Search Results (172)

Background/Objectives: Platelet-rich plasma (PRP) has been extensively used in clinical practice to treat musculoskeletal (MSK) and spinal maladies. PRP applications and preparation methods focus on variables such as delivery technique, formulation, and device performance. Few PRP preparation methods consider the variability in the biological status of the individual patient following a comprehensive homeostatic tissue repair response. In recent years, more information has become available for addressing the efficacy of PRP devices and preparation methods. Furthermore, the impact of the PRP dose and bioformulation on different pathoanatomical tissues and patient outcomes has been more widely discussed. This review aims to examine different variables in the optimization of PRP preparation methods, focusing on several platelet indices that influence hematopoiesis, subsequent to homeostasis and neuronal regulation, and how this relates to the release of platelets with variable densities, the mean platelet volume (MPV), platelet distribution width (PDW), and ultimately platelet concentration. Methods: A literature review was conducted using the PubMed, Medline, and Cochrane databases. Results: The literature indicates that the overall physiological platelet dynamics, from bone marrow megakaryocytes to peripheral blood release, differ continuously between health and disease. This study demonstrates that variations in platelet density, as indicated by mean platelet volume (MPV), and platelet count are associated with deviations in the total platelet distribution width. Conclusions: Incorporating platelet indices (PIs) into platelet-rich plasma (PRP) preparation protocols and methodologies is recommended to optimize the recovery of denser, more reactive, and regenerative platelets inherent in peripheral blood, which are integral to the patient’s homeostatic tissue repair mechanisms. Pre-procedural assessment of the patient’s platelet biological status allows for the preservation of an optimal platelet profile within PRP preparations, potentially enhancing clinical efficacy. Full article

In this study, the effect of data augmentation on machine learning (ML) models that predict the natural frequency of human long bones from the spectrogram of bone-conducted sound was investigated. Bone-conducted sound was recorded from the tibia of 45 healthy university students using a custom-developed hammering device. Short-Time Fourier Transform (STFT) was applied to the recorded sounds to generate spectrograms, from which six ML models were examined to predict the natural frequency. Ground-truth natural frequency was defined as peak values identified from Fast Fourier Transform (FFT) spectra obtained by recorded waveforms of sounds. Data augmentation was performed by shifting bone-conducted sound waveforms, expanded to 5 levels, i.e., 3-fold (3×) to 11-fold (11×). All models showed improved accuracy by data augmentations compared to the original dataset, with a particularly substantial improvement observed in many models when the dataset was expanded from the original to the 3× level. Among the ML models examined here, DenseNet-121 with 11× data augmentation achieved the lowest MAE and the highest R² (10.00 ± 2.27 Hz; R² = 0.927 ± 0.046), followed by PeleeNet, which is constructed on a lightweight DenseNet architecture, with 7× data augmentation (MAE = 10.37 ± 2.91 Hz, R² = 0.920 ± 0.059). Full article

Objectives: This study aimed to analyze in a comprehensive systematic review the hearing rehabilitation strategies for single-sided deafness (SSD) and asymmetric hearing loss (AHL) in children. Current rehabilitative options include contralateral routing of signal (CROS) devices, bone conduction devices, and cochlear implantation (CI). Methods: A systematic review of PubMed/MEDLINE was performed to identify studies on pediatric SSD and AHL rehabilitation published up to 7 July 2025. Reviews, meta-analyses, case reports, and animal studies were excluded. Eligible studies included pediatric populations treated with rehabilitative devices, with outcomes focused on speech perception, auditory performance, binaural hearing, quality of life, and questionnaire-based measures. Study selection followed PRISMA principles. Results: A total of 1527 records were identified by three authors through PubMed/MEDLINE (2003–July 2025) after duplicate removal. Title screening retained 581 studies, and abstract screening retained 267 studies. Fifty-eight full-text papers were assessed for eligibility; 10 were excluded due to overlapping patient cohorts, leaving 48 papers for the qualitative synthesis. Overall, 1622 children were analyzed; 43 studies focused on SSD and five on AHL. Conclusions: Available evidence supports rehabilitation in pediatric SSD and AHL. CROS systems offer a non-surgical and reversible option with benefits in selected listening situations but limited effects on localization. Bone conduction devices may improve hearing in noise and some functional outcomes, especially in conductive indications. CI appears to provide the greatest opportunity to restore bilateral auditory input, particularly when performed early in congenital SSD. Full article

