High insertion torques increase the primary stability of dental implants, which might be beneficial for immediate loading protocols, but may lead to local ischemia and necrosis of the bone-implant interface. This study compared the outcomes of implants placed with low (<45Ncm), conventional(45-70Ncm), and high (≥75Ncm) insertion torques in All-on-4 concept cases with up to 2-year follow-up. Patients included in this study presented edentulous or partially dentate arches with an indication for full-arch rehabilitation. Implants were installed following the All on four protocol and were divided into 3 groups: Low, Conventional, and High torque, and were followed periodically for 2 years with ISQ measurements. The results showed no significant differences in success rates between the three groups. This suggests that high insertion torques may maintain higher primary stability values for immediately loaded implants during the healing period. Further studies are necessary to confirm these findings.

Background: Despite the fact that bone reconstructive surgeries are widely practiced worldwide, the search for an ideal bone replacement matetrial is still an open issue. We aimed to provide an overview of the current status of research and developments in this field with a focus on sapphire materials; Methods: A literature search and review was conducted using the PubMed, Scopus, and Embase databases. We searched for literature using the following keywords: bone implants; biocompatible materials; bone replacement material; sapphire implants; Results: Sapphire has a unique combination of mechanical, physical and chemical characteristics thanks to wich it has an excelent biocompatability and biointegrity.Unlike other materials it is incredibly strong and has a high endurance. The successful experience of using this material in medical instrument engineering, dentistry and cardiac surgery shows its benefits; Conclusions: We consider that sapphire is a perspective material for bone replacement implants and researchers should look in this direction.

Extreme atrophy of the maxilla poses still challenging for the clinicians. Some of the techniques used could be complex, risky, expensive, time consuming and should be performed, preferably, only by skilled surgeons. Most the commonly used techniques have been reported to have very high success percentages; however, sometimes complications may occur. In this regard, Premaxillary Device (PD) is a technique that has been devised to render more simple the reconstruction of extremely atrophic maxilla, trying to avoid more complicated and risky surgical procedures. Finite Element Analysis (FEA) allows evaluation of several differen aspects of dental implant biomechanics. Our results showed that the use of PD allows an optimal distribution of the stresses on the basal bone, avoiding tension peaks that could determine bone resorption or, even, implant failure. ANSYS has been used to perform this type of localized finite element analysis; with this type of analysis, it was possible to analyze the peri-crestal area of the plant more precisely and the PD through a more accurate reconstruction of the mesh element, which allowed us to mathematically solve the FEA solution. A most favorable biomechanical behavior has been found for the materials such as titanium alloys and reduce stress levels for bone, implants, screws, and abutments. Moreover, the stress values did not exceed bone strength limits for basal bone and titanium alloy. In conclusion, from a biomechanical point of view, PD could be considered a viable alternative for rehabilitation of severe atrophic maxilla.

Background: This study aimed to evaluate survival rate, marginal bone levels, and full arch prosthetic success on short implants when placed in areas of severely resorbed and edentulous mandibles. Methods: This is a systematic review of all randomized controlled trials of at least 10 patients with a control group in which bone augmentations were performed that were published between January 2010 and February 2023. Only 3 relevant studies met the inclusion criteria. Results: It obtained demonstrate that short-term dental implant survival rates ranged from 94.2% to 97.4% with a 5-year follow-up and the prosthetic success rate varied by 62% during the same follow-up. The mean marginal bone level values ​​of the affected short implants ranged from 0.2 mm to 0.6 mm. Conclusions: The data obtained demonstrated that short dental implants positioned with criterion and precision as a full-arch fixed support are a valid therapeutic choice for the medium-long term rehabilitation of severe edentulous mandibular atrophy.

Magnesium and its alloys are not normally used as bio-resorbable temporary implants due to their high and uncontrolled degradation rate in physiological liquid environment. The improvement of corrosion resistance to simulated body fluids (SBF) of a Magnesium alloy (AZ31) coated with poly-β-hydroxybutyrate (PHB) was investigated. Scanning electron microscopy, Fourier transform infrared spectrometer, and contact angle measurements were used to characterize surface morphology, material composition and wettability, respectively. pH modification of the SBF corroding medium, mass of Mg2+ ions released, and weight loss of the samples exposed to the SBF solution, and electrochemical experiment were used to describe the corrosion process and its kinetics. Materials biocompatibility was described by evaluating the effect of corrosion by products collected in the SBF equilibrating solution on hemolysis ratio, cytotoxicity, Nitric Oxide (NO), and total antioxidant capacity (T-AOC). The results showed that the PHB coating can diffusively control the degradation rate of Magnesium alloy improving its biocompatibility: hemolysis rate of materials was lower than 5%, while in vitro Human Umbilical Vein Endothelial Cells（HUVECs) compatibility experiments showed that PHB coated Mg alloy promoted cell proliferation and had no effect on the NO content, the T-AOC was enhanced compared with the normal group and bare AZ31 alloy. PHB coated AZ31 Magnesium alloy extraction fluids have a less toxic behavior due to the lower concentration of corrosion by-products deriving from the diffusion control exerted by the PHB coating films both from metal surface to the solution and vice versa. These findings provide more reference value for the selection of such system as tunable bioresorbable prosthetic materials

Medical implants made of biodegradable materials could be of advantage for temporary applications such mechanical support during bone-healing or as vascular stents to keep blood vessels open. After completion of the healing process the implant would disappear, avoiding long-term side effects or the need for surgical removal. Various corrodible metal alloys based on magnesium, iron or zinc have been proposed as sturdier and potentially less inflammatory alternative to degradable organic polymers, in particular for load-bearing applications. Despite the recent introduction of magnesium-based screws the remaining hurdles to routine clinical applications are still challenging, such as limiting mechanical material characteristics or unsuitable corrosion characteristics. Here, salient features and clinical prospects of currently investigated biodegradable implant materials are summarized with a main focus on magnesium alloys. A mechanism of action for the stimulation of bone growth due to the exertion of mechanical force by magnesium corrosion products is discussed. To explain divergent in vitro and in vivo effects of magnesium a novel model for bacterial biofilm infections is proposed which predicts crucial consequences antibacterial implant strategies.

Keywords: artificial bone; conical implants; cylindrical implants; dental implants; implant stability quotient; insertion torque; polyurethane; post-extraction sites; removal torque.

This topical review describes the results of recent research into and development of silicon nitride, a ceramic material with unique properties. The outcome of this ongoing research strongly encourages the use of monolithic silicon nitride and coatings as contemporary and future biomaterial for a variety of medical applications. Crystallographic structure, synthesis and processing of monolithic structures and coatings, and examples of their medical applications are covered that relate to spinal, orthopedic and dental implants, bone grafts and scaffolds, platforms for intelligent synthetic neural circuits, antibacterial and antiviral particles and coatings, optical biosensors, and nano-photonic waveguides for sophisticated medical diagnostic devices. The examples provided show convincingly that silicon nitride is destined to become a leader to replace titanium and other entrenched biomaterials in many fields of medicine.

Since the development of CBCT had been utilized in dentistry, the images of the CBCT can assist the surgeon to evaluate the anatomy carefully. Despite the value of the radiology evaluation, the implant procedures may require additional consideration rather than only evaluating the anatomical factors. The purpose of this study is to evaluate the predictability of using CBCT alone to plan for implant placement on the edentulous patient digitally CBCT images were analyzed by clinicians, measuring the ridge heights and widths of 4 selected implant sites in the maxillary and 2 selected implant sites in the mandibular arches for 91 patients planning for the implant-supported overdenture. (A total of 47 patients out of the 91 had completed the implant placement on the edentulous ridge, contributing to 55 upper and/or lower arches (136 dental implants). . Both predictabilities are low, implying the CBCT planning for implant placement on the edentulous ridge is not a good index and is insufficient to predict the surgical procedures as a solo method. The finding of this study indicates that digital planning by CBCT is insufficient to serve as an individual tool to predict implant procedures. Further information and evaluation must be considered for implant placement on the edentulous ridge.

Aim: the purpose of the present prospective, case series study were to report implant survival rate and marginal bone remodeling expected five years after loading using dental implants placed in in the daily practice. Material and Methods: this research was designed as an open-cohort, prospective case series study. Any completely or partially edentulous patients scheduled to receive at least one bone leve were considered eligible for this study. Primary outcomes were: cumulative implant (ISR) and prosthetic (PSR) survival rates, and any complications experienced up the five years follow-up. Secondary outcomes were: marginal bone remodeling, implant insertion torque, implant stability quotient (ISQ), and thickness of gingival biotype. Results: ninety consecutive patients (34 males and 56 females; mean age 53.2±15.4 years; range of 24–81 years), 243 implants were placed and followed for at least five years after loading (mean of 65.4±3.1 months; range of 60–72 months). The mean implant insertion torque was 42.9±4.8 Ncm (range from 15 to 45 Ncm). Overall, 83.5% of the implants (n=203) were placed with an insertion torque between 35 and 45 Ncm. At the one year follow-up, no drop-outs were recorded, but 17 patients (18.9%) with 18 restorations (12.6%) delivered on 34 implants (14%) were lost at the five years examination. At the five-year examination, six implants failed in six patients, resulting in a cumulative ISR of 97.5%. At the five-year follow-up, four prostheses failed (2.8%) resulting in a cumulative PSR of 97.2%. At the five-year examination, five complications were reported by five different patients, resulting in a prosthetic success rate of 96.5%, measured at patient level. Five years after loading, mean MBL was 0.41 ± 0.30 mm (95% CI: 0.26–0.34). Difference from the one year data was 0.04 ± 0.19 mm (95% CI: 0.01–0.07). The mean ISQ value at implant placement was 71.6 ± 5.5 (range of 45–88). Six months later, the mean ISQ was 76.7 ± 4.4 (range of 66–89). The difference was statistically significant (P=0.0001). Statistically significant higher MBL was found for smokers, and patient with thin gingival biotype. Conclusions: High implant survival and success rates could be expected with stable marginal bone remodeling up to five years after loading. Smoking and thin tissue biotype were the most important variabilities associated with higher MBL. Further research are needed to confirm these results.

