Search Results (2,727)

Approximately 185,000 people in the United states experience limb loss each year. There is a need for an intuitive neural interface that can offer high-fidelity control signals to optimize the advanced functionality of prosthetic devices. Regenerative peripheral nerve interface (RPNI) is a pioneering advancement in neuroengineering that combines surgical techniques with biocompatible materials to create an interface for individuals with limb loss. RPNIs are surgically constructed from autologous muscle grafts that are neurotized by the residual peripheral nerves of an individual with limb loss. RPNIs amplify neural signals and demonstrate long term stability. In this narrative review, the terms “Regenerative Peripheral Nerve Interface (RPNI)” and “RPNI surgery” are used interchangeably to refer to the same surgical and biological construct. This narrative review specifically focuses on RPNIs as a targeted approach to enhance prosthetic control through surgically created nerve–muscle interfaces. This area of research offers a promising solution to overcome the limitations of existing prosthetic control systems and could help improve the quality of life for people suffering from limb loss. It allows for multi-channel control and bidirectional communication, while enhancing the functionality of prosthetics through improved sensory feedback. RPNI surgery holds significant promise for improving the quality of life for individuals with limb loss by providing a more intuitive and responsive prosthetic experience. Full article

Biofilms are structured communities of microorganisms encased in a self-produced extracellular matrix, and they represent one of the most widespread forms of microbial life on Earth. Their presence poses serious challenges in both environmental and clinical settings. In natural and industrial systems, biofilms contribute to water contamination, pipeline corrosion, and biofouling. Clinically, biofilm-associated infections are responsible for approximately 80% of all microbial infections, including endocarditis, osteomyelitis, cystic fibrosis, and chronic sinusitis. A particularly critical concern is their colonization of medical devices, where biofilms can lead to chronic infections, implant failure, and increased mortality. Implantable devices, such as orthopedic implants, cardiac pacemakers, cochlear implants, urinary catheters, and hernia meshes, are highly susceptible to microbial attachment and biofilm development. These infections are often recalcitrant to conventional antibiotics and frequently necessitate surgical revision. In the United States, over 500,000 biofilm-related implant infections occur annually, with prosthetic joint infections alone projected to incur revision surgery costs exceeding USD 500 million per year—a figure expected to rise to USD 1.62 billion by 2030. To address these challenges, surface modification of medical devices has emerged as a promising strategy to prevent bacterial adhesion and biofilm formation. This review focuses on recent advances in chemical surface functionalization using non-antibiotic agents, such as enzymes, chelating agents, quorum sensing quenching factors, biosurfactants, oxidizing compounds and nanoparticles, designed to enhance antifouling and mature biofilm eradication properties. These approaches aim not only to prevent device-associated infections but also to reduce dependence on antibiotics and mitigate the development of antimicrobial resistance. Full article

Recent evidence suggests that nano-TiO₂ particles improve antimicrobial and physical properties when incorporated into dental prosthetic materials. However, there exists a paucity of information regarding their impact on material properties when the prosthetic materials are 3D-printed over time. The purpose of this study was to evaluate the time-dependent printability and surface property changes occurring in a 3D-printed denture base resin containing nano-titanium dioxide (TiO₂) particles. A 0.4 wt% concentration of 30 nm rutile TiO₂ nanoparticles was ultrasonically dispersed into a denture base resin. Disks were printed weekly using a Form 2 SLA printer until printing failed. Printability, surface roughness (R_a), color difference (ΔE_ab), and translucency parameters were measured across timepoints. Surface roughness was assessed via profilometry, while color and translucency were evaluated using a spectrophotometer under standardized conditions. Print failure occurred at week 8, beyond which the resin could no longer reliably produce full specimens. R_a roughness decreased from 3.83 µm to 0.48 µm, which denoted a significant time-dependent decrease (ρ = −0.733, p = 0.016). Color difference with the unmodified control declined from 26.32 to 17.13 ΔE_ab units (ρ = −0.976, p < 0.001). All printed samples exceeded the clinically acceptable thresholds for both R_a (0.2 µm) and ΔE_ab (<3.7). Although the printability of the resin–TiO2 mixture was maintained for 7 weeks, mixture homogeneity declined over time. TiO₂ additions to a denture polymer produced significant changes in surface roughness and color that were not clinically acceptable. Results from this study illustrate the time dependence required for retaining surface properties in 3D-printed dentures containing nano-TiO₂. Full article

