handpiece with a guide pin-ended tapered fissure diamond bur on a modified dental surveyor. The finishing process utilized three handpiece types (n = 24/group) with fine/superfine diamond burs under controlled force with a fixed number of rotations and controlled advancement time. Marginal/internal adaptation was evaluated via the triple-scan technique; defects (marginal, axial, and occlusal) were quantified based on predefined criteria through the inspection of the Standard Tessellation Language (STL) file. Results: One-way ANOVA with Tukey HSD and Kruskal–Wallis with Dunn–Bonferroni tests were utilized. The marginal gap showed no significant differences (p > 0.05, η² = 0.04). The electric handpiece outperformed the ultrasonic (p = 0.023, η² = 0.105) in internal adaptation, while the air-driven showed no differences (p > 0.05). The ultrasonic handpiece produced fewer marginal defects than the air-driven (p = 0.039, ε² = 0.132), but more axial defects (median 9 vs. 6, p = 0.014, ε² = 0.168) than the electric handpiece and occlusal defects (5 vs. 3, 4 p = 0.007, p = 0.015, ε² = 0.227) than rotary handpieces. The air-driven handpiece exhibited comparable defect numbers to the electric handpiece without statistical significance (p > 0.05). Conclusions: Handpiece selection had a small effect on marginal adaptation but more pronounced effects on overall defect formations and internal adaptation. The ultrasonic handpiece’s decreased marginal defects but variable axial/occlusal results reveal technological constraints, whereas rotary handpieces’ consistency reflects their operator-dependent nature. Full article

Background: The increasing adoption of digital workflows in implant dentistry necessitates rigorous assessment of intraoral scanning, particularly for complex full-arch rehabilitations like All-on-Four prostheses, where posterior implant angulation may impact the accuracy of optical data acquisition. Objectives: This in vitro study aimed to assess the accuracy of digital intraoral scanners in scanning All-on-Four implant models with different posterior implant angulations. Methods: Two epoxy resin All-on-Four implant models were fabricated with two posterior implant angulations (30-degree and 45-degree). Both models were digitized to obtain control datasets using a Smart Optics reference scanner (REF). Four intraoral scanners were comparatively assessed: Cerec Omnicam AC (OMN), Trios 4 (TRI), Cerec Primescan AC (PRI), and Medit i700 (MED), with nine scans per each scanner (n = 9). All STL files were exported and analyzed using Geomagic Control X with root mean square (RMS) values computed for trueness and precision assessments. Results: The comparison between IOS types in terms of trueness revealed that with 30° angulation, the MED group showed the statistically significant least deviation (p = 402). With 45° angulation, both PRI and OMN scanners showed the statistically significant highest deviation values (p = 0.047 and 0.007, respectively). MED again showed the statistically significant least deviation (p = 402). For precision evaluation in 30° angulation models, PRI and OMN scanners showed the statistically significant least deviation values (p = 402 and <0.001, respectively). While, in 45° angulation models, no statistically significant inter-scanner differences were observed. Conclusions: While MED, PRI, and OMN scanners demonstrated clinical validity for 30° angled posterior implants, only the MED system achieved sufficient accuracy for 45° tilt. These findings emphasize the critical relationship between scanner selection and extreme implant angulations in full-arch digital workflows. Full article

