Search Results (239)

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

In recent years, there has been rapid growth in aesthetic medicine and an increase in the number of minimally invasive procedures aimed at improving appearance. With the increasing number of procedures performed, the incidence of post-operative complications is also rising, and high-frequency ultrasound (HFUS) is increasingly being used to assess these complications. The article presents the case of a 52-year-old woman who reported for an HFUS examination several months after non-surgical nose correction with hyaluronic acid (HA) and implantation of polydioxanone (PDO) lifting threads. The patient experienced post-treatment complications in the form of erythema, oedema and pain, followed by blanching and bruising of the skin. Hyaluronidase and prednisone were used for treatment. Four months after the procedure, the patient returned for another HFUS examination because, despite the disappearance of most symptoms, uneven purple-blue discoloration of the skin on the nose and a subjective feeling of cold persisted. At the time of the HFUS examination, the discoloration was barely visible. The grey-scale HFUS examination revealed foci corresponding to HA deposits and PDO threads located in close proximity to the dorsal artery of the nose. A Doppler examination revealed blood flow disturbances in this artery, which may indicate compression by the threads and be the likely cause of the patient’s complaints. High-frequency ultrasound has proven to be a useful diagnostic method for assessing such complications. Due to its safety, non-invasiveness and high reliability, HFUS has the potential to become a common diagnostic tool in aesthetic medicine practice. Full article

Traditional surgical techniques are based on the manual application of force using mallets and osteotomes, which often result in uncontrolled impact forces, procedural inconsistencies, and patient discomfort. Magnetic mallets (MMs), magnetodynamic devices, provide a controlled application of force using electromagnetism, aiming to achieve greater precision, reduced operating time, and improved surgical outcomes. The aim of the present systematic review was to evaluate the effectiveness of MMs compared to conventional surgical techniques in oral and implant surgery. The focused question was as follows: “Do magnetic mallets improve clinical outcomes in oral and implant surgery compared to traditional instruments?” Only clinical studies comparing the use of MMs with traditional techniques in oral surgery were included. The following databases were searched up to 27 November 2025: Pubmed, Scopus, Web of Science. For quality assessment, the Cochrane Risk of Bias 2 (RoB 2) tool was applied for randomized controlled trials (RCTs), while the Newcastle–Ottawa Scale (NOS) was used for non-randomized studies. Data were screened and synthesized by two reviewers. The systematic review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. In total, 347 studies were initially found and 6 matched the inclusion criteria and were included in the review, for a total of 282 patients. Five RCTs were included, as well as one retrospective study. The studies investigated were as follows: implant site preparation (two studies with a total of 86 patients), sinus lift and contextual implant insertion (three studies, total: 102 patients), dental extraction (two studies, total: 70 patients), and split-crest (one study with 46 patients). The outcomes suggest that MMs may serve as a potential alternative to traditional techniques, exhibiting promising although preliminary outcomes. The studies included reported a lower incidence of benign paroxysmal positional vertigo with the use of MMs compared to hand osteotomes. Regarding quality assessment, RCTs raised some concerns, while the retrospective study had a moderate risk of bias. Despite the promising results, the paucity of high-quality controlled trials limits definitive conclusions on the superiority of MM over conventional techniques. Further well-designed comparative trials are needed to confirm the clinical benefits, optimize protocols across different indications, and evaluate MMs’ potential role in the management of critical bone conditions and complex surgery. Full article

Background and Objectives: According to the PRISMA guidelines, this meta-analysis evaluates the outcomes of deep Superficial Musculoaponeurotic System (SMAS) lift versus Minimal Access Cranial Suspension (MACS) lift techniques in facelift surgery. Materials and Methods: We reviewed literature that included 20 studies involving a total of 7716 patients, of which four studies met our inclusion criteria, focusing on 286 patients (MACS n: 186 and SMAS n: 100). Our analysis assessed surgical duration, complications, pain levels, and aesthetic results. Results: Although both techniques yielded comparable aesthetic outcomes and postoperative complications, the MACS lift demonstrated a significantly shorter surgical duration (SMD = 2.05; 95% CI [1.61–2.48]; p < 0.00001, I² = 0%) which has high impact on patient recovery, risk of complications and cost-effectiveness. Conclusions: The findings underscore the need for further research into varying techniques to solidify their efficacy and safety profiles. Full article

