Search Results (1,083)

Background: Auricular defects resulting from congenital anomalies, trauma, or oncologic resection pose significant functional and psychosocial challenges. When autologous reconstruction is not feasible or not desired, implant-retained auricular prostheses represent a reliable alternative with high patient satisfaction. This study aimed to systematically evaluate the clinical performance of craniofacial implants used for auricular prosthetic rehabilitation, focusing on implant survival, prosthetic outcomes, workflow typologies, and complications. A secondary objective was to illustrate the long-term validity of a minimally invasive navigation technique through a clinical case with 6-year follow-up. Methods: A systematic review was conducted according to PRISMA guidelines. Clinical studies published between 2005 and 2025 reporting outcomes of implant-retained auricular prostheses were searched in PubMed and Scopus databases. Data were extracted on implant type, survival rates, prosthetic performance, workflow, and complications. Risk of bias was assessed using appropriate tools based on each study design. Results: A total of thirty-two studies were included, comprising fifteen case reports, fifteen case series, one cohort study, and one prospective observational study. Implant survival was consistently high across all workflow categories, with failures predominantly associated with irradiated or anatomically compromised bone. Prosthetic outcomes were favorable, showing excellent esthetics, stable retention, and high patient satisfaction irrespective of manufacturing method, although digital and navigation-assisted workflows improved reproducibility, symmetry, and planning precision. Complication rates were low and generally limited to mild peri-abutment inflammation manageable with conservative care. The clinical case confirmed these findings, showing stable osseointegration, healthy soft tissues, and uncompromised prosthetic function at 6-year follow-up. Conclusions: Implant-retained auricular prostheses show predictable long-term success, independent of whether traditional, hybrid, or fully digital workflows are employed. Digital technologies enhance surgical accuracy, minimize morbidity, and streamline prosthetic fabrication, although high-quality comparative studies remain limited. Full article

Background/Objectives: Peri-implantitis is a chronic inflammatory condition affecting tissues surrounding dental implants and is characterized by progressive marginal bone loss that can ultimately lead to implant failure. Reduced vascularization and impaired immune clearance in peri-implant tissues contribute to persistent inflammation and limited therapeutic efficacy. MicroRNAs (miRNAs), particularly miR-21, have emerged as key regulators of inflammatory responses and bone remodeling. The objective of this study was to develop a bioactive dental implant coating capable of locally delivering miR-21 to modulate inflammation and promote peri-implant tissue regeneration, thereby preventing peri-implantitis. Methods: Cationic nanoparticles were synthesized using lecithin and low-molecular-weight polyethylenimine (PEI) as a non-viral delivery system for miR-21. Lecithin was employed to enhance biocompatibility, while PEI functionalization provided a positive surface charge to improve miRNA complexation and cellular uptake. The resulting lecithin–PEI nanoparticles (LEC–PEI NPs) were incorporated into a chitosan-based coating and applied to titanium implant surfaces to obtain a sustained miR-21–releasing system (miR21-implant). Transfection efficiency and biological activity were evaluated in human periodontal ligament fibroblasts (hPDLFs) and compared with a commercial transfection reagent (Lipofectamine). Release kinetics and long-term activity of miR-21 from the coating were also assessed. Results: MiR-21-loaded LEC–PEI nanoparticles demonstrated significantly higher transfection efficiency than Lipofectamine and retained marked biological activity in hPDLFs relevant to peri-implantitis prevention. The chitosan-based nanoparticle coating enabled controlled and sustained miR-21 release over time, supporting prolonged modulation of inflammatory and osteogenic signaling pathways involved in peri-implant tissue homeostasis. Conclusions: The miR21-implant system, based on lecithin–PEI nanoparticles incorporated into a chitosan coating, represents a promising therapeutic strategy for peri-implantitis prevention. By enabling sustained local delivery of miR-21, this approach has the potential to preserve peri-implant bone architecture, modulate chronic inflammation, and enhance the osseointegration of titanium dental implants. Full article