Background: Patients awaiting total hip arthroplasty (THA), particularly those with hip osteoarthritis (OA), face an elevated risk of osteoporosis due to age and gender-related factors. Osteoporosis, indicated by low bone mineral density (BMD), can affect implant osteointegration, long-term stability, and increase the likelihood of periprosthetic fractures. Despite these risks, osteoporosis is often underdiagnosed and undertreated in THA candidates. While several studies have addressed this issue in Northern populations, data on Southern European cohorts, particularly Italian patients, remain limited. This study aims to evaluate the prevalence of osteoporosis and vitamin D deficiency, as well as the rates of related treatments, in patients with hip osteoarthritis scheduled for THA. Methods: This single-center, retrospective study was conducted at Policlinico Universitario di TorVergata, Italy, involving 66 hip OA patients (35 men, 31 women; mean age 67.5 years). BMD was assessed at the femoral neck, total femur, and lumbar spine via DEXA, alongside vitamin D and PTH levels. Demographic data, ongoing anti-osteoporotic therapies, Harris Hip Score (HHS), and handgrip strength were recorded. Statistical analysis included t-tests and Pearson’s correlation. Osteoporosis was defined per WHO criteria, with significance set at p < 0.05. Results: In this study of 66 patients with hip osteoarthritis (35 men, 31 women; mean age 67.5 years), women exhibited significantly lower bone mineral density (BMD) at the total femur (−0.98 ± 1.42 vs. −0.08 ± 1.04; p < 0.05) and lumbar spine (−0.66 ± 1.74 vs. 0.67 ± 1.59; p < 0.05) compared to men. Handgrip strength was also significantly reduced in females (17.1 ± 8.2 kg) versus males (27.3 ± 10.3 kg; p < 0.05). Vitamin D levels were below 30 ng/mL in 89.4% of patients, and 63.6% had levels below 20 ng/mL; PTH levels were elevated (>65 pg/mL) in 54.5% of cases, indicating frequent secondary hyperparathyroidism. Only 9 patients were receiving vitamin D supplementation and none were on anti-osteoporotic treatment. Conclusions: These findings highlight the frequent coexistence of low BMD, vitamin D deficiency, and reduced muscle strength in THA candidates, suggesting a pattern of musculoskeletal vulnerability that warrants clinical attention. Full article

Introduction: Pediatric prosthetic knee joints must be appropriately scaled from adult designs to ensure proper gait biomechanics. However, direct dimensional scaling without considering the biomechanical implications may lead to functional discrepancies. This study aimed to evaluate whether using a linear scaling factor can effectively adapt a knee for pediatric use. The study assessed whether such an approach yields a viable pediatric prosthetic knee joint by applying a fixed scaling factor and analyzing the resultant knee geometry. Methods: The linear scaling factor was determined based on the pylon tube diameter, a key constraint in compact pediatric knee design. Given a pediatric pylon diameter of 22 mm, the length of the tibial link was set to 22 mm, yielding a scaling factor of 0.6875 when compared to the adult-sized knee. This scaling factor was used to determine the dimensions of the pediatric four-bar (scaled) knee joint. Static geometric analysis was conducted using GeoGebra^® to model the lower-body segment lengths. The knee joint’s performance was evaluated based on stance and swing phase parameters. These metrics were compared between the scaled knee and a commercial pediatric knee. Results: The geometric analysis revealed that while using the linear scaling factor maintained proportional relationships, certain biomechanical parameters deviated from the expected pediatric norms. The scaled knee achieved a toe clearance of 13.5 mm compared to 19.7 mm in the commercial design and demonstrated a swing-phase heel clearance of 11.6 mm versus 13.3 mm, maintaining negative x/y ratios at heel contact and showing significant stability in push-off moments, while the stance flexion angle remained within an acceptable range. The heel contact and push-off ratios (x/y) were found to be comparable, with the scaled model achieving values of −1.21 and −0.59, respectively. The stance flexion angle measured 10.6°, closely aligning with the commercial reference. Conclusions: Using a linear scaling factor provides a straightforward method for adapting adult prosthetic knee designs to pediatric use. However, deviations in key biomechanical parameters indicate that further experimental study may be required to validate the applicability of the scaled knee joint for pediatric users. Future work should explore dynamic simulations and experimental validations to refine the design further and ensure optimal gait performance. Full article

Transcatheter aortic valve replacement (TAVR) is now established as a safe and effective treatment for severe aortic stenosis across all surgical risk categories. Nevertheless, periprocedural conduction disturbances—including new-onset left bundle branch block (LBBB), right bundle branch block (RBBB), and other intraventricular blocks—remain among the most frequent complications, often resulting in permanent pacemaker (PPM) implantation and impacting left ventricular remodeling. A review was conducted using the PubMed/MEDLINE database. Relevant clinical trials, observational studies, and meta-analyses addressing post-TAVR LBBB were included and analysed with a focus on frequency, risk factors, and association with adverse outcomes. We describe the incidence of post-TAVR conduction disturbances and identify key predictors: pre-existing RBBB, membranous septum length, valve oversizing, implantation depth, infra-annular leaflet extension, compression ratio, and valve type/generation. New-onset LBBB is a frequent complication after TAVR and may negatively affect patient outcomes. Accurate risk stratification and standardised post-procedural monitoring protocols are essential. Further prospective studies are needed to better define management strategies for patients developing LBBB after TAVR. Full article