Background: In recent years, hyaluronic acid filler for the restoration and increase in buttock volume has been a procedure that has seen increasing success, both thanks to the considerable increase in patient demand and thanks to the improvement of implant techniques and device manufacturing technologies. Aims: The primary objective of this pilot study is to demonstrate the validity of an innovative filler inoculation technique in the upper quadrants of the buttocks and in the supra- and subfascial area in order to optically restore the appearance of a pleasant lumbar lordosis and to lift the upper quadrants with reduction in the infragluteal fold. The secondary objective is to evaluate the safety and efficacy of Sofiderm SubSkin^® (Techderm Biological Products Co., Ltd., Hangzhou, China), a highly versatile hyaluronic acid filler, formulated with a rheology suitable for use on the face and body. Patients/Methods: Five female subjects (50–63 years) were subjected to gluteal fillers in the supra- and subfascial areas; the correct positioning of the filler was investigated by means of a 20 Mhz ultrasound probe. Results: All patients obtained a significant improvement in the projection of the upper part of the buttocks. The implantation technique and the optimal rheological properties of the device brought about a natural and well-defined increase in volume, with a projection of the upper part of the buttocks and a consequent lifting of the lower parts and reduction in the length of the infragluteal fold. Conclusions: This study confirmed the efficacy and safety of the cross-linked hyaluronic acid Sofiderm Derm SubSkin^® in increasing the projection of the upper part of the buttocks, using an innovative mixed implantation technique, in a sample of selected patients. Full article

Facial asymmetry significantly affects aesthetic appearance, essential functions such as mastication and speech, and psychological well-being. While traditional surgical interventions effectively address significant facial asymmetry, they are often associated with considerable morbidity, prolonged recovery periods, and potential complications. Consequently, interest in minimally invasive, non-surgical techniques has substantially increased, driven by advantages including reduced downtime, rapid recovery, and immediate aesthetic results. This narrative review critically evaluates contemporary non-surgical techniques for correcting facial asymmetry, focusing specifically on dermal fillers, collagen stimulators (polydioxanone powder), polydioxanone thread lifting, energy-based non-invasive devices (radiofrequency, ultrasound, and laser therapies), and extracorporeal shockwave therapy. The review is based on a structured literature search of PubMed/MEDLINE, Embase, and Google Scholar up to October 2025, focusing on human clinical studies and review articles on non-surgical correction of facial asymmetry and related facial contouring. We provide a detailed analysis of each treatment modality’s underlying mechanisms, clinical efficacy, advantages, limitations, and safety profiles. Current evidence suggests that these non-surgical methods effectively enhance facial symmetry by offering immediate visible improvements and progressive enhancements through natural collagen regeneration, thereby significantly improving patient satisfaction and overall quality of life. Clinicians are encouraged to incorporate these versatile, minimally invasive interventions into clinical practice, carefully tailoring treatments according to individual patient characteristics and specific aesthetic goals. Further research should aim to refine existing treatment protocols, evaluate long-term efficacy and safety, and establish standardized guidelines to optimize outcomes in facial asymmetry correction. Full article