Acromegaly is caused by an excessive secretion of growth hormone and the secondary elevation of IGF-1 levels, leading to progressive changes in multiple body systems, including the craniofacial region and oral cavity. Dental manifestations such as mandibular overgrowth, macroglossia, malocclusion, periodontal disease, and prosthetic difficulties represent not only a clinical component of the disease but also a significant therapeutic and diagnostic challenge. The aim of this review is to present the current state of knowledge on the relationship between acromegaly and oral health and to analyze the role of interdisciplinary collaboration between endocrinologists and dentists in patient care. For this narrative review, a literature search was conducted in the PubMed, Scopus, and Web of Science databases covering the period from 2000 to 2025. Sixty-two peer-reviewed publications meeting the methodological and thematic criteria were included in the analysis, including original studies, meta-analyses, systematic reviews, and case reports. The results indicate significant correlations between disease activity and the severity of periodontal and microbiological changes, while effective endocrine treatment only results in the partial regression of morphological changes. Particular attention was given to the role of the dentist in recognizing the early symptoms of the disease, planning prosthetic and surgical treatment, and monitoring therapy-related complications. Interdisciplinary collaboration models, including integrated clinics and co-managed care, were also described as optimal systemic solutions for improving treatment quality. The conclusion drawn from the analysis are as follows: there is a need for the permanent integration of dentistry into the standard of interdisciplinary care for patients with acromegaly, in both diagnostic and therapeutic dimensions. Increasing awareness among dentists and developing integrated collaboration models may reduce the time to diagnosis, improve patients’ quality of life, and enable the more effective management of craniofacial complications in the course of this rare disease. Full article

With rising global temperatures and increasing sustainability demands, the need for advanced pavement solutions has never been greater. This study breaks new ground by integrating phase change materials (PCMs), including paraffin-based wax (Rubitherm RT55), hydrated salt (Climator Salt S10), and fatty acid (lauric acid), as binder modifiers within warm mix asphalt (WMA) mixtures. Moving beyond the traditional focus on binder-only modifications, this research utilizes recycled cigarette filters (CFs) as a dual-purpose fiber additive, directly reinforcing the asphalt mixture while simultaneously transforming a major urban waste stream into valuable infrastructure. The performance of the developed WMA mixture has been evaluated in terms of stiffness behavior using an Indirect Tensile Strength Modulus (ITSM) test, permanent deformation using a static creep strain test, and rutting resistance using the Hamburg wheel-track test. Laboratory tests demonstrated that the incorporation of PCMs and recycled CFs into WMA mixtures led to remarkable improvements in stiffness, deformation resistance, and rutting performance. Modified mixes consistently outperformed the control, achieving up to 15% higher stiffness after 7 days of curing, 36% lower creep strain after 4000 s, and 64% reduction in rut depth at 20,000 passes. Cost–benefit analysis and service life prediction show that, despite costing USD 0.71 more per square meter with 5 cm thickness, the modified WMA mixture delivers much greater durability and rutting resistance, extending service life to 19–29 years compared to 10–15 years for the control. This highlights the value of these modifications for durable, sustainable pavements. Full article