Objectives: The aim of this study was to compare the surgical and postoperative clinical outcomes of punch-only and linear incision techniques for implantation of the Ponto^® bone conduction implant. Methods: Surgical and follow-up data were collected from 101 patients: 46 treated with Minimally Invasive Ponto^® Surgery (MIPS) and 55 with the linear incision technique (LT). The analysis focused on: (1) the surgical procedure, including operative time and intraoperative complications; (2) the healing process; and (3) long-term implant-site outcomes, including implant loss. Results: Median operative time was significantly shorter for MIPS than for LT (30 min vs. 40 min, p < 0.001). No major intraoperative complications were observed in either group. Adverse skin reactions were more frequent in the LT group than in the MIPS group (18.2% vs. 8.7%), but the difference was not statistically significant (p = 0.249). A single implant loss occurred in the LT group 18 months after surgery and was unrelated to failed osseointegration or the surgical technique, being caused by recurrent cholesteatoma. Conclusions: MIPS was associated with a significantly shorter operative time than the LT. Both MIPS and LT appear to be safe techniques. No statistically significant differences were detected between the groups with respect to adverse skin reactions or implant survival during the follow-up period. Full article

This cross-sectional observational study with prospectively collected outcome data compared speech recognition in noise and patient-reported outcomes in adults with single-sided deafness (SSD) who had previously received either a Baha Connect or an Osia bone-conduction hearing implant. Thirty-five patients were invited, of whom 32 had complete data available for analysis (questionnaires alone: n = 34). Speech-in-noise performance was assessed using the Digits-in-Noise test and expressed as the speech reception threshold at 50% intelligibility (SNR50) in frontal and side presentation conditions. Subjective hearing benefit and hearing-related quality of life were evaluated using the Glasgow Benefit Inventory, the Abbreviated Profile of Hearing Aid Benefit, and the Speech, Spatial and Qualities of Hearing Scale. No significant differences were observed between Baha Connect and Osia users in aided SNR50 thresholds or in any patient-reported outcome measure. A linear mixed-effects model showed a significant interaction between listening condition and presentation side (p = 0.023), indicating that speech-in-noise benefit depended on the spatial listening configuration rather than on device type. Both groups reported positive subjective outcomes, although spatial hearing remained the lowest-rated domain. Correlations between SNR50 improvement and questionnaire scores were weak and non-significant (Spearman’s ρ < 0.20; p > 0.29), suggesting that objective speech-in-noise improvement and perceived benefit capture partly different aspects of hearing rehabilitation. Baha Connect and Osia provided comparable objective and subjective outcomes in adults with SSD. Therefore, device selection should not be based solely on expected speech-in-noise performance, but should be guided by patient-specific surgical, practical and lifestyle factors. Full article

Electrical cues are essential regulators of tissue repair processes such as wound healing, nerve regeneration, and bone remodeling. Implantable electrical stimulation systems have therefore attracted increasing interest; however, conventional devices typically rely on external power supplies or batteries, leading to limitations including bulky system integration, finite lifetime, mechanical mismatch, and elevated risks of infection and revision surgery. Herein, we propose a conceptual classification of implantable electrical stimulation materials based on their relationship with electric charges, categorizing them into charge-storing materials, charge-conducting materials, and charge-generating materials. Among these, charge-generating materials represent an emerging class capable of autonomously converting endogenous mechanical, chemical, thermal, or optical energy into electrical signals, enabling self-powered and self-sustained electrical stimulation without external energy input. This review systematically summarizes the underlying mechanisms, material design strategies, and recent advances of representative charge-generating systems, including piezoelectric, triboelectric, and electrochemical materials. Their applications in tissue repair are critically discussed, highlighting unique advantages in device miniaturization, long-term operation, and intelligent responsiveness. Finally, current challenges and future perspectives are outlined to guide the development of next-generation self-powered bioelectronic therapies. Full article