Background: Facial retaining ligaments are pivotal in maintaining facial structure and are increasingly recognized as critical components in modern facelift procedures. Their age-related laxity contributes to facial sagging, jowling, and volume descent, necessitating a detailed understanding of their anatomy and function to achieve natural and lasting aesthetic outcomes. Despite advances in technique, there remains an ongoing debate regarding whether surgical preservation or release of these ligaments yields superior results. Methods: This narrative review analyzes peer-reviewed literature on various facelift techniques, focusing specifically on how each approach manages retaining ligaments. Techniques assessed include subcutaneous, SMAS, deep plane, composite, subperiosteal, and extended SMAS rhytidectomies, as well as more recent methods such as the MACS lift and PRESTO facelift. Anatomical variations and their surgical implications were evaluated, alongside aesthetic outcomes, recovery profiles, and complication risks. Results: Ligament-releasing techniques, such as the deep plane and extended SMAS facelifts, allow for greater tissue mobilization, improved repositioning of midfacial and cervical tissues. Conversely, ligament-preserving techniques, such as the MACS and PRESTO lifts, offer safer, less invasive, though with more limited correction in severe laxity. The review emphasizes that variability in ligament anatomy requires a patient-specific surgical plan to optimize results. Conclusions: The management of retaining ligaments remains a cornerstone of facial rejuvenation strategies. Surgical success hinges on a tailored approach, balancing the need for comprehensive lift with the preservation of facial identity and anatomical safety. Further clinical research and advancements in imaging and surgical technology are needed to refine technique selection and enhance long-term outcomes. Full article

The epidemiology of respiratory viruses shifted considerably following the COVID-19 pandemic and the subsequent rollback of non-pharmaceutical interventions (NPIs). The initial global containment strategies implemented during the SARS-CoV-2 outbreak profoundly altered viral transmission dynamics and circulation patterns. As the World Health Organization (WHO) declared COVID-19 no longer a public health emergency in May 2023, viral circulation began reverting to pre-pandemic trends. This retrospective observational study examined the evolving epidemiological patterns of respiratory infections during and after the lifting of NPI, assessing associated clinical manifestations and their relationship with patient-specific risk factors. Data were collected from 307 patients tested between October 2021 and December 2024 using a respiratory multiplex PCR at the Rodolphe Mérieux Laboratory in Lebanon. Results revealed a reemergence of pre-pandemic seasonal trends for most viruses. Rhinovirus remained the most prevalent pathogen, likely due to the absence of a vaccine. Respiratory syncytial virus (RSV) and Influenza A resumed their characteristic winter peaks, while human metapneumovirus (HMPV) showed no co-infections, suggesting viral interference. The persistence of Influenza A and SARS-CoV-2 appeared influenced by vaccine coverage, viral mutations, and environmental factors. Multiplex PCR testing proved to be a valuable yet costly tool for both diagnosis and epidemiological surveillance. Overall, this study highlights the importance of continued viral monitoring in the post-NPI period, reflecting both the effectiveness of NPIs in limiting viral spread and the importance of ensuring wider access to advanced diagnostic methods. Full article

Background: The thumb accounts for 40–50% of hand function. Traumatic amputation of the thumb results in significant disability and necessitates a structured approach to management. Methods: We conducted a retrospective review of 144 patients treated for thumb amputations between 2004 and 2025 at a specialist hand surgery unit. Over 21 years, an institutional algorithm was developed and refined to guide treatment decisions based on amputation level, injury mechanism and patient factors. Results: Out of the 144 cases, 118 patients underwent replantation, achieving an 82% success rate. Alternative reconstructive procedures included toe-to-thumb transfers (eight cases), index finger pollicisation (six cases) and fourth finger pollicisation (five cases). Functional outcomes showed that 90% of patients returned to work, 83% regained temperature and touch sensation, and 94% could lift a 0.5 L bottle. Conclusions: Implementing a structured treatment algorithm facilitates personalised care and leads to favourable functional outcomes in patients with traumatic thumb amputations. Full article