Background: Dental implants enhance masticatory efficiency in edentulous patients, yet discrepancies exist between objective assessments and patient perceptions. This study evaluated masticatory efficiency before and after implant rehabilitation using the two-color mixing test (Hue-Check Gum^®) and Viewgum^® software Version 1.4. 32-bit, correlating objective data with patient-reported outcomes. Methods: In a prospective study of 30 patients receiving implant-supported prostheses, masticatory efficiency was assessed objectively (VOH values via Viewgum^®) and subjectively (10 cm VAS). Statistical analysis included Shapiro–Wilk, paired t-tests (VAS), and Wilcoxon tests (VOH). Correlation and regression analyses examined subjective–objective relationships. Results: Significant improvements occurred post-rehabilitation. VAS scores rose from 3.46 (95% CI: 2.54–4.39) to 7.29 (6.55–8.02; p < 0.001). VOH values decreased from 0.462 (0.426–0.497) to 0.438 (0.403–0.473; p = 0.001), confirming better chewing performance. No correlation was found between VAS and VOH, pre- (p > 0.346) or post-treatment (p > 0.980). Conclusion: Implant rehabilitation improves masticatory function objectively and subjectively. However, the lack of correlation underscores the need for dual assessment in clinical practice. Future studies should explore factors influencing satisfaction and performance to optimize outcomes. Full article

Background: Soft liners offer a cushioning effect that aids in the healing of inflamed mucosa and allocates the relevant load in the support area of prostheses, enhancing their fit and stability. This study looks at how strontium-infused phosphate bioactive glass affects a heat-cured acrylic-based soft liner, focusing on the surface hardness and the surface roughness of the material. Methods: One hundred soft liner specimens were produced, with fifty specimens being designated for surface hardness testing and fifty specimens for surface roughness testing. PBG*Sr was incorporated into the soft liner at the concentrations of 1 wt.%, 3 wt.%, 5 wt.%, and 7 wt.%. Surface hardness and surface roughness were evaluated with a digital durometer for Shore A hardness and a profilometer, respectively. Fourier transform infrared spectroscopy analysis and field emission scanning electron microscopy were employed. Results: The Shapiro–Wilk test demonstrated that the data adhered to a normal distribution, as the p-values were not statistically significant. Subsequently, for statistical analyses following the one-way ANOVA, Dunnett’s T3 post hoc test was employed for surface hardness, while Tukey’s post hoc test was used for surface roughness. The lowest hardness value was documented in the 7 wt.% subgroup (29.040 ± 0.070), followed by the 5 wt.% subgroup (30.97 ± 0.231), and the control (40.880 ± 0.473) had the highest hardness mean value. The 7 wt.% subgroup displayed the lowest value of Ra recorded, 0.489 ± 0.077 μm, while the control subgroup showed the highest, 1.994 ± 0.168 μm. FTIR analysis suggested that the domination of physical interactions according to the analyses with the FESEM led to improved surface morphology for the 7 wt.% PBG*Sr specimens. Conclusions: The 7 wt.% PBG*Sr specimens exhibited the lowest surface hardness, suitable for soft lining material, and improved the surface morphology of acrylic soft liners compared with the control and other concentrations. Full article