Background: Temporary anchorage devices (TADs) are considered an essential and reliable component of orthodontic fixed appliance therapy, providing stable skeletal anchorage with minimal dependence on patient compliance. Objective: This study aimed to evaluate the success rate of orthodontic mini-implants and to assess the influence of patient- and treatment-related factors on their stability and success rate. Materials and Methods: A retrospective analysis of 60 patients was conducted with a total of 121 inserted TADs. Patient sex, age, orthodontic diagnosis, insertion site, and bone quality were analyzed, and descriptive statistics were calculated for all variables. Associations between categorical variables were evaluated using Pearson’s chi-square test. Variables showing potential association were further analyzed using multivariate binary logistic regression to identify independent predictors of mini-implant success. Results: No statistically significant associations were found between implant success and patient sex (p = 0.240), age (p = 0.819), or insertion site (p = 0.069); however, a trend toward higher failure rates in palatal-placed implants was noted. Logistic regression analysis did not identify any independent predictors of success (p = 0.284), and the model explained only a small proportion of outcome variability (5.9–12.0%). Conclusions: The high success rate of the TADs demonstrated high clinical reliability in this study, although patient-related factors such as age and sex did not significantly influence the success rate. Bone quality and soft tissue characteristics may contribute to TAD stability; however, these factors were not directly quantified in the present analysis. Full article

Background/Objectives: Artificial intelligence is increasingly applied to dental imaging, yet favorable internal performance does not necessarily indicate clinical transferability. This systematic review evaluated whether imaging-based dental artificial intelligence models have progressed beyond internal algorithmic development toward external validation, generalizability, reproducibility, privacy-preserving learning, and clinical implementation readiness. Methods: Searches were conducted in PubMed/MEDLINE, Scopus, and Embase up to May 2026. Eligible studies were primary empirical investigations based on human dental or oral imaging data that assessed at least one translational-validation dimension beyond internal development, including external testing, multicenter or multi-device validation, cross-dataset reproducibility, or privacy-preserving learning. Evidence was synthesized using a structured narrative synthesis reported according to the Synthesis Without Meta-analysis framework. Results: Fifteen studies published between 2023 and 2026 were included. They addressed caries detection, periodontal bone loss, gingival inflammation, root morphology, palatal radicular grooves, radiographic quality control, tooth-width estimation, and dental-structure segmentation. Translational-readiness domains included external validation, generalizability, reproducibility, privacy-preserving learning, transparency, and workflow relevance. Validation varied across cohorts, repositories, centers, devices, cross-dataset benchmarks, and federated-learning settings. Reproducibility, annotation harmonization, uncertainty reporting, explainability, workflow evaluation, and code or model availability were inconsistent. Quantitative pooling was not performed because tasks, modalities, units of analysis, reference standards, validation designs, and metrics were highly heterogeneous. Conclusions: Within this selected subset of externally tested studies, translational progress is emerging but remains uneven. Implementation readiness requires stronger reproducibility, clinically meaningful validation, workflow evaluation, and attention to regulatory, organizational, and human-factor barriers. Full article

