Search Results (52)

Background/Objectives: Maxillofacial silicone prostheses’ long-term color stability remains a challenge. This study aimed to evaluate and compare the color stability of conventional and digital maxillofacial silicone elastomers mixed with nano-sized antimicrobial additives (ZnO nanoparticles and chlorhexidine salt-CHX) at various concentrations over a 10-week period. Methods: A total of nine groups (n = 10) of maxillofacial silicone elastomers were prepared. These included a control group (no additives), conventionally pigmented silicone, digitally pigmented silicone (Spectromatch system), and silicone mixed with ZnO or CHX at 1%, 3%, and 5% by weight. Specimens were fabricated in steel molds and cured at 100 °C for 1 h. Color measurements were performed at baseline and after 1, 4, 6, and 10 weeks using a Minolta Chroma Meter (CIELAB system, ΔE₀₀ formula). Data were analyzed using two-way ANOVA and Tukey HSD post hoc tests (α = 0.05). Results: Color changes (ΔE₀₀) ranged from 0.74 to 2.83 across all groups. The conventional pigmented silicone group showed the highest color difference (ΔE₀₀ = 2.83), while the lowest was observed in the ZnO 1% group (ΔE₀₀ = 0.74). Digital silicone and all antimicrobial-modified groups exhibited acceptable color stability (ΔE₀₀ < 3.1). Time significantly affected color difference, with the largest change occurring during the first four weeks (p < 0.05), followed by stabilization. Regression analysis confirmed high color stability over time for all groups except the conventional pigmented group. Conclusions: This is one of the first studies to directly compare digital and conventional pigmentation methods combined with nano-antimicrobials in maxillofacial silicones. Maxillofacial silicone elastomers mixed with up to 5% ZnO or CHX maintained acceptable color stability over 10 weeks. Digital pigmentation is similar to conventional methods. The incorporation of nano-antimicrobials offers significant microbial resistance and improved color retention. Full article

Background: Technological progress in the field of prosthetic dentistry has changed the workflow, optimizing times and increasing the possible choices of prosthetic rehabilitation. Methods: The adaptability of three resin plates to the plaster model was evaluated by visual evaluation and by filling out a questionnaire in which two areas present in three silicone impressions obtained with three different construction methods were selected, including the traditional method, CAD/CAM method for milling, and CAD/CAM method for addition. Results: The results showed that although silicone 3 obtained with the additive method had better performances in the selected areas, the p-value of 0.735 was >0.05, and therefore there are no statistically significant differences between the different silicone impressions. Furthermore, a poor agreement between the evaluators was found (k 0.184). Conclusions: This work conducted in vitro highlights an important aspect of the choice of material used for impressions in cases of prosthetic relining. More in-depth studies with larger samples and objective measurement methods will be needed to compare fit data across different prosthetic construction modalities. Full article

Objectives: The term ‘prosthesis’ in reference to breast implants is used to clarify its distinction from the general term ‘breast implant’, which is widely adopted by plastic surgeons. This terminology highlights the role of the implant as a functional tissue substitute, particularly in post-mastectomy reconstruction, rather than solely as a cosmetic enhancement. This distinction is relevant for understanding the long-term implications of implant-based reconstruction and the associated complications. The aim of this systematic review was to compile and analyze the current evidence on the long-term complications associated with breast implants. We explored how these complications vary depending on implant type, surgical techniques, patient-specific factors, and the indication for implantation (cosmetic vs. reconstructive). These indications were analyzed separately to avoid assumptions regarding their correlation with surgical techniques. Methods: A systematic search was conducted across PubMed, Web of Science, and Scopus for studies published up to December 2024, following PRISMA 2020 guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. An initial search identified 1480 studies. After screening and applying inclusion criteria, 11 studies were selected for the final analysis. Studies included in this review reported long-term complications in human subjects, were published in English, and evaluated breast implants. The quality of the included studies was assessed using the ROBINS-E tool. Additionally, subgroup analyses examined differences based on implant type (silicone vs. saline), surgical techniques, and patient characteristics, such as age, comorbidities, and the duration of follow-up. Results: This review study was performed between September 2024 and December 2024. A total of 11 studies were included in the review. The included studies were published between 1997 and 2021, providing a long-term perspective on breast implant complications. The most frequently reported complications were capsular contracture, implant rupture, seroma, and infection, with capsular contracture being the most prevalent. Silicone implants were associated with a higher risk of rupture compared to saline implants. Techniques using textured implants and dual-plane placements were found to reduce the incidence of capsular contracture. Patient-related factors, such as age and smoking status, were identified as significant risk factors for complications, while longer follow-up periods revealed more late-onset complications. Conclusions: This review underscores the importance of understanding the long-term risks of breast implants and highlights the need for personalized surgical planning and thorough follow-up care. Future studies should focus on standardizing outcomes reporting and further evaluating the safety and effectiveness of new implant materials and surgical approaches. Full article