This study aimed to control rapid localized corrosion and inflammation of biodegradable magnesium implants by developing a pH-responsive mPEG-PLGA coating loaded with dexamethasone (Dex). The mPEG-PLGA layer was designed to selectively degrade in alkaline conditions, thereby moderating pH elevation at the implant surface while enabling controlled Dex release. By varying the molecular weight of mPEG and PLGA, the degradation rate and microsphere size were tunable, allowing adjustment of the drug release profile. Among the tested coating solution concentrations (1.5–7.5 mg/mL), the formulation with 3 mg/mL Dex yielded a final cumulative release concentration of 0.02 mg/mL over a two-week period, which suppressed inflammatory responses in RAW 264.7 macrophages with minimal cytotoxicity, while enhancing BMP-2 and RUNX2 expression in mesenchymal stem cells. In a rat femur defect model, Mg implants coated with mPEG-PLGA containing 3 mg/mL Dex significantly increased bone volume and bone mineral density and reduced early TNF-α expression, accompanied by continuous new bone formation and strong BSP-positive osseointegration. These findings suggest that the proposed pH-responsive mPEG-PLGA/Dex coating provides a promising strategy to simultaneously regulate corrosion, attenuate inflammation, and promote bone regeneration around magnesium implants. Full article

Bacterial infections and the lack of bioactivity of titanium implants and their alloys remain critical challenges for the long-term performance and clinical success of these devices. These issues arise from the undesirable combination of early microbial adhesion and the limited ability of metallic surfaces to form a bioactive interface capable of supporting osseointegration. To address these limitations simultaneously, this study employed electrical discharge machining (EDM), which enables surface topography modification and in situ incorporation of bioactive ions from the dielectric fluid. Ti-6Al-4V ELI surfaces were modified using two dielectric fluids, a fluorine/phosphorus-based solution (DF1-F) and a calcium/phosphorus-based solution (DF2-Ca), under positive and negative polarities. The recast layer was characterized by SEM and EDS, while bioactivity was evaluated through immersion in simulated body fluid (SBF) for up to 21 days. Antibacterial performance was assessed against Staphylococcus aureus at 6 h and 24 h of incubation. The results demonstrated that dielectric composition and polarity strongly influenced ionic incorporation and the structural stability of the modified layers. The DF2-Ca(+) condition exhibited the most favorable bioactive response, with Ca/P ratios closer to hydroxyapatite and surface morphologies typical of mineralized coatings. In antibacterial assays, Ca/P-containing surfaces significantly decreased S. aureus attachment (>80–90%). Overall, EDM with Ca/P-containing dielectrics enables the fabrication of Ti-6Al-4V surfaces with enhanced mineralization capacity and anti-adhesive effects against Gram-positive bacteria, reinforcing their potential for multifunctional biomedical applications. Full article

Background: Osseointegration is the cornerstone of long-term implant success, and systemic factors such as nutritional status may influence the biological cascade of peri-implant bone healing. Nutraceuticals have been proposed as adjuvant strategies to enhance bone metabolism, but clinical evidence remains scarce. This study aimed to evaluate the effect of a novel nutraceutical formulation (Osteo-therapy^®, Laboratorio Farmaceutico ERFO S.p.A., Messina, Italy; composed of spirulina standardized with 40% phycocyanin, quercetin, vitamin D3, and calcium) on early implant stability. Methods: A prospective, randomized clinical trial (RCT) was conducted in accordance with CONSORT guidelines (PLATFORM Project OR12.1). Sixty healthy patients requiring mandibular implants were enrolled (test n = 30 with Osteo-therapy^®; control n = 30). Stability was assessed via RFA (ISQ values) at baseline (T0), 1 month (T1), 2 months (T2), and 3 months (T3). Results: Both groups showed increases in ISQ. No significant differences were found at T0 and T1 (p = 0.149 and p = 0.737). From T2 onward, the test group exhibited significantly higher ISQ values (T2: 73.17 vs. 69.50, p < 0.001; T3: 78.37 vs. 76.63, p = 0.006). Conclusions: Osteo-therapy^® significantly enhanced early implant stability, indicating an accelerated transition from primary to secondary stability, potentially supporting earlier loading protocols. Full article

