Background: The target volume for post-mastectomy radiation therapy (PMRT) in breast cancer patients with reconstruction has been a subject of debate. This study aimed to assess the radiation dose distribution and treatment outcomes associated with different chest wall (CW) delineation according to ESTRO ACROP guideline for patients underwent implant-based reconstruction. Methods: We conducted a retrospective review of breast cancer patients who underwent mastectomy followed by two-stage implant-based breast reconstruction and adjuvant radiation therapy (RT) between 2007 and 2022. The expanders/implants were positioned retropectorally. The chest wall target volumes were categorized into two groups: the prepectoral group, which excluded the deep lymphatic plexus, and the whole expander group. Results: The study included 26 patients, 15 in prepectoral group and 11 in whole expander group. No significant differences were observed in normal organs exposure between the two groups. There was a trend toward a lower ipsilateral lung mean dose in the prepectoral group (10.2 vs. 11.1 Gy, p=0.06). Both groups exhibited limited instances of reconstruction failure and local recurrence. Conclusions: For patients undergoing two-stage expander-implant retropectoral breast reconstruction and PMRT, our data have provided comparable outcomes and normal organs exposure for those omitting the deep lymphatic plexus.

Breast cancer in patients with prior breast augmentation poses unique challenges for detection, diagnosis, and management. Mastectomy rates are increasing, and patients with prior augmen-tation often have a lower body mass index, making autologous techniques unsuitable. This study aims to assess the best reconstructive option in patients with a history of subglandular or dual plane breast augmentation. Materials and methods: a prospective analysis was conducted on pa-tients who underwent breast reconstruction after mastectomy. Patients with subglandular or dual plane breast augmentation were included. Patients were divided into submuscular breast recon-struction (group 2) or prepectoral breast reconstruction (group 1) groups. Demographic and sur-gical data were collected. Results: A total of 47 patients were included, with 23 in Group 1 and 24 in the Group 2. Complications occurred in 11 patients (23.4%), with significant differences be-tween groups. The most common complication was seroma formation. Implant loss occurred in 4.3% of cases in the Group 1, while no implant loss was observed in the Group 2. Patient-reported satisfaction scores were similar between groups at 12 months postoperatively. Conclusions: sub-pectoral breast reconstruction with a tissue expander seems a safer and effective technique for pa-tients with prior breast augmentation. It resulted in fewer complications. This approach should be considered as an option for breast reconstruction after mastectomy in this cohort of patients.

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.

INTRODUCTION: Breast sensibility following reconstruction surgery, though often overlooked, holds significant importance due to its widespread occurrence and profound effects on patients’ well-being and safety. Our objective is to compare the sensory outcomes between DIEP flap microsurgery reconstruction and implant-based reconstruction. Additionally, we explored the potential influence of sociodemographic and clinical factors on sensory recovery, along with assessing temperature discrimination abilities and evaluating quality of life. MATERIAL AND METHODS: We conducted an ambispective descriptive-analytical study, involving women who underwent mastectomy with reconstruction using either DIEP flap and implants at our hospital between 1990 and 2021. Data were collected from medical records, patient histories, physical examination, and validated quality of life questionnaires (BREAST-Q). RESULTS: A total of 99 women with breast reconstruction were included, 47 with DIEP flap and 52 with implants. Sensory recovery in implant-based reconstruction was found to be superior to DIEP flap reconstruction (5.03 and 5.18 respectively, p-value <0.005). A direct correlation was observed between sensory improvement and thermal discrimination (Spearman coefficient 0.9, p-value <0.001). Factors such as radiotherapy, delayed reconstruction with DIEP flap, and height with implants were associated with poorer sensory recovery in the breast. Women experiencing better breast sensibility reported higher satisfaction with their surgeon, medical team, and psychosocial quality of life. CONCLUSION: Women reconstructed with implants or DIEP abdominal flap exhibit suboptimal overall sensory recovery of the reconstructed breast, with slightly better outcomes observed in women reconstructed with implants.