Biomedical devices made from high-modulus and hardness materials play a critical role in enhancing the quality of life for individuals with bone-related ailments. While these materials have been successfully used in orthopedic applications, concerns including stress-shielding have necessitated the exploration of alternative solutions. An ideal biomedical implant requires a delicate balance of mechanical performance, corrosion resistance, tissue biocompatibility, and other properties such as tribological performance and osseointegration. This review explores the suitability of biodegradable magnesium (Mg) alloys as a promising material for biomedical implants. It delves into the essential properties of biomedical implants, emphasizing the importance of matching mechanical characteristics with human bone properties to mitigate stress shielding. The corrosion properties of implant materials are discussed, highlighting the need for controlled degradation to ensure the safety and longevity of implants. The focus then shifts to the potential of magnesium alloys as biomedical implants, examining their benefits, limitations, and the challenges associated with their high degradation rates and less-than-satisfactory mechanical properties. Alloying with elements such as aluminum, zinc, and others is explored to improve magnesium alloys' mechanical performance and corrosion resistance. Furthermore, this review discusses surface modification techniques, including chemical conversion coatings and biomimetic deposition, as effective strategies to enhance the corrosion resistance and biocompatibility of magnesium and its alloys. These modifications offer opportunities to improve the long-term performance of magnesium-based biomedical implants. This paper provides a comprehensive overview of the properties, challenges, and potential solutions associated with biodegradable magnesium alloys as a promising material for biomedical implants. It underscores the importance of addressing issues related to mechanical performance, corrosion resistance, and biocompatibility to advance the development of safe and effective biomedical implant materials.

Primary stability is an important factor for dental implant success. In the past years, a new method for bone site preparation was introduced, named osseodensification (OD). OD produces a condensation of the trabecular portion of the bone, increasing bone-to-implant contact and primary stability. This study aims to compare the effect of OD in cylindrical and conical implants to conventional instrumentation. A total of 40 implants, divided in 4 groups, were placed in porcine tibia: cylindrical conventional (1a); cylindrical OD (1b); conical conventional (2a); and conical OD (2b). Each implant was measured for implant stability quotient (ISQ), insertion torque (IT) and removal torque (RT). Group 2b showed the higher values for each of the evaluated parameters; groups 1b and 2b showed better results than 1a and 2a, respectively. Regarding IT and RT, group 1b achieved higher values than group 2a, but not for ISQ. The inter-groups comparison showed significant difference between groups 1a vs 2a, 1a vs 2b and 1b vs 2b for ISQ, and 1a vs 1b and 1a vs 2b for RT analysis. OD resulted in improved ISQ, IT and RT of both cylindrical and conical implants. Conical implants groups showed higher ISQ, but cylindrical OD resulted in higher IT and RT, compared to conical conventional ones.

Implants are used to replace damaged biological structures in human body. Although stain-less-steel (SS) is a well-known implant material, corrosion of SS implants led to the release toxic metallic ions which produce harmful effects in human body. To prevent material degradation and its harmful repercussions, these implanted materials are subjected to biocompatible coatings. Polymeric coatings play a vital role in enhancing the mechanical and biological integrity of the implanted devices. Zein is a natural protein extracted from corn and is known to have good bio-compatibility and biodegradability. In this study, Zein/Ag-Sr doped mesoporous bioactive glass nanoparticles (Ag-Sr MBGNs) were deposited on SS substrates via electrophoretic deposition (EPD) at different parameters. Ag and Sr ions were added to impart antibacterial and osteogenic properties to the coatings, respectively. In order to examine the surface morphology of coatings, optical microscopy and scanning electron microscopy (SEM) were performed. To analyze me-chanical strength, pencil scratch test, bend test, corrosion and wear tests were conducted on ze-in/Ag-Sr doped MBGNs coatings. The results show good adhesion strength, wettability, corro-sion, and wear resistance for zein/Ag-Sr doped MBGNs coatings as compared to bare SS sub-strate. Thus, good mechanical and biological properties were observed for zein/Ag-Sr doped MBGNs coatings. Results suggested these zein/Ag-Sr MBGNs coatings have great potential in bone regeneration applications.

The aim of this study was to compare the screw removal torque of mini conical prosthetic components and straight trunnion of indexed morse taper implants, after mechanical cycling. The sample consisted of 40 implants and 20 mini-conical prosthetic components (MC group) and 20 straight trunnion components (ST group). Each group consisted of 10 specimens, with 2 implants in each, and cobalt-chromium metallic crowns were screwed into each sample. The components of the MC group received a torque of 20 N.cm with a digital torque wrench and after 10 minutes were retightened with the same value as the initial torque. The components of the ST group received a torque of 30 N.cm, with a digital torque wrench and after 10 minutes, they were retightened with the same value. The screws of the respective crowns of the two groups received a torque of 10 N.cm and after 10 minutes were retightened with the same value. Each group was subjected to the fatigue test in a mechanical cycler at 2.000.000 cycles, with a load of 250 N and frequency of 4 Hz. At the end of the fatigue test, the loosening torque of each screw of the specimens was measured through a digital torque wrench. The data were analyzed by two-way ANOVA and Tukey test. In both groups, there were loss of torque. The results showed no statistic difference between MC and ST groups.

Titanium micro-scale topography results in excellent osteoconductivity and bone-implant integration. However, the biological effects of sub-micron topography are unknown. We compared osteoblastic phenotypes and in vivo bone and implant integration abilities between titanium surfaces with micro- (1–5 µm) and sub-micro-scale (0.1–0.5 µm) topographies and machined titanium. Average roughness was 12.5 ± 0.65 nm, 123 ± 6.15 nm, and 24 ± 1.2 nm for machined, micro-rough, and sub-micro-rough surfaces, respectively. The micro-rough surface showed the fewest cells attaching during the initial stage and the lowest proliferation. Calcium deposition and expression of osteoblastic genes were highest on the sub-micro-rough surface and lowest on the machined surface. Bone-to-implant integration was strongest for the micro-rough surface, consistent with it having the greatest ability to retain cells in vitro. Thus, the biological effects of titanium surfaces are not necessarily proportional to the degree of roughness in osteoblastic cultures or in vivo. Sub-micro-rough titanium ameliorates the disadvantage of micro-rough titanium by restoring cell attachment and proliferation and enhances the rate of osteoblastic differentiation over that of micro-rough titanium; however, bone integration and the ability to retain cells are compromised due to its lower interfacial mechanical locking compared to that of micro-rough titanium.

Hearing loss that arises from various causes at different stages of life has a direct impact on individuals' physical and mental well-being. This paper aimed to evaluate the employment, workplace adaptation, productivity, and professional success of individuals who have hearing loss and whose hearing loss is corrected with a cochlear implant. In this cross-sectional study, the data was collected between November 2022 and March 2023 with the participation of individuals with cochlear implants living in several settlements in all regions of Türkiye. A total of 142 participants with severe hearing loss who were corrected with a cochlear implant were included in this study. The survey method was used to collect data for the study. The questionnaire consisted of 32 questions and was distributed to the participants online. In the first part of the questionnaire (1-10 questions), general characteristics of implant patients were investigated. In the second part (11-32 questions), the positive or negative effects of implantation on the work life of the participants were evaluated. Almost half of the research group (49.3%, n = 70) consisted of women, and the mean age of the participants was determined to be 35.8 ± 14.8. There was no significant difference between gender, educational status, implanted side, working time, working style (physical, desk), and factors affecting work life (p > 0.05). Professional satisfaction and success at work increased significantly more in those with acquired hearing loss (p = 0.010). Post-implantation workplace compliance, success, and productivity were found to be higher in those with acquired hearing loss (p = 0.013). It was observed that hearing loss had a greater negative impact on the work life of married people (p = 0.006). Cochlear implantation greatly enhances workplace satisfaction, increases self-confidence, and has a positive impact on the future of profoundly deaf individuals.

Immediate load of full-arch rehabilitations over implants, specially over 4 implants are very well documented in the literature. More recently, the use of computed surgical guides to help the planning and the execution of these treatments, in many situations without the need of raising a flap, and diminishing the appearance of hematomas, bleeding and with less trauma to the patient has gained preference among implantologists. The objective of this case report is to show a clinical case of an immediate load full-arch fixed rehabilitation over 4 implants produced by 3D printing manufacturing technology, and placed with a computed surgical guide, in the same appointment, and the 24 months follow-up. The patient returned after 3 months to replace the immediate temporary fixed prosthesis for a new one, with metallic bar, better teeth and more delicate. Soft and hard tissue around the implants seemed to be stable, without signs of inflammation, either on the 3 or the 24 months follow-up. 3D printing of implants by direct metal laser sintering is a technology that seems to be promising for oral implantology, with solid studies showing reliable results, as seen in this single case. More clinical studies are necessary to testify its efficacy.