Background/Objectives: Limited residual bone height in the atrophic posterior maxilla complicates implant placement. Transcrestal sinus elevation can be used to correct bone shrinkage after sinus pneumatization or crestal bone loss. This study evaluated a minimally invasive, one-stage transcrestal sinus lift using a double-layer crosslinked collagen scaffold (MCCS) with autogenous bone from the implant osteotomy site in patients with RBH ≤ 6 mm. Methods: In this prospective series, 11 patients (48–64 years, mean RBH 4.75 mm, SD 0.95 mm) underwent one-stage transcrestal sinus floor elevation with simultaneous implants. After osteotomy, autogenous bone chips collected during drilling were compacted into the site, and two layers of MCCS were placed under the elevated Schneiderian membrane. Buccal and palatal bone heights were measured on CBCT before and after surgery to assess vertical bone gain (ΔRBH). Results: All implants achieved stable osseointegration. Mean ΔRBH was approximately 3.1 ± 0.9 mm (combined buccal–palatal). No postoperative complications occurred. Two small Schneiderian membrane perforations were sealed intraoperatively by MCCS placement, with uneventful healing. Follow-up imaging showed maintenance of the augmented bone around the implants. Conclusions: This double-layer MCCS plus autogenous bone approach is a safe, effective, and minimally invasive transcrestal sinus lift for atrophic maxillae. It yielded crestal bone gains even with minimal initial RBH, leveraging the palatal sinus wall’s osteogenic potential and the implant’s tent-pole effect. The MCCS scaffold maintained space for bone formation and enabled immediate sealing of any membrane perforations. This one-stage protocol is viable for implant placement in low-RBH sites. Full article

Background/Objectives: Dental implant placement protocols including immediate (IIP) and delayed implant placement (DIP) are likely to affect bone tissue repair and regeneration after the surgery. Despite many benefits of IIP, it has remained unclear whether IIP demonstrates comparable healing processes and outcomes to those observed in DIP. This review aims to summarize and compare biological and clinical outcomes of IIP and DIP, focusing on success and survival rates, periodontal status, esthetics and radiographic outcomes, and biochemical markers. Methods: A literature search of electronic databases was conducted using PubMed/MEDLINE, Embase, and the Scopus databases (January 1983–February 2025). 109 articles published in English, consisting of in vitro, in vivo, and clinical studies met the inclusion criteria. Results: This review shows that both IIP and DIP show similar implant survival rates, but IIP may lead to a higher risk of mid-facial recession in esthetic areas. DIP, on the other hand, can result in better soft tissue and bone healing. Histological and radiographic evidence shows comparable bone to implant contact (BIC) between the two methods, although peri-implant bone loss tends to be higher with IIP. Lastly, although specific molecular markers are well-established in all phases of osseointegration following DIP, there is no available literature comparing differences in biomarkers during healing periods between IIP and DIP. Conclusions: This review highlights the similarities and differences in the outcomes of IIP and DIP, as well as the knowledge gaps that require further investigation, providing valuable insights for predicting treatment outcomes and managing complications associated with dental implant placement. Full article

Background: Postoperative bone healing can be impaired by systemic factors and surgical trauma, leading to delayed recovery. Photobiomodulation therapy (PBMT) has been proposed as a non-invasive method to enhance osteogenesis, but variability in protocols and outcomes limits its clinical use. Aim: To systematically review and synthesize evidence from randomized controlled trials (RCTs) evaluating PBMT’s effectiveness in promoting postoperative osteogenesis. Methods: A systematic search of PubMed, Embase, Scopus, and Cochrane Library was conducted following the PRISMA 2020 guidelines. Only RCTs comparing PBMT with sham treatment or standard care were included. Data on laser parameters, surgical indications, and outcomes such as bone regeneration, healing time, and implant stability were extracted. The risk of bias of the included randomized studies was evaluated using the Cochrane Risk of Bias 2 (RoB version 2) tool. Results: Twelve RCTs were included. PBMT consistently improved early soft tissue healing and reduced postoperative inflammation and edema. Some studies showed accelerated bone maturation, especially in grafted sockets and distraction osteogenesis, while others reported no significant long-term effects on implant stability or chronic lesion healing. Heterogeneity in laser parameters limited comparability. Conclusions: PBMT is a safe adjunct that reliably enhances early postoperative healing and may promote bone remodeling in selected cases. Standardized protocols and larger, high-quality RCTs are needed to confirm long-term benefits and optimize treatment parameters. Full article