The treatment of maxillofacial defects presents significant challenges due to the complexity of facial anatomy and the diversity of affected tissues. Traditional workflows are labor-intensive, costly, and limited in customization. Recent advancements in fully digital workflows and direct 3D printing technologies offer new possibilities for improving the fit, aesthetics, and efficiency of prosthetic manufacturing. This scoping review aims to evaluate the current state of direct 3D printing for maxillofacial soft prostheses, assess material properties and biocompatibility, and identify challenges and future directions in this field. Methods: A comprehensive search of PubMed and Scopus databases, along with a manual search of relevant journals, was conducted to identify studies published up to December 2024. Articles focusing on direct 3D printing of maxillofacial soft prostheses were included, while studies involving traditional or mold-based workflows, ocular prostheses, and literature reviews were excluded. Data on materials, manufacturing techniques, and clinical outcomes were extracted and analyzed. Results: Out of 898 articles screened, 11 were included, 5 of which were in vivo studies (case reports). The additive manufacturing methods used in these case reports were Drop-on-Demand (DoD) silicone printing and PolyJet technology. Conclusions: Fully digital workflows and direct 3D printing technologies show promise for advancing maxillofacial prosthesis manufacturing. However, the absence of dedicated software, biocompatible materials, and medium- to long-term clinical evaluations highlight significant research gaps. Future research should focus on material development, workflow optimization, and clinical validation to enable widespread clinical adoption. Full article

Background: Medical devices used for functional or esthetic purposes improve health and quality of life; however, they are not risk-free. Anaplastic large-cell lymphoma (ALCL), associated with breast implants, is a well-known and recognized distinct lymphoma entity. More recently, additional lymphomas have been reported in relation to prosthesis other than breast implants, as these allow the pericyte to develop into a clone that undergoes a maturation process, progressing toward full malignancy. Methods: We performed a systematic review with a descriptive analysis of data extracted from primary studies following PRISMA guidelines, including the search string “(IMPLANT* OR PROSTHES*) AND LYMPHOM*” in the PubMed, Scopus, Embase, and Google-Scholar databases. Data such as patient sex, age, implant site, prosthesis material, and lymphoma type were analyzed. Statistical methods, including Student’s t-test and Fisher’s exact test, were employed to compare lymphoma characteristics, with significance set at a p-value < 0.05. Results: From a total of 5992 studies, we obtained 43 case reports and series on a total of 52 patients diagnosed with prosthesis-associated lymphomas. The majority of implant-related lymphoma cases (85%) were of the B-cell type, mostly fibrin-associated large B-cell lymphoma (LBCL). This lymphoma type was more associated with biological (non-human-derived biological tissue), metallic, and synthetic implants (synthesized from non-organic components) (p-value = 0.007). Patients with ALCL had equal frequencies of metal and silicone prostheses (37.5%, 3 cases each), followed by synthetic prostheses (25%, 2 cases). ALCL cases were most common at skeletal (50%) and muscular-cutaneous sites (25%), whereas B-cell lymphomas were predominantly found in cardiovascular implants (50%), followed by skeletal (27%) and muscular-cutaneous (21%) sites. Death attributed to lymphoma took place in 67% of the cases, mostly LBCL occurring in cardiovascular sites. Conclusions: Because the included studies were limited to case reports and series, a potential non-causal link might have been documented between different implant materials, implant sites and lymphoma types. This underscores the importance of further comprehensive research and monitoring of non-breast implants. Full article

Over 10% of patients undergoing aortic endograft implantation experience endoleaks within a few years. In the case of type 1a endoleaks, a crack forms between the aorta and the prosthesis collar, allowing blood to pass. This blood fills the aneurysmal sac and can lead to its rupture. None of the strategies, such as prostheses with barbs and hooks or ad hoc pharmacological therapies, can prevent the phenomenon. An alternative approach is to reduce diameter oscillations due to pulsating pressure to improve the endoprosthesis adhesion to the internal vessel walls during the initial post-implantation phases. To reach this objective, we propose to use a passive intra-aortic balloon pump (PIABP) inserted and then maintained inside the vessel immediately after the surgical procedure. We tested our hypothesis in a mechanical mock of the cardiovascular system. A silicon aorta with physiological behavior was created for this purpose. The PIABP was inflated to increasing pressures between systolic and diastolic values (120/80 mmHg). For each aorta and each condition, the variations in aortic diameter between systole and diastole, and the pressure variations, were measured. For the normal aorta, with a PIABP pressure of 110 mmHg, the variations in diameter were reduced by 38%. Assuming an endoprosthesis with a diameter of 30 mm (oversized by 5% compared to the diastolic diameter), the time the oscillations are higher than 30 mm is also reduced by 36%. The results are positive and suggest the usefulness of a biomechanical approach to the problem of type 1a endoleaks. Further in silico and clinical trials are necessary to validate the method. Full article