Background: Aesthetic dentistry increasingly demands minimally invasive, predictable, and patient-centered solutions. Digital technologies and AI-driven planning tools are now integral to interdisciplinary treatments. Aim: To evaluate, by means of a 16-item questionnaire, patients’ perceptions of smile aesthetics and oral function before and after receiving clear aligner therapy followed by minimally invasive ceramic veneers, using digital planning and Smile Creator software. Materials and Methods: Five adult patients underwent digital smile design, clear aligner therapy, and feldspathic veneer placement. Pre- and post-treatment perceptions of smile aesthetics and function were assessed using a structured questionnaire. AI-based simulation tools (2D and 4 K TruSmile video previews) were incorporated. Paired t-tests were used to compare outcomes before and after treatment. Results: Mean pre-treatment scores were 4.8 for smile aesthetics and 6.6 for function. Post-treatment scores significantly improved to 9.8 (p = 0.001) and 9.4 (p = 0.002), respectively. Patients rated AI-generated smile previews more favorably than 2D designs and acknowledged the value of digital tools in understanding and accepting treatment. Conclusions: The integration of digital and AI-based tools in aesthetic dentistry enhances patient communication, improves predictability, and enables minimally invasive treatment. Patient satisfaction was high, underscoring the effectiveness of the combined orthodontic and prosthetic approach. Full article

Background/Objectives: Bovine pericardial valve conduits (PVCs) are commonly used for right ventricular outflow tract reconstruction in both pediatric and adult patients. Calcification, particularly prevalent in children and young adults, is a leading cause of conduit failure and is affected by the chemical composition of the treated biomaterials. In this study, we aimed to compare the structural changes in diepoxy-treated (DE-PVCs) and glutaraldehyde-treated PVCs (GA-PVCs) and to identify factors contributing to tissue mineralization in a large animal model. Methods: Pulmonary artery replacement was performed in minipigs (33–88 kg) using twelve DE-PVCs and four GA-PVCs. After six months, the animals were euthanized, and the explanted PVCs underwent macroscopic and microscopic examination. Results: Large calcium deposits formed along conduit joining suture (CJS) lines in all PVCs, regardless of the cross-linking agent. Mineral clusters surrounded the multifilament braided thread, and its fibers were encrusted with hydroxyapatite crystals. In DE-PVCs, no mineralization occurred outside the suture lines, and they showed successful integration and graft vitalization with a uniform neointima and well-developed endothelial monolayer. GA-PVCs developed a rigid external capsule, foci of collagen fiber calcification within the walls, and neointimal hyperplasia with limited endothelial coverage. Conclusions: In PVCs, calcification predominantly occurs along the CJS lines, where the multifilament suture acts as a nucleation site for hydroxyapatite crystals. DE treatment prevents collagen mineralization, unlike GA, and offers better integration, reduced neointimal hyperplasia, and a well-developed endothelial layer. These findings suggest that DE-PVCs may be a superior option for pediatric cardiac surgery by reducing calcification and improving conduit durability. Overall, the results will help optimize PVC manufacturing strategies to lower the risk of conduit failure. Full article

Background: This study compared performance-based function and self-report function in lower-limb prosthesis users. Methods: Twenty-two lower-limb prosthesis users (aged 52.1 ± 14.2) were administered the Orthotic Prosthetic User Survey (OPUS) Lower Extremity Functional Status (LEF), Satisfaction With Devices (SWD), alongside the Godin Leisure-Time Exercise Questionnaire (GLTQ), Timed Up and Go (TUG) test, two-minute walk test (2MWT), and six-minute walk test (6MWT). Body composition and standing postural sway displacement and velocity were also measured. Pearson’s Product Moment coefficients were used to assess relationships between the OPUS and other outcome variables. ANOVAs were used to identify differences in all outcome variables between lower unilateral (LU) and all other (AO) amputees. Results: There was a moderate correlation between LEF and center of pressure (CoP) path length with eyes open (r₍₁₉₎ = −0.43, p = 0.048) and eyes closed (r₍₁₉₎ = −0.43, p = 0.049). While the relationship between LEF and TUG was significant (r₍₂₀₎ = −0.49, p = 0.021), this was not so with SWD and TUG (r₍₂₀₎ = −0.17, p = 0.456). Both the 2MWT (r₍₂₀₎ = 0.48, p = 0.023) and 6MWT (r₍₂₀₎ = 0.47, p = 0.028) were moderately correlated with LEF. GLTQ was significantly correlated with LEF (r₍₂₀₎ = 0.70, p = 0.001). The LU group outperformed the AP group during the TUG and 6MWT (p < 0.05). LU group scored significantly higher on LEF compared to the AO group (p < 0.05). The reliability of LEF between the measurement on day 1 (54.3 ± 12.0) and day 2 (53.6 ± 12.8) was high (α = 0.94). Conclusions: This study provides an insight into associations of balance and self-reported function in lower limb prosthesis users. Future work can target rehabilitation strategies to address challenges faced by multiple limb prosthesis users. Full article