Background/Objectives: Oral cancer resection often leads to maxillofacial defects and dentition loss, compromising patients’ quality of life. Implant-supported prosthetic rehabilitation offers a reliable solution to restore function, though factors such as bone reconstruction, radiotherapy, and timing of implant placement (immediate vs. delayed) may influence outcomes. This study aimed to evaluate long-term implant survival and rehabilitation timelines in oncologic patients, comparing two cohorts (2005–2014 and 2015–2024) to assess the impact of evolving clinical practices. Methods: A retrospective cohort study was conducted at Hospital General Universitario Gregorio Marañón (Madrid, Spain), including 304 patients who underwent ablative oral cancer surgery and subsequent implant-based rehabilitation between 2005 and 2024. Data on demographics, oncologic treatment, reconstruction, implant timing, and prosthetic rehabilitation were collected. Outcomes were compared using Kaplan–Meier analysis and appropriate statistical tests between the 2005–2014 (n = 122) and 2015–2024 (n = 182) cohorts. Results: A total of 2341 Ticare Implants^® were placed, supporting 281 prostheses. Implant placement during primary surgery increased from 41% to 71% (p < 0.001). The median time from surgery to prosthesis significantly decreased from 24 to 15 months (p < 0.001). Five-year implant survival was 95% in the early cohort versus 97% in the later cohort. Implant survival was comparable between irradiated and non-irradiated patients (~94–96%). Fixed prostheses became more frequent (92% vs. 79%, p = 0.002). Conclusions: Implant-supported rehabilitation in oncologic patients is highly feasible and durable, with improved timelines and functional outcomes associated with early implant placement and modern digital planning strategies. Full article

Background/Objectives: This study aimed to assess the long-term clinical performance of full-arch fixed restorations made of fiber-reinforced composite (FRC) supported by four ultra-short implants (4.0 × 5.0 mm) in patients with edentulous, atrophic mandibles. Methods: Ten patients were treated at Sapienza University of Rome and monitored over a 10-year period. Each case involved the placement of four plateau-design implants with a pure conometric connection and a calcium phosphate-treated surface. The final prostheses were fabricated using CAD/CAM-milled Trinia^® fiber-reinforced composite frameworks. Clinical parameters included implant and prosthesis survival, marginal bone level (MBL), peri-implant probing depth (PPD), and patient-reported outcome measures (PROMs). Results: Implant and prosthesis survival reached 100% over the 10-year follow-up. MBL data showed a minor bone gain of approximately 0.11 mm per 5 years (p < 0.0001). PPD remained stable under 3 mm, with a minimal increase of 0.16 mm over the same period (p < 0.0001). PROMs reflected sustained high patient satisfaction. No technical complications, such as chipping or framework fracture, were observed. Conclusions: Rehabilitation of the edentulous mandible with ultra-short implants and metal-free FRC prostheses proved to be a minimally invasive and long-lasting treatment option. The 10-year follow-up confirmed excellent implant and prosthetic outcomes, favorable peri-implant tissue health, and strong patient satisfaction. Nonetheless, further studies with larger sample sizes are needed to confirm these encouraging results and strengthen the clinical evidence. Full article

Background: Abdominal wall endometriosis (AWE) is a rare pathological condition that mostly occurs in the post-cesarean section. This study aimed to describe the surgical approach employed in treating 31 patients at our center over the past decade and compare the outcomes with those reported in scientific literature. Methods: We retrospectively evaluated the data of 31 patients with a cesarean section history who underwent surgery for AWE excision between 1 November 2012, and 31 January 2023, at the University of Naples Federico II, Italy. Subsequently, we reviewed the scientific literature for all AWE-related studies published between 1 January 1995, and 31 July 2024. Results: Most women presented with a palpable abdominal mass (90.3%) at the previous surgical site associated with cyclic abdominal pain (80.6%) concomitant with menstruation. All patients underwent preoperative abdominal ultrasound and magnetic resonance imaging, 71% underwent computed tomography, and 32.2% received ultrasound-guided needle biopsies. Furthermore, 90.3% and 9.7% had previous Pfannenstiel and median vertical surgical incisions, respectively. All patients underwent laparotomic excision and abdominal wall reconstruction, with prosthetic reinforcement used in 73.5% of cases. No recurrent nodules were detected in any patient at the 12-month follow-up. Conclusions: AWE should be suspected in women with a history of cesarean section presenting with palpable, cyclically painful abdominal mass associated with the menstrual cycle. Preoperative ultrasound and magnetic resonance imaging are essential, and surgical excision must ensure clear margins. Abdominal wall reconstruction should include prosthetic reinforcement, except when the defect is minimal (≤1.5 cm). An ultrasound follow-up at 12 months is recommended to confirm the absence of recurrence. Full article