Emulating very soft tissues with synthetic materials is important for clinical prosthetists who want to improve compliance in maxillofacial and breast prosthesis. It is equally important for theatrical prosthetists wanting to model bariatric conditions and soft organs for surgical or palpation training. Polydimethylsiloxane (PDMS) gels, which are often used in medical model construction, are stiff and highly elastic compared to the friable soft tissues found in the body. Silicone oil is known to soften PDMS gels, but it is not known precisely how oil dispersal affects these gels and what proportion of oil is needed to simulate very soft tissue membranes like adipose tissue. In this work, internationally agreed test standards were used to mechanically characterize a range of PDMS gel membranes saturated with different amounts of silicone oil to determine whether materials with behavioral similarities to adipose tissue could be created. Mechanical properties like hardness, elasticity, strength, viscoelastic behavior and cure-time are presented in this study, which are all key factors required by the creators of such membranes. Results were compared to identical tests on porcine fat and data in the literature for porcine and human fat. The data revealed a strong correlation between increases in oil content and decreases in membrane hardness, strength and elastic modulus. It was also found that increases in oil content caused proportional increases in cure time, while membranes with equal amounts of oil and gel were best at mimicking characteristics of human and porcine fat, like hardness and elasticity. Full article

Oral rehabilitation with dental implants has resulted in high success rates. However, some complications have been described, such as the loss of the prosthetic screw. Some manufacturers sell screws with different coatings to avoid screw loosening, but even these types of screws can come loose. We aimed to investigate the screw coatings that can be applied during a dental appointment to avoid screw loosening. Following PRISMA Guidelines, we searched PubMed/Medline, Embase and Web of Science for studies published up to January 2024. All studies of single dental implant crowns, in which the prosthetic screw was coated with a lubricant and the preload and/or the removal torque value (RTV) was recorded, were analyzed. We excluded studies applying the finite element method (FEM) as well as studies without a control group. The risk of bias was assessed with a tool developed by our research group. Of the 1959 records identified, 19 were selected. Ten studies were considered to have a low risk of bias, and nine were considered to have a medium risk of bias. The coatings tested were adhesives, saliva, chlorhexidine, Vaseline, silicone gel, Polytetrafluoroethylene (PTFE) tape, blood, fluoride, Listerine^® Mouthwash and normal saline. The preload, the RTV with and without cyclic loading and the percentage of RTV loss were recorded. Some coatings show promise, although there is no clear evidence that any option is superior in minimizing screw loosening. Full article

This paper presents an integrated approach for a retinal prosthesis that overcomes the scalability challenges and limitations of conventional systems that use external cameras. Silicon nanowires (SiNWs) are utilized as photonic sensors due to their nanoscale dimensions and high surface-to-volume ratio. To enhance these properties and achieve high photoresponsivity, our research team developed a vertically stacked SiNW structure using a fabrication method entirely based on dry etching. The fabricated SiNW photodetector demonstrated excellent electrical and optical characteristics, including linear I–V characteristics that confirmed ohmic contact formation and high photoresponsivity exceeding 10⁵ A/W across the 400–800 nm wavelength range. The SiNW photodetector, following its integration with a switched capacitor stimulator circuit, exhibited a proportional increase in stimulation current in response to higher light intensity and increased SiNW density. In vitro experiments confirmed the efficacy of the integrated system in inducing neural responses from retinal cells, as indicated by an increased number of neural spikes observed at higher light intensities and SiNW densities. This study contributes to sensor technology by demonstrating an approach to integrating nanostructures and electronic components, which enhances control and functionality. Full article