This study aims to develop a novel retention method combining the retrievability of the screw retention method with the ideal occlusal table and the aesthetics capability of cement retention. Coping was developed to have lateral screw access allowing the screw to lock coping using lateral forces from screw tightening and friction between the tip of the screw and the sandblasted surface of an abutment. Sandblasting parameters varied based on particle size. Results show a positive correlation to surface roughness and indicate a positive correlation to retention force. The highest surface roughness and retention force result was shown by groups that were sandblasted using 686 μm of aluminum oxide. Experiment on the tightening strength of 48 subjects measured in simulated conditions similar to assembly conditions of lateral screw retention implant resulted in a mean of 69.75 Nmm with the highest and lowest values of 120.67 Nmm and 34.67 Nmm. This result became the basis of tightening torque variation. Each group's retention capability is measured and compared to cement-retained dental implants. Results show that tightening torque correlates positively with retention force, with the highest average retention score showed by lateral screw retained under tightening torque of 200 Nmm with 317.87 N higher than cement-retained.

This review provides a comprehensive overview of two major advancements in hearing loss treatment: the middle ear implant (MEI) and bone conduction implants (BCIs). MEI, surgically inserted in the middle ear, directly stimulate the ossicles, and are primarily employed to treat sensorineural, conductive, or mixed hearing losses. BCIs work via bone conduction, bypassing the outer and middle ear to deliver sound vibrations to the inner ear, beneficial especially for conductive or mixed hearing losses and single-sided deafness. The decision to opt for these devices is a multifaceted process, considering audiological criteria, surgical feasibility, and patient expectations. The review also details the portfolio of available devices, their functioning, and audiological usage indications. While both MEI and BCIs prove beneficial for patients, the review emphasizes the need for careful preoperative planning and counselling, considering factors such as potential complications, surgical challenges, and patient suitability. Overall, the two types of implants, despite their individual complexities, provide an effective alternative to traditional hearing aids, offering a path to improved sound clarity and quality for patients with various types of hearing loss.

Autogenous demineralized dentin matrix (ADDM), derived from human extracted tooth, is commonly used as a bone-graft substitute to reconstruct alveolar defects when placing dental implants. The purpose of this retrospective study is to examine efficacy of ADDM in terms of surgical complications and marginal bone resorption by analyzing the medical records and radiographs of patients who received ADDM graft from 2008 to 2011 in our institute. Occurrence of complications, marginal bone loss around implants were investigated with regard to the type of defect, location of bone grafting, and types of bone graft techniques. ADDM-based bone grafting was performed on 221 sites in 82 patients and 208 implants were placed afterwards: The percentage of complications after bone grafting was 15.84%, and the implant survival rate was 95.19%. All complications were resolved with conventional treatment except for the 10 cases of osseointegration failure. The average marginal bone loss was 0.31 mm at the last examination after the average follow-up period of 7.2 years. Within the limitation of this study, the results of long-term follow-up are consistent with the short-term results of relevant studies. ADDM can produce promising clinical outcomes when used for alveolar ridge augmentation around implants.

Abstract: Air-polishing with low abrasiveness powders is fats arising as a valid and mini-invasive instrument for the management of biofilm colonizing dental implants. The reported advantage is the efficient removal of plaque with respect of the titanium integrity. In the present study, we evaluated the in-situ plaque-removal and continual the post-treatment anti-bacterial efficacy of an innovative erythritol/chlorhexidine air-polishing powder and compared it with sodium bicarbonate. Two peri-implantitis-linked biofilm formers strains Staphylococcus aureus and Aggregatibacter actinomycetemcomitans were selected and used to infect titanium disks before and after the air-polishing treatment. Cells number and viability were assayed by colonies forming units (CFUs) count and metabolic-colorimetric (2,3-Bis-(2-Methoxy-4-Nitro-5-Sulfophenyl)-2H-Tetrazolium-5-Carboxanilide) (XTT) assay. Air-polishing performed with either sodium bicarbonate or erythritol/chlorhexidine was effective in reducing bacteria biofilm viability and number onto pre-infected specimens, while erythritol/ chlorhexidine showed a higher post-treatment biofilm re-growth inhibition. Surface analysis via mechanical profilometry failed to show an increase in titanium roughness, regardless of the powder selected.

Background: Restorative materials might significantly affect load transmission at peri-implant bone. The aim of the present study is to evaluate the shock absorption capacity of two different polymeric materials to be used as frameworks for implant-supported prostheses. Methods: A masticatory robot was used to compare the shock absorption capacity of polyether-ketoneketone (PEKK) Pekkton®ivory (Cendres+Mètaux) and glass fiber-reinforced composite (GFRC) TRINIATM (Bicon). Five identical sample crowns for each of the materials was tested un-der the same conditions described in previously published papers (Menini et al. 2013). Forces transmitted at the simulated periimplant bone were recorded and statistically analysed. Results: The statistical analysis of forces transmitted at the simulated dental implant revealed significant differences between all the materials tested and significant differences with the mate-rials tested in a previously published paper (Menini et al. 2013: zirconia, glass ceramic, composite resin, acrylic resin). Only differences between PEKK and veneered PEKK and between PEKK and one of the previously tested composite resins were not statistically significant. PEKK samples demonstrated significantly greater shock absorption capacity compared to GFRC. Conclusions: PEKK revealed optimal shock absorption capacity. Further studies are needed to evaluate its efficacy in case of long span prostheses with reduced prosthetic volume.

Hip joint surgeries, including total hip replacement or resurfacing, have increased tremendously in the last decades. Number of patients of all ages, replace their hip, due to severe injuries or trauma problems, so as to have a better life. According to these factors, new material and processes in implants manufacturing are imported to medicine, through research programs, every year. In the scope of one of these programs, that has to do with ceramic coatings on metallic resurfacing implants, a new 3axis Hip simulator was designed and manufactured in the Laboratory of Manufacturing Technology of the National Technical University of Athens. The scope of this paper is to present the main parts, materials and process used to manufacture the simulator as well as the way the simulator is working and how its movement in 3axis is accomplished. Furthermore, the evaluation of the machine and its use to examine resurfacing implants is presented.

Today, dental implantology is a reliable technique for the treatment of partial and total edentulism. The fixing of dentures on dental implants can be achieved by a number of different techniques. The choice of technique depends on the specific needs of the patient, the condition of the jawbone and the design of the prosthesis itself. Currently, the two most common types of prosthetic abutment connections are cemented or screwed connections, both of which have disadvantages and ad-vantages. The aim of this study is to analyze, with Finite Element Analysis (FEA), a new Cone Morse connection system between the prosthesis and implant. The connection retention has been analyzed by adopting three different approaches: analytical, in vitro and the FEA method. The systems formed by abutment, healing-cap, and crown with three different inclination conditions were modeled in 3D: 0°, 15° and 30°. With Ansys finite element software, the effect of tilt on system retention was studied. The FEA analysis showed comparable results with in vitro studies regarding the retention strength for an abutment-cap system with a taper of 4°, obtaining 66.6 N compared to 68 N calculated through an in vitro study. The inclination of the abutment affects the retention of the system because the hole made on the surface of the abutment, decreases the contact area between the components. The Cone Morse prosthesis implant connection system is the most stable and efficient system compared to the threaded or cemented system. Retention is influenced by factors such as abutment conicity, insertion strength and the contact surface be-tween components.

Background: Bleeding disorders can be divided into three categories: congenital coagulation disorders (CCDs), antiplatelet induced bleeding disorders (APBDs) and anticoagulant induced bleeding disorders (ACBDs). Implant placement can be challenging in this kind of patients. The aim of this study is to provide evidence on implant surgery in patient with bleeding disorders and to generate some practical recommendations for clinicians. Material & Methods: Pubmed/MEDLINE, Scopus, Web of Science and Cochrane Library databases were screened. The latest search was performed in July 2022. Case Reports, Case Series, Cohort Studies, Cross-Sectional Studies, Case Control Studies, Reviews, Consensus Reports, Surveys and Animal Studies were included in the analysis. Results: Seventeen articles on CCDs were found, fourteen on APBDs, twenty-six on ACBDs. Most of these articles were case report or case series. Patients with CCDs can be treated after the infusion of the missing coagulation factor. Patients with APBDs can be treated without withdrawing the therapy. Patients with ACBDs should be treated depending on the anti-coagulative medication. Conclusion: Despite the low level of evidence, dental implants can be safely placed in patients with bleeding disorders. However, careful preoperative evaluation and the adoption of local and post-operative bleeding control measures are mandatory.

Intracortical microelectrodes that can be implanted have the ability to capture fast-changing neuron action potentials in the living brain. Despite this potential, many obstacles must still be overcome for reliable, long-term, high-quality recordings and accurate analysis of brain activity. These challenges include improving recording quality, enhancing recording stability, increasing recording capacity, and adding multi-functional features. One potential approach to enhance implantable microelectrodes involves the advancement of materials, refinement of implantation methodologies, and augmentation of the number of sites for recording. However, these challenges are still being actively researched, and advancements in microelectrode technology are underway. The difficulties with implantable microelectrodes are evaluated, and solutions are presented from different perspectives. The latest advancements in microelectrode technology are reviewed and condensed, and future possibilities are explored.