Introduction: Cochlear implantation is a well-established treatment for adults with bilateral postlingual deafness. In recent years, increasing research attention has focused on its use in patients with single-sided deafness (SSD) with or without tinnitus. Restoration of binaural auditory input through cochlear implantation may partially reestablish binaural processing. Methods: We conducted a narrative review of the literature focusing on studies examining the basic mechanisms associated with hearing impairment in SSD, as well as cochlear implantation outcomes in this population, including hearing performance, tinnitus suppression, and quality of life (QoL). We also reviewed comparative studies between cochlear implants (CIs) and alternative hearing devices, along with current candidacy criteria and the challenges associated with cochlear implantation in this patient group. Results: Current evidence suggests that CIs can provide significant benefits in this population, including tinnitus reduction or suppression, improved speech perception in both quiet and noise, enhanced sound localization, and better disease-specific and overall QoL. Furthermore, numerous studies—despite some variability in outcomes—indicate that CIs may offer superior performance compared with alternative options, such as contralateral routing of signals hearing aids (CROS-HAs) and bone-conduction devices, particularly in terms of speech perception, localization, tinnitus control, and aspects of QoL. Nevertheless, appropriate candidacy criteria and key challenges—most notably device non-use—should be carefully considered when evaluating cochlear implantation in this patient population. Conclusions: Further research is required to address these challenges and to advance a more personalized approach to cochlear implantation in individuals with SSD, with the aim of optimizing outcomes and reducing cochlear implant non-use. Full article

Objectives: Cone-beam computed tomography (CBCT) is central to three-dimensional assessment in oral surgery and implant dentistry; however, CBCT-derived gray values expressed as HU-like units are not equivalent to true CT-derived Hounsfield Units (HU). This brief methodological secondary analysis evaluated the reliability and practical limitations of such values in assessing radiographic changes after peri-implantitis surgery. Methods: The analysis used the imaging protocol and group-level radiological data from a previously published prospective clinical cohort, conducted under the same protocol and ethical approval of the Institutional Ethics Committee of the Medical University of Lublin (KE-0254/248/11/2023; 23 November 2023). The source cohort included 57 patients treated after implant removal for severe peri-implantitis with small-particle dentin (n = 22), Bio-Oss (n = 15), or spontaneous healing without grafting (n = 20). CBCT scans were analyzed in OnDemand3D (version 1.0.11.1007) using manually selected square regions of interest (ROI; 30 × 30 pixels). No external phantom calibration, cross-device normalization, or formal intra-/inter-observer reproducibility assessment was available in the secondary dataset. Results: The previously reported mean study-site values were 779.62 ± 325.92 gray-value units for small-particle dentin, 910.51 ± 155.03 gray-value units for Bio-Oss, and 206.04 ± 174.21 gray-value units for controls. These findings are presented as protocol-dependent attenuation patterns, not as direct material rankings, bone-density thresholds, or proof of regeneration. Variability remained substantial, with study-site coefficients of variation of 41.8%, 17.0%, and 84.6%, respectively, and high adjacent-site variability. Interpretation was constrained by manual ROI placement, lack of calibration, absence of observer-agreement metrics, unequal follow-up timing, and CBCT sensitivity to scatter, beam hardening, field of view, reconstruction settings, and metal-related artifacts. Conclusions: CBCT-derived gray values may be useful as relative indicators of local radiographic attenuation change within a standardized protocol, but they should not be interpreted as absolute measures of bone density. Future regenerative oral surgery studies should combine standardized acquisition, explicit ROI methodology, repeated measurements, observer-agreement analysis, and complementary clinical, radiographic, or histological outcomes. Full article