Home-based rehabilitation supports neuromuscular patients while minimising the need for extensive clinical supervision. Due to a growing number of stroke survivors, this approach appears to be more practical for patients across diverse demographics. Although existing hardware-based assistive devices are pretty common, they have limitations in terms of usability, wearability, and safety, as well as other technical constraints such as bulkiness and torque-to-weight ratios. To overcome these issues, soft actuator–based assistance prioritises user safety and ergonomics, as it is more wearable and lightweight, offering overall support while reducing the social stigma associated with disability. Among the existing soft actuation techniques and related materials, shape memory alloys (SMA) present a feasible option, offering current-controlled actuation and compatibility with integration into flexible textiles, thereby enhancing the wearability of the device. This paper presents a compact, SMA-driven assistive device designed to support natural motion, reduce muscle fatigue, and enable daily therapy. Embedded in a glove, the device allows mirrored control, where one hand’s movement assists the other, using flex sensors for feedback. The functionality of the electromyography (EMG) sensor is also used to evaluate the activation of the SMA wire; however, it is not employed for detecting individual finger motions in the assistive hand. Polyurethane foam insulation minimises thermal effects while maintaining lightweight wearability. Experimental results demonstrate a reduction in actuation time at higher voltages and the effective lifting of light to moderate weights. The device shows strong potential for affordable, home-based rehabilitation and everyday assistance. Full article

Post-traumatic lymphedema (PTL) is a chronic and often under-recognized sequela of soft tissue trauma, leading to persistent swelling, functional impairment, and increased risk of infection. While lymphedema is traditionally associated with oncologic interventions, growing evidence highlights the significant burden of PTL in trauma patients. This review provides a comprehensive analysis of the current understanding of PTL, including epidemiology, risk factors, pathophysiology, diagnostic modalities, and treatment strategies. PTL often occurs after high-impact musculoskeletal injuries (such as open fractures with significant soft tissue loss) or burns (especially if deep or circumferential). This risk is increased if injury occurs at critical areas of increased lymphatic density (such as anteromedial leg, medial knee, medial thigh, medial elbow, or medial arm). Advances in imaging techniques, including indocyanine green lymphography and magnetic resonance lymphangiography, have improved early detection and classification of PTL. Management approaches range from conservative therapies, such as complete decongestive therapy (CDT), to surgical interventions, including lymphaticovenous anastomosis (LVA), vascularized lymph node transfer (VLNT), and vascularized lymph vessel transfer (VLVT)/lymph-interpositional-flap transfer (LIFT). We report on our experience with two patients. At our center, we diagnose and stage PTL with ICG lymphography and trial CDT for 6 months. If there is no significant improvement, we recommend LVA. If there is insufficient improvement after 12 months, we recommend LIFT/repeat LVA/VLNT. We also treat open fractures with significant soft tissue defects with LIFT, as prophylaxis against PTL. PTL remains an underdiagnosed condition, necessitating increased awareness and intervention to prevent long-term disability. Full article

The zygomaticus major and minor (ZMa/ZMi) are key determinants of smile dynamics and midface contour, yet they exhibit substantial morphological variability—including bifid or multibellied bellies, accessory slips, and atypical insertions. Such variants can alter force vectors, fat-compartment boundaries, and SMAS planes, increasing the risk of asymmetry, contour irregularities, or “joker smile” following facelifts, fillers, thread lifts, and smile reconstruction. To our knowledge, this is the first review to integrate the Landfald classification of ZMa/ZMi variants with a standardized dynamic imaging-based workflow for aesthetic and reconstructive midface procedures. We conducted a narrative literature synthesis of anatomical and imaging studies. Bifid or multibellied variants have been reported in up to 35% of cadaveric specimens. We synthesize anatomical, biomechanical, and imaging evidence (MRI, dynamic US, 3D analysis) to propose a practical protocol: (1) focused history and dynamic examination, (2) US/EMG mapping of contraction vectors, (3) optional high-resolution MRI for complex cases, and (4) individualized adjustment of surgical vectors, injection planes, and dosing. Procedure-specific adaptations are outlined for deep-plane releases, thread-lift trajectories, filler depth selection, and muscle-transfer orientation. We emphasize that standardizing preoperative dynamic mapping and adopting a “patient-specific mimetic profile” can enhance safety, predictability, and preservation of authentic expression, ultimately improving patient satisfaction across diverse midface interventions. Full article