Traditional prosthetic liners are often limited in customization due to constraints in manufacturing processes and materials. Typically made from non-compressible elastomers, these liners can cause discomfort through uneven contact pressures and inadequate adaptation to the complex shape of the residual limb. This study explores the development of bioinspired cellular metamaterial prosthetic liners, designed using additive manufacturing techniques to improve comfort by reducing contact pressure and redistributing deformation at the limb–prosthesis interface. The gyroid unit cell was selected due to its favorable isotropic properties, ease of manufacturing, and ability to distribute loads efficiently. Following the initial unit cell identification analysis, the results from the uniaxial compression test on the metamaterial cellular samples were used to develop a multilinear material model, approximating the response of the metamaterial structure. Finite Element Analysis (FEA) using a previously developed generic limb–liner–socket model was employed to simulate and compare the biomechanical behavior of these novel liners against conventional silicone liners, focusing on key parameters such as peak contact pressure and liner deformation during donning, heel strike, and the push-off phase of the gait cycle. The results showed that while silicone liners provide good overall contact pressure reduction, cellular liners offer superior customization and performance optimization. The soft cellular liner significantly reduced peak contact pressure during donning compared to silicone liners but exhibited higher deformation, making it more suitable for sedentary individuals. In contrast, medium and hard cellular liners outperformed silicone liners for active individuals by reducing both contact pressure and deformation during dynamic gait phases, thereby enhancing stability. Specifically, a medium-density liner (10% infill) balanced contact pressure reduction with low deformation, offering a balance of comfort and stability. The hard cellular liner, ideal for high-impact activities, provided superior shape retention and support with lower liner deformation and comparable contact pressures to silicone liners. The results show that customizable stiffness in cellular metamaterial liners enables personalized design to address individual needs, whether focusing on comfort, stability, or both. These findings suggest that 3D-printed metamaterial liners could be a promising alternative to traditional prosthetic materials, warranting further research and clinical validation. Full article

Esthetically pleasing temporary prostheses are often necessary for extended periods in a variety of clinical scenarios. Adjustments to the occlusion or margins are commonly needed before cementing the temporary prosthesis. Therefore, it is clinically necessary to repolish the rough surface to avoid biological and esthetic issues associated with rough surfaces. The purpose of this in vitro study was to assess and compare the impact of various polishing protocols on the surface roughness and color stability of three resin materials used for provisional crowns. A total of 150 specimens were fabricated from auto-polymerizing polymethyl methacrylate, bis-acryl composite, and Methyl methacrylate-LC resin using a stainless steel mold. Each material group was divided into five groups (n = 10) based on the applied surface treatment: positive control group (G1): no roughening or surface treatment, Negative control group (G2): acrylic bur-roughened surface without any polishing, the different surface treatment groups of silicon carbide and aluminum oxide stone polishing (G3), diamond-coated rubber twist (G4), and Surface Glaze (G5). An optical profilometer was used to assess the surface roughness of all samples. After undergoing 6000 cycles of thermocycling followed by immersion in a coffee solution for 15 days at 37 °C, color parameters were measured using a spectrophotometer both before and after a storage period to evaluate color differences. A two-way ANOVA test with α = 0.05 significance level was carried out to determine the impacts of both the materials utilized and the polishing protocol. Among the three types of resin examined, the bisacryl group exhibited superior surface quality in positive control groups, while PMMA resin demonstrated higher polishability. The diamond-coated rubber twits resulted in lower Ra values of 0.36 (0.01) µm, 0.52 (0.11) µm, and 0.28 (0.05) µm for PMMA, BAMA, and MMLC resins, respectively. The application of photo-polymerized surface glaze led to a plaque accumulation threshold of 0.2 µm across all resin groups. The greatest mean color change occurred in the negative control group, indicating a propensity for more staining on rougher surfaces. The Bisacryl resin exhibited higher ΔE values, whereas PMMA showed better color stability. The lowest ΔE values were found when the surface glaze was applied to all of the provisional crown resins. Untreated Bisacryl resin exhibited the lowest Ra values, while PMMA resins demonstrated superior surface morphology after polishing. PMMA provisional crown resins showed increased resistance to staining. The use of surface glaze enhanced both smoothness and color stability on the surfaces. Full article