(1) Importance of problem: Breast cancer accounted for 685.000 deaths globally in 2020, and half of all cases occur in women with no specific risk factor beside gender and age-group. During last 4 decades we see a reduction by 40% of age-standardized breast cancer [1], which in turn means that the number of mastectomies performed for younger women increased, raising the need for adequate breast reconstructive surgery. Advances in oncological treatment have made it possible to limit the extent of what represents radical surgery for breast cancer, yet in the past decade, we see a marked trend toward mastectomy in breast conserving surgery eligible patients [2]. Prophylactic mastectomy has also registered an upward trend [3,4]. This trend together with new indication for breast reconstruction like chest feminization in transgender patients [5] have increased the need for breast reconstruction surgery. (2) Purpose: The purpose of this study is to analyze the types of reconstructive procedures, their indications, their limitations, their functional results and the safety profiles when used during the integrated treatment plan of the oncologic patient; (3) Methods: We conducted an extensive literature review of the main reconstructive techniques, especially the autologous procedures, summarized the findings and presented a few cases from our own experience for exemplification of the usage of breast reconstruction in oncologic patients. (4) Conclusions: Breast reconstruction has become a necessary step in the treatment of most breast cancers and many reconstructive techniques are now routinely practiced. Microsurgical techniques are considered the "gold standard", but they are not accessible to all services, from a technical or financial point of view, so pediculated flaps remain the safe and reliable option, along with alloplastic procedures, to improve the quality of life of these patients.

Background: This study aimed to investigate the impact of the COVID-19 pandemic on breast reconstruction trends in the United States, focusing on implant-based and autologous techniques, as well as the timing of reconstruction (immediate vs. delayed). Methods: A retrospective analysis of data from the American Society of Plastic Surgeons' National Plastic Surgery Statistics from 2015 to 2022 was conducted. Annual trends in breast reconstruction procedures were analyzed, comparing the pre-pandemic (2015-2019) and pandemic (2020-2022) periods. Results: The total number of breast reconstructions increased from 106,338 in 2015 to 151,641 in 2022. The proportion of implant-based reconstructions decreased from 81.41% pre-pandemic to 76.51% during the pandemic (p < 0.001), with a notable rise in direct-to-implant procedures from 10.37% to 19.12% (p < 0.001). Autologous reconstructions increased from 18.59% to 23.49% (p < 0.001). Among autologous techniques, DIEP flaps remained the most popular. Immediate reconstruction rates increased from 72.61% pre-pandemic to 75.57% during the pandemic, while delayed recon-struction rates decreased from 27.39% to 24.43% (p < 0.001). Conclusions: The COVID-19 pandemic has significantly influenced breast reconstruction trends in the United States, with a shift towards autologous techniques, particularly DIEP flaps, and an in-crease in immediate reconstructions. These changes may reflect adaptations in surgical practice and decision-making processes in response to the unique challenges posed by the pandemic. Further research is needed to assess the long-term outcomes and patient satisfaction associated with these trends.

The incidence of breast cancer and therefore need for breast reconstruction is expected to increase. The many reconstructive options available and the changing aspects of the field make this a complex area of plastic surgery, requiring knowledge and expertise. Two major types of breast reconstruction can be distinguished: Breast Implants and Autologous Flaps. Both present advantages and disadvantages. Autologous fat grafting is also commonly used. MRI is the modality of choice for evaluating breast reconstruction. Knowledge of the type of reconstruction is preferable to provide the maximum of pertinent information and avoid false positives. Early complications include seroma, hematoma, and infection. Late complications depend on the type of reconstruction. Implant rupture and implant capsular contracture are frequently encountered. Depending on the implant type, specific MRI signs can be depicted. In case of myocutaneous flap, fat necrosis, fibrosis and vascular compromise represent the most common complications. Late cancer recurrence is much less common. Rare reported late complications include breast implant associated large cell anaplastic lymphoma (BIA-ALCL) and, recently described and even rarer, Breast implant-associated squamous cell carcinoma (BIA-SCC). In this review article, the various types of breast reconstruction will be presented, with emphasis on pertinent imaging findings and complications.