Purpose: Surgical site infection (SSI) is a significant complication of non-reconstructive and reconstructive breast. This study aimed to assess SSI after breast surgery over 5 years in a single center in Poland. The microorganisms responsible for SSI and their antibiotic susceptibility were determined. Materials/methods: Data of 2129 patients acquired over 5 years postoperatively by the [center] were analyzed. Results: SSI was diagnosed in 132 patients (6.2%) and was an early infection in most cases (65.2%). The incidence of SSI was highest in patients who underwent subcutaneous amputation with simultaneous reconstruction using an artificial prosthesis (14.6%) and breast reconstruction via the TRAM flap method (14.3%). Gram-positive bacteria were responsible for SSI in most cases (72.1%), and these were mainly Staphylococcus strains (53.6%). These strains were 100% susceptible to all beta-lactam antibiotics (except penicillin), but were less susceptible to macrolides and lincosamides. Conclusions: SSI is a serious problem, and attention should be focused on its prevention. Reconstruction using an artificial prosthesis or via the TRAM flap method is connected to increased SSI incidence. Further studies are required to prevent SSI following breast surgery.

The type of implant at the fracture site has effects not only from biological perspective but also from mechanical perspective in fracture healing. Biodegradable implants such as magnesium (Mg) based alloys have shown faster secondary bone healing properties as compared to bioinert implants such as titanium (Ti). The general reasoning behind this is the benefit of Mg from biocompatibility perspectives. We study the effect of Ti and Mg as base materials for implants with their different mechanical properties. The focus of our work is on the displacements at the fracture site of the tibia and their influence on the stimulus for bone healing. We have found that in comparison to Ti, Mg implants have minimal stress shielding problem, only which led to better mechanical stimulus at the fracture site.

The odontogenic cysts can lead to a bone destruction that can hamper the dental implant place-ment in the ideal 3D position. Different biomaterials and techniques that allow bone regeneration are described in the literature, each with its advantages and disadvantages. This clinical case with 18 months of follow-up shows the enucleation of an odontogenic cyst fol-lowing the guide bone regeneration with fence technique. After 6 months 2, dental implants were placed at the region of tooth 11 and 21, being rehabilitated nine weeks after. The fence technique allowed the recovery of the bone morphology and the placement of the dental implants in the 3D ideal position.

Biocompatibility of ceramic materials in CaO-P2O5 system was investigated using different methods, including in vitro and in vivo tests. Ceramics based on calcium pyrophosphate Ca2P2O7 were obtained by annealing cement-salt stone from highly concentrated hardening suspensions (HCHS). Cement-salt stone was prepared using powder mixtures of calcium citrate tetrahydrate Ca3(C6H5O7)2·4H2O and monocalcium phosphate monohydrate (MCPM) Ca(H2PO4)2·H2O. These salts were mixed with each other in such a way that calcium pyrophosphate and calcium polyphosphate were present in the final ceramic product in the following weight ratios: Ca(PO3)2/Ca2P2O7 = 0/100; 5/95; 10/90 and 20/80. Distilled water was added to a homogenized powder mixtures of Ca3(C6H5O7)2·4H2O and Ca(H2PO4)2·H2O by a water/solid ratio of 0,5 by weight. The obtained suspensions were shaped using silicon molds and left to dry in air for a week. The phase composition of the obtained samples of cement-salt stone was represented by brushite CaHPO4·2H2O, monetite CaHPO4, calcium citrate tetrahydrate Ca3(C6H5O7)2·4H2O and monocalcium phosphate monohydrate Ca(H2PO4)2·H2O. According to the XRD data, the phase composition of ceramic materials after annealing in the temperature range of 800-1000 0C was mainly represented by the β-Ca2P2O7 phase. In vivo tests shown that obtained ceramic materials can be recommended for regenerative treatments for bone defects.

Recent progress in microfabrication technique allowed the rapid development of neural implants. They are getting categorized as effective tools for clinical practice, especially to treat traumatic and neurodegenerative disorders. Microelectrode arrays already have been used in numerous neural interface devices. Basically, almost all neural implants have been developed based on BCI (Brain Computer Interface) system. When BCI system falls under invasive technique, it is referred as BMI or Brain Machine Interface. BMIs hold promises for neurorehabilitation of motor and sensory function, cognitive state evaluation and treatment of neurological chaos. A directed overview of the field of neural implants is discussed in this article. The aim of this review is to give a brief introduction of neural prosthetics as well as their exciting applications in treating neurological disorders and a deep discussion on their functionality are mentioned. BCI system and their different types, their functionality, their pros and cons, how other neural implants developed, and their present status have been covered. Different possibilities and possible future of deep brain stimulation (DBS), Neuralink, motor and sensory neural prosthetics are further discussed.

The clinical application of Phentolamine Mesylate (PM) as an anaesthetic reversal agent has been documented in paediatric patients and in conservative dentistry, but no studies have been found in implant surgery. A prospective randomised study was conducted in 60 patients eligible for mandibular implant treatment, randomly divided between the Control Group (CG) and Experimental Group (EG), who were administered PM. Haemodynamic changes, adverse effects and patient satisfaction were assessed. No statistically significant differences in haemodynamic changes and postoperative pain were found between CG and EG (p<0.05), except for Systolic Blood Pressure (SBP) which increased slightly in EG, without posing a risk to the patient. There were no differences in the presence of adverse effects between the two groups, except in the CG which presented greater difficulty in chewing and biting (p<0.05) and the EG with greater pain in the injection area (p=0.043). 83.3% of the EG patients would request PM again for future dental treatment. The use of PM offers an alternative in implant surgery, without increasing the risks and increasing the patient's quality of life.

The effect of the different dental implants positioning region on the stress performance of the implant-supported prosthesis is not yet clear. This study evaluated the dental treatment with six dental implants in three different models and three different occlusal loading conditions, in terms of the biomechanical response of implants, prosthetic screw and maxilla, using three-dimensional finite element analysis. The finite element models were modelled containing external hexagon implants, as well as a Cobalt-Chromium superstructure. Three types of loads were applied: in the area of ​​the central incisors, first premolar and in the second molars. For the finite element simulations, the von-Mises stress peaks in the implant and in the surrounding cortical bone were analyzed. All recorded results reported higher values ​​for the implant-supported prosthesis in group C compared to the groups A and B. The highest stress values, ​​regardless the evaluated model, was in the prosthesis in group C and in screws, the smallest were in group A.

Dental agenesis is one of the most common developmental anomaly in humans and it is frequently as-sociated with several other oral abnormalities. The present case describes nonfamilial agenesis of per-manent teeth in a twenty-one-year-old boy, with no apparent systemic abnormalities. The treatment in-cluded a personalized and interdisciplinary approach by the means of endodontics, orthodontics, im-plants supported restorations and prosthetic treatments. The treatment plan was thoroughly elaborated using photographic analysis, study models, orthopantomogram, CBCT and cephalograms. Virtual smile design, diagnostic waxing, and mock-up previsualized the treatment objectives. The edentulous spaces were reconstructed by inserting dental implants, and monolithic Zirconia implant supported restorations. The final results showed a highly aesthetic and functional rehabilitation. Periodic checkups have shown that the stability of the result is well maintained and that the implant supported restorations are an op-timal solution for patients with multiple anodontia.

Current scientific knowledge and guidelines in bone and soft tissue augmentation, suggest the use of
staged surgical workflows as gold standards in regenerative procedures during implant therapy. In this
context, the process is always the same regardless of the techniques applied: an
alternate series of surgical acts is following one another after the completion of a specific period of
osseointegration or graft maturation. As a result, the overall surgical treatment is often long, invasive and
induce scar tissue formation.
This article proposes a novel, fast and less invasive biphasic protocol with the use of a well documented
cortical barrier mounted on stock healing abutments that are further replaced by customised abutments
on an early second stage. 2 cases are reported, one for an upper maxillary edentulous area and the other
for a mandibular, with a total of 4 implants placed.
Results at 4 months post op, showed an optimal soft tissue configuration for both cases with adequate
cervical profile generation and sufficient supracrestal complex height above the implant platforms.
Significant bone gains were also recorded through CBCT data collection either with alveolar width
measurements on axial slices, superposition of preop and postop datasets and 3D visualization after bone
volume segmentation.
Further studies will be needed in the future to evaluate the efficacy of this protocol in both hard and soft
tissue augmentation for edentulous sites in need of implant rehabilitation.

Advanced manufacturing techniques, aimed at implants with high dependability, flexibility, and low manufacturing costs, are crucial in meeting the growing demand for high-quality products like biomedical implants. Incremental sheet forming is a promising flexible manufacturing approach for rapidly prototyping sheet metal components using low-cost tools. Titanium and its alloys are used to shape most biomedical implants because of its superior mechanical qualities, biocompatibility, low weight, and great structural strength. The poor formability of titanium sheets at room temperature, however, limits their widespread use. The goal of this research is to show that gradual sheet formation of a titanium biomedical implant is possible. The possibility of creative and cost-effective concepts for the manufacturing of such complicated shapes with significant wall angles is explored in this study. A numerical simulation based on finite element modeling as well as a design process tailored to metal forming is used to complete the development. The mean of uniaxial tensile tests with a constant strain rate was used to study the flow behavior of the studied material. To forecast the crack, the obtained flow behavior was modeled using the behavior model and failure model.

The aim of this study was to evaluate implants survival rate, marginal bone loss, surgical and prosthetic complications of implants placed through sinus floor elevation and tilted implants en-gaged in basal bone in order to bypass maxillary sinus. 60 patients were enrolled for this study. According with residual bone height of posterior maxilla the sample was divided in three groups of 20 patients: Group A (lateral sinus floor elevation), Group B (transrectal sinus floor elevation) and Group C (tilted implants employed to bypass sinus floor). Follow-up visits were performed one week after surgery, at 3, 6 months and then once a year for next 4 years. The outcomes were implants survival rate, marginal bone loss and surgical and prosthetic complications. Although the Group A, B and C have demonstrated an implants survival rate of 83.3%, 86,7% and 98,3% respectively, the statistically analysis showed that there was no statistically significant difference between groups. Statistically significant differences between the groups were also not found con-cerning marginal bone loss, as recorded by intra-oral X-ray measurements during follow-up. About complications it wasn’t possible to perform a statistical analysis. To as to reduce potential surgical risks implants placement in basal bone should be preferred.