The integration of artificial intelligence (AI) and advanced digital workflows is revolutionising full-arch implant dentistry, particularly for geriatric patients with edentulous and atrophic arches, for whom achieving both prosthetic passivity and optimal aesthetic outcomes is critical. This narrative review evaluates current challenges in intraoral scanning accuracy—such as scan distortion, angular deviation, and cross-arch misalignment—and presents how innovations like the Medit SmartX AI-guided workflow and the Scan Ladder system can significantly enhance precision in implant position registration. These technologies mitigate stitching errors by using real-time scan body recognition and auxiliary geometric references, yielding mean RMS trueness values as low as 11–13 µm, comparable to dedicated photogrammetry systems. AI-driven prosthetic design further aligns implant-supported restorations with facial symmetry and smile aesthetics, prioritising predictable midline and occlusal plane control. Early clinical data indicate that such tools can reduce prosthetic misfits to under 20 µm and lower complication rates related to passive fit, while shortening scan times by up to 30% compared to conventional workflows. This is especially valuable for elderly individuals who may not tolerate multiple lengthy adjustments. Additionally, emerging AI applications in design automation, scan validation, and patient-specific workflow adaptation continue to evolve, supporting more efficient and personalised digital prosthodontics. In summary, AI-enhanced scanning and prosthetic workflows do not merely meet functional demands but also elevate aesthetic standards in complex full-arch rehabilitations. The synergy of AI and digital dentistry presents a transformative opportunity to consistently deliver superior precision, passivity, and facial harmony for edentulous implant patients. Full article

Background/Objectives: Additive manufacturing (AM) technology has emerged as an innovative approach in dentistry. Recently, manufacturers have developed permanent resins engineered explicitly for the fabrication of definitive prostheses using AM techniques. This systematic review evaluated the mechanical and physical properties of 3D-printed permanent resins in comparison to milled resins and hybrid ceramics for the fabrication of indirect dental restorations. Methods: Three electronic databases—Scopus, Web of Science, and PubMed—were searched for English-language articles. Two independent researchers conducted study selection, data extraction, quality assessment, and the evaluation of the certainty of evidence. In vitro studies assessing the mechanical and physical properties of the permanent resins were included in this review. Results: A total of 1779 articles were identified through electronic databases. Following full-text screening and eligibility assessment, 13 studies published between 2023 and 2024 were included in this qualitative review. The investigated outcomes included physical properties (surface roughness, color changes, water sorption/solubility) and mechanical properties (flexural strength, elastic modulus, microhardness). Conclusions: Three-dimensionally printed permanent resins show promising potential for fabricating indirect dental restorations. However, the current evidence regarding their mechanical and physical properties remain limited and inconsistent, mainly due to variability in study methodologies. Full article

Background/Objective: The most effective strategy for addressing users’ prosthetic needs is a comprehensive clinical assessment that provides a holistic understanding of the individual’s symptoms, health, function, and environmental barriers and facilitators. A standardized evaluation form would provide guidance for a structured approach to comprehensive clinical assessments of people with LLA. The objective of this study was to determine a list of relevant elements to be included in prosthetic evaluation for adults with lower limb amputation. Methods: Three independent focus group discussions were conducted with prosthetists (n = 15), prosthesis users (n = 11), and decision makers (n = 4) to identify all relevant elements that should be included in the clinical assessment of prosthetic services. The final content was then determined using the Delphi technique, with 35 panelists (18 prosthetists and decision makers, and 17 prosthesis users) voting in each round. Results: A total of 91 elements were identified through the focus group, of which 78 were included through the Delphi process. The identified elements are mostly related to the physical health of the prosthesis user (e.g., mobility, pain, and medical information), while others address personal or psychosocial aspects (e.g., activities of daily living, goals, and motivation) or technical aspects (prosthesis-related). Conclusions: Through a Delphi consensus, a list of relevant elements to be included in a prosthetic evaluation was generated. These results will inform the development of a standardized clinical prosthetic assessment form. This form has the potential to improve the quality of clinical evaluations, guide interventions, and enhance the well-being of prosthetic users. Full article