Background/Objectives: i-Factor™ Bone Graft is a composite bone substitute containing P-15 synthetic collagen fragment that has demonstrated noninferiority to local autograft in single-level anterior cervical discectomy and fusion (ACDF); however, direct head-to-head comparisons with demineralized bone matrix (DBM) using contemporary 3D-printed titanium cages are lacking. The aim of this retrospective study was to compare radiographic fusion rates, segmental stability, and clinical outcomes between i-Factor™ and DBM in single-level ACDF, with a particular focus on the early time course of fusion. Methods: A retrospective propensity score-matched cohort study was conducted in patients with single-level cervical degenerative disc disease (cervical disc herniation, cervical spondylotic radiculopathy, or cervical spondylotic myelopathy) operated between December 2021 and January 2024 at a single tertiary care hospital. Seventy-six consecutive patients undergoing single-level ACDF with 3D-printed titanium cages were matched 1:1 (i-Factor™ vs. DBM) on age, sex, and operative level. Fusion status was assessed by serial dynamic radiographs at 1, 3, 6, and 12 months and by 3D-CT at 12 months in all patients (with additional CT at earlier timepoints when plain films were equivocal), by two independent spine surgeons blinded to graft type; inter-rater agreement (Cohen’s κ) was computed. Results: Mean follow-up was 18.1 months. Fusion rates for i-Factor™ at 3, 6, and 12 months were 94.7%, 100%, and 100%, respectively, compared to 71.1%, 84.2%, and 94.7% for DBM. The differences were statistically significant at 3 months (p = 0.047) and 6 months (p = 0.012), but not at 12 months (p = 0.493). Inter-rater agreement was almost perfect (κ = 0.86–1.00). No adverse reactions or device-related complications were observed. Conclusions: In this matched cohort, i-Factor™ was associated with significantly faster fusion than DBM in single-level ACDF, with similar 12-month fusion rates. No adverse reactions were observed, although the sample size is insufficient to exclude rare complications. Full article

Background/Objectives: Anterior cruciate ligament reconstruction, often combined with anterolateral ligament reconstruction, requires accurate anatomical positioning of bone tunnels, which is a key determinant of surgical success. In current clinical practice, postoperative radiographs are routinely performed for both medico-legal and clinical purposes. The objective of this study is to analyze the content of early postoperative radiology reports following ACL ± ALL reconstruction and assess their clinical relevance regarding tunnel positioning, as well as the terminology used to describe surgical findings. Methods: A retrospective bicentric descriptive study was conducted, including 100 consecutive postoperative radiographic reports performed within two weeks after ACL ± ALL reconstruction. The primary outcome was the mention of bone tunnel positioning. Secondary outcomes included the reporting of joint effusion, surgical complications, fixation devices, and terminology used. All radiographs were independently reviewed by two experienced orthopedic surgeons. Results: Among the 100 reports analyzed, interpretations were performed by 60 different radiologists. None of the reports included an assessment of bone tunnel positioning based on validated anatomical criteria. Joint effusion was reported in 83% of cases, without specification of its physiological nature. In 22% of reports, bone tunnels were not mentioned. Terms such as “sequelae” or “stigmata” of ligament reconstruction were used in 50% of reports. No complications or surgical errors were identified upon independent radiographic review. Conclusions: Early postoperative radiology reports after ACL reconstruction appear standardized but often lack clinically relevant contextualization regarding tunnel-related technical aspects. Rather than advocating replacement of surgeon-led image review, our findings support clearer postoperative terminology and better contextualized reporting, including explicit acknowledgment when detailed tunnel assessment is not feasible on routine radiographs. Full article

Continuous cough monitoring provides valuable insights into respiratory health; however, conventional air-conduction microphones are highly susceptible to ambient noise and raise privacy concerns. This work presents BCough, a bone-conduction-based embedded AI platform for on-device cough detection, designed and evaluated on the MAX78000 neural accelerator. The system employs a skin-contact bone-conduction sensor worn on the chest to capture body vibrations transmitted through bone and tissue, detecting cough events while minimizing environmental interference. The custom prototype integrates a bone-conduction microphone, a synchronized 6-axis IMU, power management circuitry, and an embedded neural accelerator to support real-time inference and future multimodal extensions. A compact 8-bit quantized convolutional neural network was optimized for deployment on the MAX78000 and evaluated using leave-one-subject-out cross-validation on one-second cough and non-cough segments derived from a corpus of 19,955 labeled events collected from five participants under controlled conditions. The deployed model achieved 0.80 Macro-F1, 0.81 balanced accuracy, 0.74 cough F1, and 0.89 AUC, with 15–16 ms inference latency and approximately 20 $\mathsf{\mu }$J energy per inference on chip. These results demonstrate the feasibility of low-power, privacy-preserving, bone-conduction cough detection on embedded AI hardware within an initial five-participant study. The current design is a benchtop prototype; the findings should therefore be interpreted as an initial feasibility assessment rather than evidence of robust performance across diverse users and real-world conditions. Future work will extend this platform toward miniaturized wearable implementations combining bone-conduction and inertial sensing for continuous multimodal respiratory monitoring. Full article