There are different treatment options in modern dentistry for the replacement of lost dentition. Of these the most upcoming and acceptable treatment option is Dental implants. The common problem usually with immediate implant placement in the anterior region is the post-operative soft tissue contour as a part of the bone modelling during healing. Hurzeler et al in 2010 introduced a new technique called the “socket shield technique”. This technique has been used as an alternative treatment modality for immediate implant placement in the aesthetic zone.This review articles provides a detailed information regarding the clinical concept of Root membrane technique.

Magnesium (Mg)-based biomaterials are promising candidates for bone and tissue regeneration. Alloying and surface modifications provide effective strategies for optimizing and tailoring their degradation kinetics. Nethertheless, biocompatibility analyses of Mg-based materials are challenging due to its special degradation mechanism with continous hydrogen release. In this context, the hydrogen release and the related (micro-) milieu conditions pretend to strictly follow in vitro standards based on ISO 10993-5/-12. Thus, special adaptions for the testing of Mg materials are necessary, which have been described in a previous study from our group. Based on these adaptions, further developments of a test procedure allowing rapid and effective in vitro cytocompatibility analyses of Mg-based materials based on ISO 10993-5/-12 are necessary. The following study introduces a new two-step test scheme for rapid and effective testing of Mg. Specimens with different surface characteristcis were produced by means of plasma electrolytic oxidation (PEO) using silicate-based and phosphate-based electrolytes. The test samples were evaluated for corrosion behavior, cytocompatibility and their mechanical and ostogenic properties. Thereby, two PEO ceramics could be identified for further in vivo evaluations.

Dental implants provide a predictable treatment option for partial and complete edentulism via the placement of fixed permanent artificial root to support prosthetic dental crowns. Despite the high survival rates, long-term implant failures are still reported leading to implant removal and additional financial and health burdens. While extrinsic factors that improve survival rate of implants have been well explored, the impact of genetic factors on this matter is poorly understood. A systematic review and meta-analysis study was conducted to determine whether genetic factors contribute to increase the risk of dental implant failure. A comprehensive search for peer-reviewed articles on dental implants and genetics was performed using various literature database libraries. The study design was conducted according to PRISMA guidelines, and the obtained records were registered in PROSPERO database. According to the exclusion/inclusion criteria, 11 studies were eligible for this study out of 808 articles. The meta-analysis of the combined association studies of DNA variations and dental implants did not indicate an increase risk for implant failure due to DNA variations in IL-1B, IL-10 and TNF-α. This study emphasizes the need for larger randomized controlled clinical trails to inform clinicians and patients about the role of genetic factors on dental implant survival and success rate in healthy and compromised patients.

Background and Objectives: Mechanical and biological complications can lead to system fracture or screw loss on dental implants. Narrow and regular platforms have been used without a consensus about the effect of distance the abutment from the prosthetic platform margin. The aim of this study is to evaluate different insertion torques in the deformation of tri-channel platform connections through two- and three-dimensional measurements with micro-CT. Materials and Methods: 164 implants were divided into groups (platform diameter and type): 3.5, 3.75, and 4.3 mm NP (Narrow Platform), and 4.3 mm RP (Regular Platform). Each implant-platform group was then divided into four subgroups (n = 10) with different torques: T45 (45 Ncm), T80 (80 Ncm), T120 (120 Ncm) and T150 (150 Ncm). The implant-abutment-screw assemblies were scanned and the images obtained were analyzed. Results: A significant difference was observed for the linear and volume measures between the different platforms (p <0.01) and the different implant insertion torques (p <0.01). Qualitative analysis suggested higher deformation resistance for the 3.75 NP compared to the 3.5 NP, and RP was more resistant compared to the NP. Conclusions: The 0.25-mm increment in the implant platform did not increase the resistance to the applied insertion torques; the 4.3-mm implant was significantly stronger compared to the 3.5-mm implant and the proposed micro-CT analysis was considered valid for both 2D and 3D analyses of micro gaps, qualitatively and quantitatively.

The employment of breast silicone implants, both in aesthetic and reconstructive medicine, is widespread thanks to their recognized biocompatibility and durability. Some critical situations, as for example in case of accidental impacts, may however induce concerns by potential patients about their use. Experimental data is collected by means of static compressive and tensile tests. Aging at 37, 60, 75° and 90° Celsius is performed in a physiological saline solution (0,9% NaCl). Impact dynamic tests are carried out using a Hybrid II anthropomorphic test dummy with the prostheses implanted. Mechanical tensile and compressive tests show mechanical degradation of the prostheses characteristics after aging. Impact dynamic tests show a great probability of breast implant rupture at speeds up to 90 km/h. Accidental events like car crashes or bad falls, are con-firmed as possible causes of significant damages to implanted prostheses. In addition, the possi-ble long-term aging of the silicone shell, although of limited relevance in terms of body compati-bility or reaction, can lead to some degradation of mechanical properties, rendering the outcome of accidental events even more worthy of attention.

The purpose of this in vitro study is to evaluate the effectiveness of incorporating a new irrigation system into a surgical guide and monitor its effect on heat generation during implant bed preparation. A total of 48 surgically guided osteotomies were performed on 12 bovine ribs divided into 4 groups, using different irrigation techniques: Group A (test) had entry and exit channels incorporated into the guide; Group B had a similar design with an entry channel only; Group C had conventional external irrigation; Group D (control) had no irrigation. Heat generation during the osteotomies was measured using thermocouples placed at a depth of 2 mm and 6 mm. The lowest mean temperature was observed in Group A (22.1°C at 2mm and 21.4°C at 6mm), this was statistically significant when compared with Groups C and D (p<0.001). Group A showed a lower mean temperature compared with Group B as well, however statistically significant only at 6mm depth (p<0.05). In conclusion, the proposed guide has significantly reduced heat generation during implant osteotomy. The integration of an exit cooling channel can resolve limitations found in previously designed surgical guides and can be easily incorporated into computer designing and 3D printing software.

Both types of surgical guides – with and without metal sleeves are founded beneficial in clinical studies. The aim of this in vitro study was to compare time of surgical procedure in dental implantology depending of used type of the surgical guide. Ten three dimensional (3D) printed models of lower jaws were prepared based on complete virtual model of patient clinical conditions with missing teeth 37, 46 and 47. Five of this models were used for implant sites preparation performed with use of surgical guide without metal sleeves and dedicated surgical kit, and next five were used for the same procedure performed with surgical guide with metal sleeves and dedicated surgical kit. Time of implant site preparation were measured and noted. Statistical analysis was performed using Student’s t test for independent samples. Difference of time in both groups were founded as statistically significant (t=-9.94; df =28; p=0.0000). Type of surgical guide is important factor which can impact on time of implant site preparation and all surgical procedure.

Purpose: to assess any differences on marginal bone loss between bone-level or tissue-level dental implants through a review of literature until September 2019. Materials and methods: MEDLINE, Embase and other database were searched by two independent authors. The search was limited to articles in English. Results: The search provided 1028 records and, after removing the duplicates through titles and abstracts screening, 45 full-text articles were assessed for eligibility. For qualitative analysis 20 articles were included, 17 articles of them for quantitative analysis. A total of 1161 patients (mean age 54,4 years) and 2933 implants were observed, 1427 (Tissue-level) and 1506 (Bone-level). The survival rate and the success rate were more than 90%, except for 2 studies with a success rate of 88% and 86.2%. No studies reported any differences between groups in term of success and survival rates. Three studies showed that BL-implants had statistically less marginal bone loss (P< 0.05). Only one study reported statistically less marginal bone loss in TL-implants (P< 0.05). In the most part of the studies, differences between implant types in marginal bone loss were not statistically significant. Conclusion: Despite to the peri-implant tissue around transmucosal implants has been reported to be inflammation-free because of the absence of bacterial infiltration in the micro-gap between the fixture and abutment, no clinical and radiological differences were highlighted between groups from the included studies after a variable period of follow-up ranged between 1 to 5 years.

The present review compared the efficacy of soft tissue substitutes (STS) and autogenous free gingival graft (FGG) or connective tissue graft (CTG) in mucogingival procedures to increase keratinized tissue (KT) width around teeth and implants. Two independent examiners performed the electronic search on Medline and Cochrane Library based on the following PICO’s format: (P) adult patients; (I) soft tissue substitutes and FGG/CTG; (C) STS vs CTG; STS vs FGG; STS vs CTR; (O) KT width gain; (S) Systematic Reviews, Randomized Controlled Trials. Results showed that around teeth, all biomaterials showed superior performance compared to CAF alone for treating gingival recessions. However, when compared to CTG, ADM yields the most similar outcomes to the gold standard (CTG), even though in multiple recessions CTG still continue to be considered the most favorable approach. Use of STSs (acellular matrix or tissue engineered) in combination with an apically positioned flap resulted in a significantly less gain of KTW compared to what achieved with FGG and APF. Around dental implants, free gingival grafts were deemed more effective than soft tissue substitutes in enhancing keratinized mucosa width.