Recently, 3D-printed resins have been introduced as materials for definitive indirect restorations. Herein, a comparative assessment of the bond strengths of 3D-printed resins to a resin cement was performed. Methods: four definitive restorative materials were selected, i.e., a Feldspar ceramic (VITA Mark II, VM), a polymer-infiltrated ceramic network (VITA Enamic, VE), a nanohybrid resin composite (Grandio Bloc, GB), and one 3D-printed resin (Crown Permanent, CP). VM and VE were etched and silanized, GB was sandblasted, and CP was glass bead blasted; for one further experimental group, this was followed by sandblasting (CPs). A resin cement (RelyX Unicem) was then used for bonding, and then a notched shear bond strength test (nSBS) was performed. Failure modes were observed and classified as adhesive, cohesive, or mixed, and SEM representative images were taken. Data were statistically analyzed with one-way ANOVA, Tukey, and Chi-square tests. Significant differences were detected in nSBS among materials (p < 0.001). The highest nSBS was found in VM (30.3 ± 1.8 MPa) a, followed by CP^b, GB^bc, CP^bc, and VE^c. Failure modes were significantly different (p < 0.001), and with different prevalent failure modes. The bond strength for 3D-printed permanent resin materials was shown to be lower than that of the felspathic ceramic but comparable to that of the resin block and PICN substrates. Full article

Aortic valve diseases affect a significant percentage of the population, and with the extension of survival expectancy, they are expected to increase furthermore. Surgical treatment of aortic valve diseases mainly includes valve replacement and, rarely, its repair. The technology of both surgical and transcatheter valves is evolving, and new prosthetic valves with improved characteristics are available, e.g., longer lifespan, faster implantation, better hemodynamic performance with better effective orifice area, suitable for small aortic annuli, etc. Minimally invasive surgical techniques are constantly evolving and spreading. New access sites are used for transcatheter valve implantation. The Heart Team determines the most appropriate intervention for each patient based on their anatomical and clinical profiles, aiming to optimize long-term outcomes. Full article

Background: The use of lower limb prosthesis can impact all aspects of daily life, activities and participation. Various studies have compared the microprocessor-controlled knee (MPK) to the non-microprocessor-controlled knee (NMPK) using a variety of different outcome measures, but results are inconsistent and raise the question of which type of knee is most effective. Therefore, we aimed to assess the effect of MPKs compared to NMPKs across all classified ICF domains in adult prosthesis users. Methods: Participants performed baseline measurements with the NMPK (T0). One week later, they started a four-to-six-week trial period with the MPK. Afterward, measurements were repeated with the MPK (T1). Functional tests (6MWT, TUG-test and activity monitor) and questionnaires (ABC, SQUASH, USER-P and PEQ) were used. For statistical analyses, paired t-tests, Wilcoxon signed-rank tests and Chi² test were applied. The Benjamini–Hochberg procedure was applied to correct for multiple testing. Results: Twenty-five participants were included. Using an MPK compared to an NMPK significantly resulted in improvements in balance and walking confidence, safety, walking distance and self-reported walking ability, as well as a decrease in number of stumbles and falls. Additionally, participants using an MPK were significantly more satisfied with their participation, experienced fewer restrictions, reported greater satisfaction with the appearance and utility of the MPK, experienced less social burden and reported better well-being, compared to using an NMPK. Conclusions: Using an MPK instead of an NMPK can lead to significant improvements in all classified ICF domains, such as improved walking ability, confidence and satisfaction and reduced fall risk. Full article

This study presents the design, fabrication, and clinical validation of a lightweight, body-powered prosthetic index finger actuated via metacarpophalangeal (MCP) joint motion. The proposed system incorporates an underactuated, cable-driven mechanism combining rigid and compliant elements to achieve passive adaptability and embodied intelligence, supporting intuitive user interaction. Results indicate that the prosthesis successfully mimics natural finger flexion and adapts effectively to a variety of grasping tasks with minimal effort. This study was conducted in accordance with ethical standards and approved by the Institutional Review Board (IRB), Project No. 670161, titled “Biologically-Inspired Synthetic Finger: Design, Fabrication, and Application.” The findings suggest that the device offers a viable and practical solution for individuals with partial hand loss, particularly in settings where electrically powered systems are unsuitable or inaccessible. Full article