This study investigates the use of multi-field electrostimulation with the Fesia Grasp device for hand rehabilitation in patients with Multiple Sclerosis (MS). This research aims to evaluate the effectiveness of this novel approach in improving hand function and dexterity in MS patients. A cohort of MS patients with varying degrees of hand impairment underwent a structured rehabilitation program using the Fesia Grasp device, which delivers targeted electrical stimulation to specific muscle groups. Outcome measures assessed multiple aspects of hand function, including gross and fine motor skills, strength, and functional independence, at baseline, post-intervention, and 1-month follow-up. The main finding was a sustained between-group improvement in gross manual dexterity, measured by the Box and Block Test, at 1-month follow-up (p = 0.008, η²ₚ = 0.429). Secondary analyses showed task-specific gains in the experimental group, with significant intragroup improvements in Jebsen–Taylor Hand Function Test items related to simulated feeding (p = 0.012) and lifting light objects (p = 0.036), and a trend toward better performance in stacking checkers (p = 0.069) and faster page-turning (p = 0.046) after the intervention. Other outcomes showed non-significant changes favoring the experimental group. This research contributes to the growing body of evidence supporting the use of advanced electrostimulation techniques in neurological rehabilitation and offers promising implications for enhancing the quality of life for individuals with MS-related hand dysfunction. Full article

Aim: This retrospective observational clinical cohort study evaluated 84-month clinical and radiographic outcomes of a regenerative protocol combining autologous dentin grafts processed with the Tooth Transformer^® device and Concentrated Growth Factors (CGFs) in patients with severe maxillary atrophy undergoing sinus augmentation with simultaneous implant placement. Materials and Methods: Thirty-one patients (30–75 years) with residual crestal bone height ≥ 5 mm and requiring extraction of ≥2 molars were included. Extracted teeth were processed with the Tooth Transformer^® to obtain demineralized dentin granules (500–1000 µm), which were combined with CGFs prepared using the Medifuge MF200^® to form “sticky bone.” All patients underwent sinus lift via a lateral window approach (Hilt Tatum technique) with simultaneous placement of 98 implants (12–14 mm), which were loaded after six months. Results: At the 84-month follow-up, no implant failures or peri-implantitis were recorded. CBCT and clinical evaluations showed stable regenerated bone volume and absence of peri-implant bone resorption. All patients received fixed prostheses within six months without complications. Conclusions: The combined use of processed autologous dentin and CGFs proved to be a safe, predictable, and effective regenerative technique in cases of severe maxillary atrophy, with a 100% implant survival rate at five years. Full article

Background/Objectives: The aim of the study was to investigate the risk factors related to early implant failures in patients treated in a private implant clinic. Methods: The study was retrospectively conducted on 392 patients (mean age = 51.2 ± 15.4 years, 48.9% female and 51.1% male) who received 930 dental implants within the period from 2000 to 2020. Included patients had received at least one implant. Patients were excluded in case of incomplete dental records that did not contain the necessary information, including personal information (patient’s name, age, gender, history and current condition of systemic diseases) and treatment protocol record. No patients were excluded on the basis of systemic disease if it did not contraindicate dental implant surgery. Patient-related variables (age, gender, smoking, history of periodontitis, accompanying disease), surgical-related variables (surgical technique, bone augmentation, lateral sinus lift, internal sinus lift, immediate implant placement after tooth extraction, immediate mucosal grafting, insertion torque,) and implant-related variables (implant design, implant level, implant surface, site of implant placement, implants diameter, length and implants brand name) were recorded. Results: GEE analysis results showed that the implant-based failure rate before or at the abutment connection stage was 5.8%. Seven factors were identified associated with early implant failures: male gender, smoking, history of radiotherapy and chemotherapy, maxilla implant placement, non-submerged healing method, implant design and implant brand. Conclusions: In light of the results obtained, both patient-related variables (gender, smoking, history of radiotherapy and chemotherapy) and variables related to the type of implant, its position and the surgical technique used (maxilla implant placement, non-submerged healing method, implant design and implant brands) were found to be statistically correlated with early failures in this study. Full article