Polyhydroxyalkanotes (PHA) are bio-based microbial biopolyesters with stiffness, elasticity, crystallinity and degradability tunable by the monomeric composition, bio-production strategy and post-synthetic processing; they display biological alternatives for diverse technomers of petrochemical origin. This, together with the fact that their monomeric and oligomeric in vivo degradation products do not exert any toxic or elsewhere negative effect to living cells or tissue of humans or animals, makes them highly stimulating for various applications in the medical field. The article provides an overview of PHA application in the therapeutic, surgical and tissue engineering area, and reviews strategies to produce PHA at purity levels high enough to be used in vivo. Tested applications of differently composed PHA and advanced follow-up products as carrier materials for controlled in vivo release of anti-cancer drugs or antibiotics, as scaffolds for tissue engineering, as guidance conduits for nerve repair or as enhanced sutures, implants or meshes are discussed from both a biotechnological and a material-scientific perspective. Particular attention is devoted to the adaptation of traditional polymer processing techniques for production of medicine-related devices based on PHA, such as melt-spinning, melt extrusion, or solvent evaporation, and to emerging processing techniques like 3D-printing, computer-aided wet-spinning, laser perforation, or electrospinning.

Background: One challenge in implant dentistry is to reduce marginal bone resorption to avoid long-term esthetic and biological complications. Sub-gingival implant placement has been suggested as a suitable strategy. Methods: 38 healthy patients were enrolled to receive bone level (BL – Control group) or 2 mm sub-crestal (SC - Test group) conical connection, platform-switched implants. An immediate tissue level abutment was used in the Test group by following a One Time Abutment (OTA) restorative procedure. Marginal Bone Modification (MBM) was calcu-latied on standardized radiographs at surgery (T0), loading (T1), and 6 months (T2) and 12 months after loading (T3), and cathegorised in Bone Loss (BL) if the resorption occurred below the implant neck and Bone Remodeling (BR) if above. Pocket probing depth (PPD), Bleeding on probing (BoP) and Plaque Index (PI) were also collected. Results: The mean MBM in the test group after 12 months was 0.61mm, compared to 0.52mm in the control group. However, no BL was observed in the test group, as the MBM completely occurred above the implant neck as BR, whilst in the control group MBM corresponded in total to BL. The average PPD was 2.38mm in the test group and 3.04mm in the control group after 12 months, BoP 50% and 43%, PI 33% and 19.44% respectively. Conclusions: Sub-crestal conical connection, platform-switched implants could be a suitable clinical choice to avoid BL with exposure of the treated implants surfaces.

The majority of contemporary total hip arthroplasty (THA) implants are constructed from Ti-alloys, which are generally believed to generate fewer adverse local tissue reactions (ALTR) compared to CoCr-alloys. This study presents a case of unusual primary THA failure where a substantial release of Ti-alloy debris was observed. A 52-year-old active male underwent THA after posttraumatic aseptic necrosis of the femoral head in 2006. Seventeen years after the procedure, the patient presented with groin pain and restricted range of motion. X-rays revealed protrusion of the alumina ceramic head through the Ti6Al4V acetabular cup. Trace element analysis indicated significantly elevated levels of serum Ti, Al and V. CT and MRI confirmed Ti-alloy cup failure and severe ALTR. During revision surgery, the worn-out ceramic head was in direct contact with the acetabular cup, having protruded through the central hole it created over time. Histological analysis of tissue samples showed wear-induced synovitis with areas of multinucleated foreign-body giant cells and accumulation of numerous metal particles but no acute inflammatory response. Six months after the revision THA, the patient has experienced favourable outcomes. This case provides an instructive illustration for studying the consequences of substantial release of Ti-alloy debris from orthopaedic implants.

Hypertension (HTN) is the foremost contributor to cardiovascular diseases (CVD), which remain a leading cause of death. However, adherence to the properly prescribed dosage form is critical and challenging for patients with chronic diseases such as HTN to prevent illness progression and death. The study’s objective was to develop AMB-loaded subcutaneous implants to reduce the frequency of administration, thus improving patient compliance during HTN management. AMB subcutaneous implants were prepared using continuous hot melt extrusion technology using PCL and PLGA with dimensions of 7.5 cm (length) by 2 mm (diameter). The implants were characterized for thermal characteristics, drug-excipient incompatibilities, surface morphology, fracturability, in vitro release, and stability studies. DSC showed that the drug was in the crystalline state in the fabricated implants. Scanning Electron Microscopy (SEM) revealed a smooth surface. The lead formulation presented good drug content, showed an extended drug release profile over 30 days, and followed zero-order release kinetics with a mean dissolution time of 15 days. The formulation was stable over 30 days in accelerated stability conditions (the last time point was tested, 40℃/75% RH), and the release profile was similar to the initial drug release profile. The lead formulation showed good fracturability during textural analysis. Therefore, the hot melt extruded implants could be an alternative management strategy for conventional amlodipine besylate (AMB) formulation.

Purpose: The objective of the study was to qualitatively assess micro-gap dimensions, connecting fitting surface profile and bacterial leakage of machined and cast high gold alloy UCLA abutments, with or without electrodeposited gold coatings attached to external hexagon implants. Materials and methods: 16 plastic UCLA (PUCLA) and 5 machined cast-to UCLA (GUCLA) abutments were cast with a high gold content alloy. 10 were electrolytically gold plated (8 - PUCLA, 2 - GUCLA). All abutments were attached to implants giving 21 implant-abutment combinations (IACs). External perimeter micro-gaps measured with SEM under different illumination and magnification conditions were averaged over three regions. The IACs were examined for E.coli leakage following an initial sterility test. Disassembled combinations were examined with SEM and surface profiles qualitatively assessed. Results: External micro-gap measurements did not reflect the variable connecting surface profiles but average values < 3.5 μm were observed for all IACs. Bacterial transfer was observed in 3 of 5 PUCLA plated and 2 of 5 PUCLA non-plated IACs. No transfer occurred in the 3 GUCLA non-plated or 2 GUCLA plated IACs. Abutment connecting surfaces, both Au plated and not Au plated, showed plastic deformation (smearing) in variable mosaic patterns across the micro-gap. External micro-gap dimensions although not truly reflective of surface connecting profiles averaged < 3.5 μm measured under shadow eliminating silhouette illumination for both cast and pre-machined external hexagon abutments with and without Au plating. Conclusions: Micro-gap dimensions < 5 μm were obtained with both high noble metal cast and pre-machined external hexagon abutments with and without Au electrodeposited on the abutment connecting surface. Regions of intimate contact due to plastic deformation (smearing) of these surfaces was observed. A continuous smeared region around the circumference of the surfaces can provide an effective barrier to egress of E.coli bacteria from the internal regions of the implant under static loading.

In recent years, antibacterial coatings have become a significant approach in the global fight against bacterial pathogens. Developments in materials science, chemistry and biochemistry have led to a plethora of materials and chemical compounds that have potential for creating antibacterial coatings. Nonetheless, there has been insufficient consideration given to the analysis of the techniques and technologies used to apply these coatings. Among the various inorganic coating techniques, Atomic Layer Deposition (ALD) is noteworthy. It enables the successful synthesis of high-purity inorganic nanocoatings on surfaces of complex shape and topography, while also providing precise control over their thickness and composition. ALD has various industrial applications, but its practical application in medicine is still limited. In recent years, a substantial number of papers have been published on the suggested implementation of thin films and coatings produced through ALD in medicine, notably those with antibacterial properties. The aim of this paper is to carefully evaluate and analyse the relevant literature on this subject. Simple oxide coatings, including TiO2, ZnO, Fe2O3, MgO, and ZrO2, were examined, as well as coatings containing metal nanoparticles such as Ag, Cu, Pt, and Au, and mixed systems such as TiO2-ZnO, TiO2-ZrO2, ZnO-Al2O3, TiO2-Ag, and ZnO-Ag. Through comparative analysis, we have been able to draw conclusions on the effectiveness of various antibacterial coatings of different compositions, including key characteristics such as thickness, morphology, and crystal structure. ALD has been analysed in its use for developing antibacterial coatings for various applications. Furthermore, assumptions regarding the most promising development areas have been presented.

Introduction Despite efforts to use scaffolds to treat meniscus tears, minimal progress has been made in facilitating meniscus regeneration and return of function. Our research objective was to develop a meniscus repair and regeneration implant by applying a resorbable scaffold in combination with cells and growth factors. We report here the results of using platelet-rich plasma (PRP) as a source of growth factors to induce fibrochondrogenic differentiation of human adipose-derived mesenchymal stem cells (hADSC) in a three-dimensional (3D) Type I collagen-based scaffold in vitro. Methods Scaffold Preparation. Type I collagen scaffolds were prepared following a protocol previously published. Two different densities of scaffolds, high density (HD) and low density (LD), were produced for in vitro study. hADSC and PRP Preparation. hADSCs were cultured to the fifth passage to reach the desired number for experimentation. PRP was collected from human blood and activated. Cell Culture Procedure. Effects of PRP on hADSC proliferation and differentiation into fibrochondrogenic cells were examined in four scaffold groups: LD, HD, LD+PRP and HD+PRP. hADSCs were seeded onto scaffolds (n=5) at a concentration of 2 × 106 cells/scaffold. 1% of PRP was added to the experimental media. Cellular proliferation was assessed at 1, 7, 14, and 21 days. Differentiation was measured using qRT-PCR on Days 14 and 21. qRT-PCR analysis of gene expression was completed with primers for COLLAGEN 1 and AGGRECAN. Data Analysis. ANOVAs were conducted (two-tailed tests) at the .05 significance level. Results Cellular proliferation of hADSCs seeded on each scaffold increased over time. Similar trend was observed for cells seeded on HD scaffolds with and without PRP. hADSC showed significant increase in cellular proliferation on the LD scaffolds at Days 1 and 7. At Day 21, PRP treatment and LD scaffold had a synergistic positive effect on Type I collagen gene expression. PRP did not elevate type I collagen gene in the HD group, the HD scaffold alone had the same level of type I collagen gene expression as LD+PRP. Aggrecan expression was elevated in the presence of PRP in both the HD and LD scaffold groups, indicating enhanced fibrochondrogenic differentiation of hADSCs. Effective cell infiltration was observed across both HD and LD scaffolds with and without PRP treatment. HD scaffolds displayed larger cell clusters and more extensive cell migration over time compared to LD scaffolds. However, LD scaffolds resulted a more uniform cellular distribution than HD scaffolds. Conclusion Our study demonstrates that PRP can play an important role in directing hADSCs towards fibrochondrogenic differentiation in Type I collagen-based scaffolds in vitro. Additionally, our study shows that collagen scaffold density can influence the spatial distribution and cellular behavior of infiltrated cells.