Contemporary advances in bioengineering and materials science have substantially improved the viability of medical implants. The demand for optimized implant technologies has led to the development of advanced coatings that enhance biocompatibility, antimicrobial activity, and durability. Implant manufacturers and surgeons must anticipate both biological and mechanical challenges when implementing devices for patient use. Key areas of concern include infection, corrosion, wear, immune response, and implant rejection; regulatory and economic considerations must also be addressed. Materials science developments are optimizing the integration of established materials such as biometrics, composites, and nanomaterials, while also advancing fabrication-based innovations including plasma functionalization, anodization, and self-assembled monolayers. Emerging smart and stimuli-responsive surface technologies enable controlled drug delivery and real-time implant status communication. These innovations enhance osseointegration, antimicrobial performance, and overall device functionality across orthopedic, dental, and cardiovascular applications. As implant design continues to shift toward personalized, responsive systems, advanced coating technologies are poised to deliver significantly improved long-term clinical outcomes for patients. Full article

Background and Objectives: Short femoral stems are increasingly used in total hip arthroplasty (THA), yet evidence regarding their performance in elderly femoral neck fracture (FNF) patients is limited. In this study, we compared clinical and radiographic outcomes of the use of a short femoral stem (SFS) versus a conventional standard stem (CSS) in cementless THA. Materials and Methods: This prospective, single-center case–control study (1:2) included patients ≥ 65 years of age with displaced FNF (Garden 3–4) treated with cementless THA. Follow-up lasted a minimum of 2 years. Clinical evaluations included the Harris Hip Score (HHS), Roles and Maudsley satisfaction score, and thigh pain assessment. Radiographic evaluations assessed cup position, osseointegration (Moore signs), radiolucencies (DeLee–Charnley and Gruen zones), subsidence, leg length discrepancy (LLD), and heterotopic ossification. Results: A total of 114 patients were analyzed (38 with SFS versus 76 with CSS). The final follow-up HHS was 87 ± 2.7 (SFS) and 88 ± 2.5 (CSS) (p = 0.231), and satisfaction was excellent in nearly all patients in both groups. Thigh pain was rare and resolved by final follow-up in all SFS patients, and no radiographic loosening was observed. Early subsidence (≤3 mm) occurred in two SFSs and three CSSs without progression, while LLD < 1 cm was present in three SFS and eight CSS cases. No implant-related revisions occurred, and complication rates were low and comparable. Conclusions: Short femoral stems provided clinical and radiographic outcomes equivalent to those of conventional stems in elderly FNF patients treated with cementless THA. Short stems appear to be a safe and effective option in this population, and further studies with longer follow-up are needed to confirm their durability. Full article

Additive manufacturing (AM) has emerged as a key enabling technology in contemporary dental manufacturing, driven by its capacity for customization, geometric complexity, and seamless integration with digital design workflows. This article presents a technology-oriented narrative review of additive manufacturing in dental implant production, focusing on dominant processing routes, material systems, and emerging research trends rather than a systematic or critical appraisal of the literature. An indicative descriptive analysis of publications indexed in the Web of Science and Scopus databases between 2014 and 2024 was used to contextualize the technological development of the field and identify major research directions. Emphasis was placed on metal powder bed fusion technologies, specifically Selective Laser Melting (SLM) and Direct Metal Laser Sintering (DMLS), which enable the fabrication of titanium implants with controlled porosity and enhanced osseointegration. Ceramic AM approaches, including SLA, DLP, and PBF, are discussed in relation to their potential for aesthetic dental restorations and customized prosthetic components. The publication trend overview indicates a growing interest in ceramic AM after 2020, an increasing focus on hybrid and functionally graded materials, and persistent challenges related to standardization and the availability of long-term clinical evidence. Key technological limitations—including manufacturing accuracy, material stability, validated metrology, and process reproducibility—are highlighted alongside emerging directions such as artificial intelligence-assisted workflows, nanostructured surface modifications, and concepts enabling accelerated or immediate clinical use of additively manufactured dental restorations. Full article