The biomedical applications of silicones are countless due to their outstanding properties. In dentistry, silicone for maxillofacial and plastic surgery has become indispensable, from both physiological and aesthetic points of view. In this mini-review, silicone materials for dentistry and facial prostheses are discussed, focusing on their properties and alterations when exposed for long periods to different environments. A significant number of studies reported in the literature have been conducted in vitro, mimicking some of the main degradative factors which have been identified as triggers for discoloration and deterioration of the mechanical properties. Among these, in artificial aging and accelerated natural aging studies, UV radiation is considered the most important. Other weathering factors, biological contamination, and disinfection agents may have dramatic effects as well. Several general properties of silicones are described at the beginning, with a focus on biocompatibility, cross-linking mechanisms, and applications in dentistry and maxillofacial prosthetics. We discuss the ongoing cross-linking and/or possible exudation after manufacturing, which also affects the stability of the prosthesis over time, and possibly the patient. Next, the main environmental factors that affect the prostheses in service are presented, including the role of cigarettes smoke, which has been discussed very little so far. A few aspects, such as biofilm formation, its negative effects, and proposed solutions to overcome this phenomenon regarding silicones, are also described. We conclude by proposing a set of topics for future research and development based on the gaps that have been identified in the literature. Although silicones are probably irreplaceable in maxillofacial prosthetics, improvements in terms of base materials, additives, surface treatments, and maintenance are possible and necessary for long-lasting and safer prostheses. Full article

Background: Arthroplasty is gaining more and more popularity in the treatment of osteoarthritis (OA) of the metatarsophalangeal I joint (MTP1). The aim of our study was to evaluate the early and long-term objective clinical and radiographic results, as well as the subjective results, of MTP1 arthroplasty in comparison to MTP1 arthrodesis among patients with OA and a valgus deformity of their MTP 1 joint. Methods: Patients with OA MTP1 were examined before surgery and in the 5-year period after surgery. The inclusion criteria for the study were OA of the MTP1 joint and a non-axial position of the toe in valgus between 20 and 40 degrees. Prostheses were created for the patients with higher demands for mobility of their MTP 1 joint and arthrodesis was carried out for those with lower expectations. The treatment outcomes were assessed by clinical examination, radiography, the AOFAS scale, the SEFAS scale, and using patient-related outcome measures (PROM). Results: A total of 39 people, 37 women and 2 men, aged 55 to 67 years old (average, 61 years old) participated in the study. During the follow-up period, there were no complications in the form of infection or a loosening of the implant after both arthroplasty and arthrodesis. The follow-up examination 60 months after the surgery showed an improvement in scores (>20 points) on both the AOFAS and SEFAS scales. All patients, after surgery, reported reduced pain. Conclusions: The use of a silicone prosthesis in the surgical treatment of degenerative changes in the MTPI joint, with appropriate indications and excluding cases with large hallux valgus, gives better results than arthrodesis. Full article

The placement of endotracheal prostheses is a procedure used to treat tracheal lesions when no other surgical options are available. Unfortunately, this technique remains controversial. Both silicon and metallic stents are used with unpredictable success rates, as they have advantages but also disadvantages. Typical side effects include restenosis due to epithelial hyperplasia, obstruction and granuloma formation. Repeat interventions are often required. Biodegradable stents are promising in the field of cardiovascular biomechanics but are not yet approved for use in the respiratory system. The aim of the present study is to summarize important information and to evaluate the role of different geometrical features for the fabrication of a new tracheo-bronchial prosthesis prototype, which should be biodegradable, adaptable to the patient’s lesion and producible by 3D printing. A parametric design and subsequent computational analysis using the finite element method is carried out. Two different stent designs are parameterized and analyzed. The biodegradable material chosen for simulations is polylactic acid. Experimental tests are conducted for assessing its mechanical properties. The role of the key design parameters on the radial force of the biodegradable prosthesis is investigated. The computational results allow us to elucidate the role of the pitch angle, the wire thickness and the number of cells or units, among other parameters, on the radial force. This work may be useful for the design of ad hoc airway stents according to the patient and type of lesion. Full article

The object of the study was to evaluate the suitability and trueness of the removable partial denture (RPD) framework fabricated by polyether ether ketone (PEEK) with the CAD-CAM technology in vitro. Four different types of dentition defects were selected. In each type, five PEEK RPD frameworks were fabricated by the CAD-CAM technology, while five Co-Cr RPD frameworks were made by traditional casting. The suitability of the framework was evaluated by silicone rubber film slice measurement and the three-dimensional image overlay method. The trueness of the PEEK framework was detected by the three-dimensional image overlay method. Data were statistically analyzed with the use of an independent samples t-test (α = 0.05). The suitability values by silicone rubber film slice measurement of the PEEK group were lower than those of the Co-Cr group in four types, with the differences indicating statistical significance (p < 0.05) in type one, type two, and type four. The suitability values using the three-dimensional image overlay method showed no statistical differences (p > 0.05) between the two groups in four types. The trueness values of the PEEK group were within the allowable range of clinical error. The suitability and trueness of the PEEK RPD framework fabricated by CAD-CAM technology met the requirements of the clinical prosthesis. Full article