The advent of zirconia ceramics with excellent mechanical, biomechanical and optical properties has made it an attractive metal-free substitute for titanium implants. Both animal and human studies have documented shortcomings with titanium implants. A review of the current literature on 3 iterations of zirconia implant designs has been challenging due to heterogeneous success data and limited follow-up. Zirconia implants hold promise for a new generation of dental implants, but technical developments are needed for design and material enhancements that will need to be validated by long-term rigorous studies.

Maxillofacial defects, arising from trauma, oncological disease or congenital differences, detrimentally affect everyday life. Prosthetic repair offers the aesthetic and functional reconstruction with the help of materials mimicking natural tissues, among which polymers take unprecedented role. The three-dimensional (3D) printing techniques based on the computer-aided design, where polymers are essential, provide a rapid and cost-effective workflow protocol to perfectly restore patient-specific anatomy for prosthetics. This review discusses the main 3D printing approaches to maxillofacial prostheses fabrication: extrusion and lithography, which are radically preferable to the traditional methods. The main assessment criteria, affording the polymer implementation in 3D printing of prostheses, as well as the characteristics of the key advanced polymers, are considered. The success of the prosthesis is shown to be largely dependent on the retention system, predominantly using polymers in the form of adhesives and osseointegrated implants as a support for the prosthesis. The approaches and technological prospects are also discussed in the context of specific aesthetic restoration on the example of the nasal, auricle and ocular prostheses. 3D printing techniques determine the development of personalized approaches to improve aesthetic and functional effect of prosthetics in patients with maxillofacial defects.

The method of micro-arc oxidation has been utilized to synthesize a protective biocompatible coating for a bioresorbable orthopedic Mg implant. This paper presents the results of a comprehensive research of micro-arc coatings based on diatomite – a biogenic material consisting of shells of diatom microalgae. The main focus of this study was the functionalization of diatomite-based micro-arc coatings by incorporating the particles of titania (TiO2) into them. Various properties of the resulting coatings were examined and evaluated. The XRD analysis has revealed the formation of a new magnesium orthosilicate phase – forsterite (Mg2SiO4). It has been established that the corrosion current density of the coatings has decreased by 2-4 orders of magnitude after the inclusion of TiO2 particles, depending on the coating process voltage. The adhesion strength of the coatings has increased following the particle incorporation. The processes of dissolution of both coated and uncoated samples in a sodium chloride solution were studied. The in vitro cell viability was assessed, which showed that the coatings significantly reduce the cytotoxicity of Mg samples.

Introduction: Heat is a kinetic process whereby energy flows from between two systems; hot-to-cold objects. In oro-dental implantology, conductive heat transfer/(or thermal stress) is a complex physical phenomenon to analyze and consider in treatment planning. Hence, ample research has attempted to measure heat-production to avoid over-heating during bone-cutting and -drilling for titanium (Ti) implant-site preparation and insertion, thereby preventing/minimizing early (as well as delayed) implant-related complications and failure. Objective: Given the low bone-thermal conductivity whereby heat generated by osteotomies is not effectively dissipated and tends to remain within the surrounding tissue (peri-implant), increasing the possibility of thermal-injury; this work attempts to obtain an exact analytical solution of the heat equation under exponential thermal-stress, modeling transient heat transfer and temperature changes in Ti implants upon hot-liquid intake. Materials and Methods: We investigate the impact of the material, the location point along implant length, and the exposure time of the thermal load on temperature changes. Results: Despite its simplicity, the presented solution contains all the physics and reproduces the key features obtained in previous numerical analyses studies. To the best of knowledge, this is the first introduction of the intrinsic time, a “proper” time that characterizes the geometry of the dental implant, where we show, mathematically and graphically, how the interplay between “proper” time and exposure time influences temperature changes in Ti implants, under the suitable initial and boundary conditions. Conclusions: This work aspires to accurately complement the overall clinical diagnostic and treatment plan for enhanced bone-implant interface, implant stability and success rates, whether for immediate or delayed loading strategies.

The osseointegration process in and around additively manufactured (AM) lattice structures of a new titanium alloy, Ti–19Nb–14Zr, was evaluated. Three different implants, including lattices with increasing high sidewalls gradually closing them, were designed, manufactured and implanted in the tibia and metatarsal bone of two sheep for twelve weeks. After removal, they were characterized with X-ray computed tomography (XCT). The 3D XCT images were segmented using machine learning. The bone-interface implant (BII) and bone-implant contact (BIC) were studied. The results show that, since AM naturally leads to high roughness surface finish, the wettability of the implant is increased. The new alloy possesses an increased affinity to the bone enhancing the quality of osseointegration. The lattice provides crevices, in which the biological tissue can jump in and cling. The combination of these factors is pushing ossification beyond its natural limits. Therefore, the quality and speed of the ossification and osseointegration in and around these Ti–19Nb–14Zr AM laterally closed lattice implants open the possibility of bone spline key of prostheses. This enables the stabilization of the implant into the bone while keeping the possibility of punctual hooks allowing the implant to be removed more easily if required.

Bioactive surface coatings have retained the attention of researchers and physicians due to their versatility and range of applications in orthopedics, particularly in infection prevention. Antibacterial metal nanoparticles (mNPs) are a promising therapeutic, with vast application opportunities on orthopedic implants. The current research aimed to construct a polyelectrolyte multilayer on a highly porous titanium implant using alternating thin film coatings of chitosan and alginate via the layer-by-layer (LbL) self-assembly technique, along with the incorporation of silver nanoparticles (AgNPs) or titanium dioxide nanoparticles (TiO2NPs), for antibacterial and osteoconductive activity. These mNPs were characterized for their physicochemical properties using quartz crystal microgravimetry with dissipation system, nanoparticle tracking analysis, scanning electron microscopy, and atomic force microscopy. Their cytotoxicity and osteogenic differentiation capabilities were assessed by AlamarBlue and alkaline phosphatase (ALP) activity assays, respectively. The antibiofilm efficacy of the mNPs tested against Staphylococcus aureus. The LbL polyelectrolyte coating was successfully applied to the porous titanium substrate. A dose-dependent relationship between nanoparticle concentration and ALP as well as antibacterial effects was observed. TiO2NP samples were also less cytotoxic than AgNP counterparts, although similarly antimicrobial. Together, these data serve as a proof-of-concept for a novel coating approach for orthopedic implants with antimicrobial and osteoconductive properties.

Load transfer through orthopaedic joint implants is poorly understood. The longer-term outcomes of these implants are just starting to be studied, making it imperative to monitor contact loads across the entire joint implant interface to elucidate the force transmission and distribution mechanisms exhibited by these implants in service. This study proposes and demonstrates the design, implementation, and characterization of a 3D-printed smart polymer sensor array using conductive polyaniline (PANI) structures embedded within a polymeric parent phase. The piezoresistive characteristics of PANI were studied to characterize the sensing behaviours inherent to these embedded pressure sensor arrays. PANI's stable response to a continuous load, its stability throughout loading and unloading cycles, and its repeatable and linear response to incremental loading cycles together with the accuracy of these measurements were investigated. It is demonstrated that this specially developed multi-material additive manufacturing process for polyaniline is an attractive approach for the fabrication of implant components having embedded smart-polymer sensors for the measurement and analysis of joint loads in orthopaedic implants.

The objective of this study was to evaluate the pain and inflammatory response in soft tissues using healing and prosthetic abutments of different diameters and lengths. Methods: The study population was rehabilitated with Astra tech EV single implants (Dentsply Sirona, Atlantis, Dentsply Sirona S.A., Barcelona, Spain), 4.2 and 4.8 millimetres in diameter in upper and lower maxilla and loaded with custom abutments digitally designed with the software of the company Dentsply Sirona (Atlantis WebOrder, Dentsply Sirona S.A., Barcelona, Spain), version 4.6.5, with a larger diameter than the healing abutment, to account for biomarkers through ELISA. Results: Rehabilitations in mandible and with healing abutments below 4.29 millimetres and rehabilitators below 2.18 millimetres elicited higher pain and inflammatory responses, and in turn higher interleukin 1β values. Conclusions: Greater inflammation was evident in cases in which healing abutments with reduced diameter were used in relation to the same subsequent rehabilitation with prosthetic abutments of larger diameter.