Early oxidative stress caused by titanium implants can impair osseointegration. Manganese dioxide (MnO₂) nanozyme coatings have the potential to scavenge H₂O₂ and simultaneously generate O₂ to alleviate hypoxia, but their activity is mostly static, and the ion release is detrimental. A nano-MnO₂/Ti/P(VDF-TrFE) sandwich-structured composite was fabricated, and ferroelectric polarization was applied to preset a tunable surface potential. Kelvin probe force microscopy (KPFM) verified a presettable potential within ±500 mV. Steady-state kinetics confirmed an enhancement in overall catalytic efficiency (higher V_max and lower K_m). This translated to a faster initial decomposition rate at a low, physiologically relevant H₂O₂ concentration (300 μM). Correspondingly, under these oxidative stress conditions, cell survival in the polarized group was higher than that in the unpolarized group, indicating that the enhanced initial rate can have a positive effect in such conditions. Overall, this study demonstrates a proof-of-concept strategy to tune MnO₂ nanozyme catalysis using a polarization-preset surface potential, targeting implantation-relevant ROS-rich conditions. Full article

Background/Objectives: Orthopaedic infections associated with implant surgery remain a major public health concern, often caused by bacterial colonization of implant surfaces. Staphylococcus epidermidis is among the most common pathogens involved. Developing antimicrobial bone implants that prevent infection without compromising bone regeneration is therefore essential. This study investigates the antimicrobial and osteointegrative performance of calcium phosphate (CaP) materials functionalized with vanillin, an essential oil component with known antimicrobial properties. Methods: Commercial CaP regenerative materials were covalently coated with vanillin. Antibacterial activity was evaluated against Staphylococcus epidermidis RP62A using viability assays. In vivo osseointegration was assessed in New Zealand female rabbits implanted with vanillin-coated and uncoated CaP scaffolds. Results: Vanillin-functionalized CaP scaffolds exhibited strong bactericidal activity at 24 h and bacteriostatic effects at 48 h at a concentration of 10 mg/mL. In vivo analyses showed no significant differences in osseointegration between vanillin-coated implants and control CaP materials. Conclusions: Vanillin-functionalized CaP materials maintain a high safety profile without impairing bone integration, supporting their potential use in clinical applications. Full article

This study evaluated the surface functionalization of a non-equiatomic TiZrNbTaMo high-entropy alloy (HEA) by micro-arc oxidation (MAO) in Cu-rich electrolytes to tailor its performance for biomedical implants. The Cu content was varied, and the resulting coatings were investigated for their morphology, phase constitution, chemical structure, wettability, and cytocompatibility. X-ray diffraction (XRD) measurements of the substrate indicated a body-centered cubic (BCC) matrix with minor HCP features, while the MAO-treated samples depicted amorphous halo with sparse reflections assignable to CaCO₃, CaO, and CaPO₄. Chemical spectroscopic analyses identified the presence of stable oxides (TiO₂, ZrO₂, Nb₂O₅, Ta₂O₅, MoO₃) and the successful incorporation of bioactive elements (Ca, P, Mg) together with traces of Cu, mainly as Cu₂O. MAO treatment increased surface roughness and rendered a hydrophilic behavior, which are features typically favorable to osseointegration process. In vitro cytotoxic assays with MC3T3-E1 cells (24 h) showed that Cu addition did not induce harmful effects, maintaining or improving cell viability and adhesion compared to the controls. Collectively, MAO in Cu-rich electrolyte yielded porous, bioactive, and Cu-incorporated oxide coatings on TiZrNbTaMo HEA, preserving cytocompatibility and supporting their potential for biomedical applications like orthopedic implants and bone-fixation devices. Full article

Zinc and its alloys have been regarded as an alternative option for biodegradable implant materials to magnesium and iron-based alloys due to their promising degradation rate. However, poor osseointegration with bone tissue limits their further clinical application. Considering the biofunction of strontium (Sr), namely promoting the formation of bone tissue, in this work, a ZnO-Sr composite coating was prepared on pure Zn via anodic oxidation to boost bioactivity. Surface morphology and composition of the layer were examined via scanning electron microscopy (SEM) and X-ray diffraction (XRD). Electrochemical measurements were carried out to assess the corrosion behaviour. Long-term immersion tests in simulated body fluid (SBF) for up to 21 days were conducted to evaluate the in vitro bioactivity. Corrosion morphology and corrosion products were studied to reveal the corrosion mechanism. The results demonstrated that the Sr-ZnO coating optimized the corrosion rate and enhanced the bioactivity of the substrate, improving its potential for orthopedic applications. Full article