Background: While dental implants have become a reliable solution for tooth loss, their long-term success is increasingly challenged by biological and technical complications such as impact fracture and peri-implantitis. These complications significantly impact implant longevity and patient satisfaction. Aim: This consensus conference aimed to identify and standardize clinical guidelines to prevent implant fractures and peri-implant diseases based on current evidence and expert opinions. Methods: A panel of 10 expert clinicians and researchers in prosthodontics participated in the Osstem Global Consensus Meeting. This paper focuses on the prosthetic division. A structured literature review was conducted, and evidence was synthesized to formulate consensus-based clinical recommendations. Participants answered structured questions and discussed discrepancies to achieve consensus. Results: The panel reached consensus on several key prosthetic risk factors, including (1) the role of biomechanical overload in implant fracture, (2) the impact of emergence profile design on peri-implant tissue stability, (3) the influence of implant positioning and connection geometry on marginal bone loss, and (4) the importance of occlusal scheme and restorative material selection, particularly in high-risk patients such as bruxers. Guidelines to prevent implant fracture and peri-implantitis were developed, addressing these factors with practical preventive strategies. Conclusions: Despite the limitations of narrative methodology and reliance on retrospective data and expert opinion, this consensus provides clinically relevant guidelines to aid in the prevention of mechanical failures and peri-implant diseases. The recommendations emphasize prosthetically driven planning, individualized risk assessment, and early intervention to support long-term implant success. Full article

Background: Ferrous metals are used extensively in the manufacturing of plates, pins, Kirschner wires (K-wires), and screws, and in the performance of partial and total joint replacement surgeries for the shoulder, elbow, and wrist joints. The primary surgical procedures commonly performed are hip and knee replacement surgeries. Metals possess a combination of high modulus, yield point, and ductility, rendering them well suited for load-bearing applications, as they can withstand significant loads without experiencing substantial deformations or permanent alterations in their dimensions. Application of metals and alloys is of prime importance in orthopedics as they lead the way to overcoming many issues encountered in implant use. In some instances, pure metals are used, but alloys consisting of two or more elements typically exhibit greater material characteristics, including corrosion resistance as well as toughness. The first item to address when selecting a metallic implant material is its biocompatibility. In this regard, three classes of materials are also commonly known as biomedical metals—316L stainless steel, pure titanium, and titanium alloys. Objective: The aim of this work is to create a model describing the material behavior and then simulate the metals under a load of 2300 N, which is equivalent to plastic loading. Methods: Under ten different case studies, a sub-routine was developed to combine the material characteristics of titanium and 316L stainless steel with the software. Results: The outcomes of the research were then investigated. A femur model was created using ANSYS software, and two materials, stainless steel and titanium, were used. The model was then exposed to a force of 2300 N. Full article

Background: The rehabilitation of complex bone defects in the anterior maxilla presents significant challenges in restoring both function and esthetics. A multidisciplinary approach integrating guided bone regeneration (GBR) and connective tissue grafting (CTG) has proven effective in addressing such cases. Methods: This report describes the case of a 60-year-old female patient who presented with severe alveolar ridge resorption and peri-implant bone loss, necessitating an advanced regenerative strategy. The treatment protocol involved the use of autologous and xenogeneic bone grafts in combination with hyaluronic acid and polynucleotides to enhance osteogenesis and tissue integration. A six-month healing period was observed before histological and clinical evaluations were conducted. Results: The results demonstrated a significant increase in lamellar bone formation and vascularization in sites treated with biomodulators compared to conventional GBR techniques. Subsequently, CTG was employed to optimize peri-implant soft tissue volume and stability, leading to improved keratinized tissue thickness and enhanced esthetic outcomes. This case underscores the importance of a comprehensive surgical and prosthetic plan that integrates bone regeneration with mucogingival management for optimal results in implant rehabilitation. Additionally, histological analysis revealed that the incorporation of hyaluronic acid and polynucleotides resulted in improved cellular activity, reduced inflammatory responses, and enhanced overall bone quality. Conclusions: These results highlight the potential role of biomodulators in regenerative procedures. While the findings suggest promising clinical applications, further long-term studies are necessary to validate the outcomes and establish standardized protocols for the integration of advanced biomaterials in implantology. Full article