Long-acting (LA) drug-delivery system (DDS) successes are linked to their abilities to harness biocompatible polymers and materials for sustained and predictable release of therapeutic agents over an extended period of time. For human immune deficiency virus type one (HIV-1) infections, LA DDSs hold great promise in closing the gaps of daily oral therapy for treatment and prevention. Examples are Cabenuva, Apretude and Sunlenca, which have been shown to be safe and effective. Alternative promising drug delivery technologies such as implants, prodrugs, vaginal rings, and microarray patches are being explored to further meet patients’ needs. We posit that improved physicochemical properties of the formulation payloads and material chemistry design with optimal drug release kinetics holds the potential to optimize release profiles. Furthermore, for the treatment and prevention of HIV-1 infection, the landscape of LA medicines now in clinical or preclinical development offers hope that the strategic design of polymers will further improve upon controlled delivery of drugs to simplify dosing schedules.

The study focuses on a novel porous TiNi-based material for ophthalmic orbital implants which was produced by self-propagating high-temperature synthesis (SHS) and, after proper surface modification, possesses a specific microstructure of its surface pores, which makes it attractive for biomedical use in implants. After preparation via SHS, the obtained porous TiNi material was etched in acidic environment, to get rid of its surface Ti2Ni secondary-phase particles. This was found to improve the material’s surface morphology, adding micro-roughness to its macro-rough pores. As a result, cell growth tests conducted on the material demonstrated improved cell adhesion and growth kinetics on such a porous material with improved roughness. Finally, the material was tested in vivo as an ophthalmic orbital implant, demonstrating good biocompatibility, good degree of biointegration with surrounding eyeball tissues, and no signs of rejection after as long as 180 days. Thus, the novel porous TiNi-based material shows promise for its use in ophthalmic implantology, for instanse for manufacturing musculoskeletal stumps of the eyeball after evisceration, as it is biocompatible, has a high tissue-implant integration potential and demonstrates reduced risks of exposure and rejection of the implant.

This work deals with a novel porous TiNi-based material for ophthalmic orbital implants that was produced by high-temperature synthesis (SHS) and possesses a specific microstructure of its surface pores, which makes it attractive for biomedical use in implants. After preparation via SHS, the obtained porous TiNi material was etched in acidic environment, to get rid of its surface Ti2Ni secondary-phase particles. This was found to improve the material’s surface morphology, adding micro-roughness to its macro-rough pores. As a result, cell growth tests conducted on the material demonstrated improved cell adhesion and growth kinetics on such a porous material with improved roughness. Finally, the material was tested in vivo as an ophthalmic orbital implant, demonstrating good biocompatibility, good degree of biointegration with surrounding eyeball tissues, and no signs of rejection after as long as 180 days. Thus, the novel porous TiNi-based material shows promise for its use in ophthalmic implantology, for instanse for manufacturing musculoskeletal stumps of the eyeball after evisceration, as it is biocompatible, has a high tissue-implant integration potential and demonstrates reduced risks of exposure and rejection of the implant.

Single-sided deafness (SSD) refers to a condition where there is severe to profound Sensorineural hearing loss in one ear, while the other ear has normal or near-normal hearing. SSD can significantly impact an individual's ability to localize sounds, understand speech in noisy environments, and maintain spatial awareness, often resulting in a reduced quality of life and increased social isolation. In children with unilateral deafness, it can impede spoken language development and potentially impact cognitive abilities. Historically, there was a misconception that the unaffected ear could adequately support speech development in early cases and provide acceptable hearing function in adults. Consequently, SSD was frequently undertreated. However, advances in technology and a deeper understanding of the psychological and developmental impact of SSD have led to a shift in management strategies. Various treatment options are available for addressing SSD, but ongoing debate surrounds the most effective approach. These options include cochlear implants (CI), contra-lateral-routing-of-signal (CROS) devices, and bone conduction devices (BCDs). The aim of this study is to review the scientific evidence on different treatment options for SSD and compare their impact on the quality of life of individuals with this condition.

Existing implants used with Total Knee Arthroplasty (TKA), Total Hip Arthroplasty (THA), and other joint reconstruction treatments, have displayed premature failures and frequent needs for revision surgery in recent years, particularly with young active patients who represent more than 55% of all joint reconstruction patients. Bone cement and stress shielding have been identified as the major reasons for premature joint failures. A breakdown of the cement may happen, and revision surgery may be needed because of the aseptic loosening. The significant mismatch of stiffness properties of patient trabecular bones and metallic implant materials in joint reconstruction surgery results in the stress shielding phenomenon. This could lead to significant bone resorption and increased risk of bone fracture and the aseptic loosening of implants. The present project introduces an approach for development of customized cellular structures to match the mechanical properties and architecture of human trabecular bone. It consists of four modules:1- characterization of geometry, microarchitecture, and stiffness properties of patient’s bones; 2- developing customized lattice structures tailored to mimic properties established in module 1; 3 - integration of developed lattice structure into full scale implant design and manufacturing; 4- implementation of the developed technology for use in implants that would overcome most of the issues related to aseptic loosening phenomenon. The present work aims at fulfilling the objectives of module 2 by exploring new designs of customized lattice structures and texture tailored to mimic closely patients’ bone anisotropic properties and that can incorporate an engineered biological press-fit fixation technique. The effects of various lattice design variables on mechanical performance of the structure are examined through systematic experimental plan using statistical design of experiments technique and analysis of variance method. All tested lattice designs were explored under realistic geometrical, biological, and manufacturing constraints. Of the four design factors examined in this study, strut thickness was found to have the highest percent contribution (41%) regarding the structure stiffness, followed by unit cell type, and cell size. Srut shape was found to have the lowest effect with only 11% contribution. The introduced solution offers lattice structure designs that can be adjusted to match bone stiffness distribution and promote bone ingrowth and hence eliminating the phenomenon of stress shielding while incorporating biological press-fit fixation technique.

Peri-implant bone resorption has been reported around some implants after loading and this could create problems for the long-term stability of peri-implant soft and hard tissues. The causes are still not completely known, but a relevant importance could be assumed by the presence of a bacterial contamination at the micro-gap level of the implant-abutment junction. In this regard, external and internal implant-abutment assemblies have been shown to be much more permeable to bacterial colonization than Cone-Morse or conical connections. A subcrestal implant placement could have aesthetic advantages allowing a better prosthetic emergence profile. In literature controversial experimental and clinical results have been reported about bone resorption around implants placed equicrestally and subcrestally. Interestingly, Finite Element Analysis (FEA) studies revealed to be extremely useful for assessing the peri-implant bone strain and stress. Thus, the aim of this study was a FEA evaluation of implants with a Cone-Morse implant-abutment assembly (Implacil De Bortoli, São Paulo, Brazil) inserted into a bone block model (width: 10 mm, vertical height: 17.5 mm, thickness of the cortical area: 1.5 mm) mimicking equicrestal and subcrestal placements (1 and 2 mm). The results demonstrated that maximum stresses were observed within the cortical bone around the equicrestally placed implants, the lowest in the implant placed 2-mm subcrestally and intermediate stresses within the implant placed 1-mm subcrestally. Cortical bone was more stressed under lateral loads than axial loads. In conclusion, this FEA study suggested that implant placement at -1 mm could be recommended.

The etiology of exaggerated fibrous capsule formation around silicone mammary implants (SMI) is multifactorial but primarily induced by immune mechanisms toward the foreign material silicone. The aim of this work was to enlighten the disease progression from implant insertion and immediate tissue damage response reflected in (a) the acute wound proteome, and (b) the adsorption of chronic inflammatory wound proteins at implant surfaces. An intra-individual absolute quantitation TMT-liquid chromatography-tandem mass spectrometry approach was applied to profile wound proteome formed around SMI the first five days post-implantation. Compared to plasma, the acute wound profile resembled a more complex composition comprising plasma-derived and locally differentially expressed proteins (DEPs). DEPs were subjected to functional enrichment analysis, which revealed the dysregulation of signaling pathways mainly involved in immediate inflammation response and ECM turnover. Moreover, we found time-course variations in protein enrichment immediately post-implantation and adsorbed to SMI surfaces after 6-8 months. Characterization of the expander-adhesive proteome by label-free approach uncovered a long-term adsorbed acute wound and the fibrosis-associated proteome. Our findings propose a wound biomarker panel for the early detection and diagnosis of excessive fibrosis that could potentially broaden insights into the characteristics of fibrotic implant encapsulation.

The most common long-term complication of silicone breast implants (SMI) remains capsular fibrosis. The etiology of this exaggerated implant encapsulation is multifactorial but primarily induced by the host response towards the foreign material silicone. Identified risk factors included specific implant topographies. Of note, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), has only been observed in response to textured surface implants. We hypothesize that reduction of SMI surface roughness causes less host response hence better cosmetic outcome with fewer complications for the patient. A total of 7 patients received the routinely used CPX®4 breast expander (~60 µM Ra) and the novel SmoothSilk® (~ 4 µM Ra), fixed prepectoral with a titanised mesh pocket and randomized to the left or right breast after bilateral prophylactic NSME (nipple-sparing mastectomy). We aimed to compare the postoperative outcome regarding capsule thickness, seroma formation, rippling, implant dislocation as well as comfortability and practicability. Our analysis shows that surface roughness is an influential parameter in controlling fibrotic implant encapsulation. First time intra-individually compared in patients, our data confirm an improved biocompatibility with minor capsule formation around SmoothSilk® implants with an average shell roughness of 4 µM and in addition an amplification of host response by titanised implant pockets.