Background/Objectives: A non-surgical orthodontic treatment strategy for transverse maxillary deficiencies, especially in late adolescents and young adults, is microscrew-assisted rapid palatal expansion (MARPE). The literature indicates several concerns regarding its long-term efficacy and potential complications. Recent studies have provided valuable insights into the MARPE technique, particularly focusing on its efficacy, potential complications, and treatment failures. The present scoping review aims to synthesize and critically appraise clinical evidence on MARPE in post-pubertal patients, with a specific focus on treatment outcomes, mechanisms of failure, and local and systemic adverse effects to inform risk–benefit assessment and clinical decision-making. Methods: A systematic search was conducted across four electronic databases (PubMed, EMBASE, Scopus, and Cochrane Library) to identify English-language clinical trials, observational studies, and systematic reviews published between January 2015 and December 2025. The search strategy employed controlled vocabulary (MeSH terms) and Boolean operators targeting MARPE, treatment failure, and adverse effects in patients aged ≥ 16 years. After title/abstract screening and full-text assessment using predetermined inclusion criteria, 15 studies (3 systematic reviews with meta-analysis, 2 umbrella reviews, 4 systematic/scoping reviews, 2 randomized controlled trials, and 4 observational studies) were selected for qualitative synthesis. Results: Fifteen studies were finally included, which demonstrated significant heterogeneity in methodological design, sample characteristics, outcome measurement protocols, and MARPE device specifications. Mean success rates of 92.5% for maxillary transverse expansion were reported, with mean expansion duration ranging between 20 and 126 days. Key adverse effects comprised dentoalveolar tipping (buccal inclination of maxillary molars and premolars), periodontal complications (buccal bone resorption of 0.6–0.9 mm, gingival recession, papilla recession in 18% of cases), root resorption, miniscrew loosening, midpalatine/circummaxillary sutures, and potential but minimally documented intracranial effects. Conclusions: MARPE appears to be a valid non-surgical option for selected post-pubertal patients, but its success depends on careful case selection and monitoring for dentoalveolar, periodontal, sutural, and rare intracranial adverse effects. Full article

Background: Congenital hearing loss occurs in about 2 of every 1000 newborns, of which half probably have a genetic origin. In syndromic patients, hearing impairment often results from craniofacial malformations affecting the outer and middle ear. Anatomical limitations such as microtia or external auditory canal atresia often preclude conventional air-conduction hearing aids, leaving bone-conduction devices as one viable option. However, surgical intervention in such patients is challenging. This study aimed to evaluate the audiological outcomes, safety, and effectiveness of the Bonebridge BCI 602 implant in 10 patients with genetic syndromes. Methods: The case series was made up of 10 patients aged 6–45 years, each diagnosed with a congenital syndrome affecting the external and/or middle ear. All cases involved surgical implantation of the Bonebridge system. Audiological outcomes were evaluated in free-field conditions on the day of sound processor activation and at 3–6 months follow-up via pure-tone and speech audiometry. Results: All surgical procedures were completed without serious adverse events, and the incidence of postoperative complications was low. Audiological outcomes showed clinically significant hearing improvement in all patients following Bonebridge implantation. Post-implantation hearing thresholds ranged from 25 to 40 dB HL, with notable gains in speech perception in both quiet and noisy environments. Conclusions: The Bonebridge implant appears to be a safe and effective option for auditory rehabilitation in patients with hearing loss associated with various genetic syndromes involving craniofacial malformation. However, this complex patient population requires individual assessment, interdisciplinary evaluation, and careful surgical planning. Full article