Background: Finger orthoses are essential for treating injuries, deformities, and disorders of the upper limbs by supporting, immobilizing, or correcting deformities. Recent advances in three-dimensional (3D) printing have significantly enhanced precision and customization compared to traditional fabrication methods such as thermoplastic molding, plaster or fiberglass casting, and the use of prefabricated splints. Methods: The present review was conducted using PubMed, Scopus, and other databases with keywords such as “hand therapy”, “additive manufacturing”, “finger and thumb”, and “orthosis”. Only English-language publications were considered, with a primary focus on articles published between 2010 and 2025. Key themes were identified and categorized into conditions necessitating finger orthoses, types and classifications, ergonomic design considerations, and advancements in additive manufacturing. Results: Finger orthoses address musculoskeletal injuries, inflammatory diseases, and neuromuscular disorders. Three-dimensional printing provides enhanced customization, reduced material waste, rapid prototyping, and the ability to create complex geometries, improving patient comfort and functionality. Conclusions: Finger orthoses effectively treat various conditions by supporting and stabilizing fingers. A thorough understanding of anatomy, biomechanics, and fabrication methods is crucial for achieving functional and comfortable designs. Three-dimensional printing offers a transformative approach to producing lightweight, customizable, and cost-effective orthoses, enabling innovative and personalized solutions. By bridging clinical needs and design strategies, this review may guide future innovations in patient-specific orthotic development. Full article

Background/Objectives: Semi-active prosthetic feet present a promising solution that enhances adaptability while maintaining modest size, weight, and cost. We propose a semi-active Two-Keel Variable-Stiffness Foot (VSF-2K), the first prosthetic foot where both the hindfoot and forefoot stiffness can be independently and actively modulated. We present a model-based analysis of the effects of different VSF-2K settings on prosthesis characteristics and gait metrics. Methods: The study introduces a simulation model for the VSF-2K: (1) one sub-model to optimize the design of the keels of VSF-2K to maximize compliance, (2) another sub-model to simulate the stance phase of walking with different stiffness setting pairs and ankle alignment angles (dorsiflexion/plantarflexion), and (3) a third sub-model to simulate the keel stiffness of the hindfoot and forefoot keels comparably to typical mechanical testing. We quantitatively analyze how the VSF-2K’s hindfoot and forefoot stiffness settings and ankle alignments affect gait metrics: Roll-over Shape ($ROS$), Effective Foot Length Ratio ($EFLR$), and Dynamic Mean Ankle Moment Arm ($DMAMA$). We also introduce an Equally Spaced Resampling Algorithm (ESRA) to address the unequal-weight issue in the least-squares circle fit of the Roll-over Shape. Results: We show that the optimal-designed VSF-2K successfully achieves controlled stiffness that approximates the stiffness range observed in prior studies of commercial prostheses. Our findings suggest that stiffness modulation significantly affects gait metrics, and it can mimic or counteract ankle angle adjustments, enabling adaptation to sloped terrain. We show that $DMAMA$ is the most promising metric for use as a control parameter in semi-active or variable-stiffness prosthetic feet. We identify the limitations in $ROS$ and $EFLR$, including their nonmonotonic relationship with hindfoot/forefoot stiffness, insensitivity to hindfoot stiffness, and inconsistent trends across ankle alignments. We also validate that the angular stiffness of a two-independent-keel prosthetic foot can be predicted using either keel stiffness from our model or from a standardized test. Conclusions: These findings show that semi-active variation of hindfoot and forefoot stiffness based on single-stride metrics such as $DMAMA$ is a promising control approach to enabling prostheses to adapt to a variety of terrain and alignment challenges. Full article