Enophthalmos is a severe complication of primary reconstruction following orbital floor frac-tures, oncological resections or maxillo-facial syndromes. The goal of secondary reconstruction is to re-store symmetrical globe positions to recover function and aesthetics. In this article we pre-sent a method of computer-assisted orbital floor reconstruction using a mirroring technique and a customized titanium or high-density polyethylene mesh, printed using computer aided manufac-turing techniques. This reconstructive protocol involves 4 steps: mirroring of the healthy orbit at the affected site, vir-tual design of a patient specific orbital floor mesh, computer-assisted manufacturing (CAD) of the implant, and surgical insertion of the device. Using a computed tomography data set, the un-injured side of the craniofacial skeleton was reflected onto the contralateral injured side, and a reconstructive orbital floor prosthesis was virtually designed on the mirrored orbital bone sur-face. The solid-to-layer (.STL) files of the prosthesis were then manufactured using Direct Metal Laser Sintering (DMLS) or Computer Numerical Control (CNC) methods, leading to the produc-tion of 10 titanium meshes and 2 high density polyethylene (HDPE) implants. Clinical outcomes were assessed using 3dMD photogrammetry and computed tomography measures in 14 treated patients. The technique described here appears to be a viable method to correct complex orbital floor de-fects needing delayed reconstruction. This article represents the prosecution of a previous study, which is part of a wider experimental protocol for orbital floor reconstruction using comput-er-assisted design-computer-assisted manufacturing (CAD-CAM) technology

Background: The main objective of this study is to develop a customized metatarsophalangeal implant for the treatment of various conditions affecting this specific joint. This approach involves replacing the joint with a custom implant designed specifically to fit each patient's unique anatomical structure. The need for custom implants stems from the obvious lack of size variety available, which presents a major challenge when, the search for the ideal size implant can be a hard task, also when considering the possibility of extensive modification of the bone to adapt it to the available implant. This adaptation, often synonymous with bone reduction, can cause significant post-operative pain for the patient and impact healing time. Methods: A comparative study of modeling software was carried out to select the perfect software, by defining and comparing the relevant criteria. Similarly, the different biomaterial options were examined and compared to select the one best suited to this project, mentioning the imaging modality used to determine the types of images used for our approach. Finally, the 3D printers used in this work were represented, highlighting their technical characteristics. Findings: A resin metatarsophalangeal implant prototype was created using 3D modeling and reconstruction software and tools. Interpretation: Reconstruction and 3D modeling techniques are revolutionizing implant creation, offering customized solutions for patients suffering from metatarsophalangeal joint disorders caused by a wide range of diseases. These results have significant implications for disability management and rehabilitation, encouraging further exploration and progress.

Pure orbital blowout fractures occur within the confines of the internal orbital wall. Restoration of orbital form and volume is paramount to prevent functional and esthetic impairment. The anatomical peculiarity of the orbit has encouraged surgeons to develop implants with customized features to restore its architecture. This has resulted in worldwide clinical demand for patient-specific implants (PSIs) designed to fit precisely in the patient's unique anatomy. Fused filament fabrication (FFF) three-dimensional (3D) printing technology has enabled the fabrication of implant-grade polymers such as Polyetheretherketone (PEEK), paving the way for a more sophisticated generation of biomaterials. This study evaluates the FFF 3D printed PEEK orbital mesh customized implants with a metric considering the relevant design, biomechanical, and morphological parameters. The performance of the implants is studied as a function of varying thicknesses and porous design constructs through a finite element (FE) based computational model and a decision matrix based statistical approach. The maximum stress values achieved in our results predict the high durability of the implants, and the maximum deformation values were under one-tenth of a millimeter (mm) domain in all the implant profile configurations. The circular patterned implant (0.9 mm) had the best performance score. The study demonstrates that compounding multi-design computational analysis with 3D printing can be beneficial for the optimal restoration of the orbital floor.

A healthy 47-year-old woman consulted the Oral Surgery and Implantology Unit of the University Hospitals of Geneva with a request to treat her painful tooth 11 and replace the missing tooth 21. The dental history revealed that the patient had lost teeth 21 and 22 due to advanced caries. On clinical examination, tooth 11 showed an ill-fitting prosthetic crown with overhanging margins, an increased localized probing depth of 8 mm in the disto-vestibular area and sensitivity to percussion. The edentulous site 21 showed horizontal bone atrophy. Radiological examination revealed a well-defined unilocular radiotransparent lesion surrounded by a thin radiolucent border, located at the apex of tooth 11 and measuring 10 x 8 mm. The treatment consisted of extraction of 11, enucleation of the apical lesion, insertion of implants at sites 11 and 21 with simultaneous bone augmentation in a single surgical procedure with aesthetic and functional results at 3-year follow-up without any complications. Our case highlights that immediate implant placement in case of cystic periapical lesion represents a good valid alternative to standard treatment.

The aim of the present study was to monitor implant stability after sinus floor elevation with two biomaterials during the first 6 months of healing by a resonance frequency analysis (RFA), and how physico-chemical properties affect the implant stability quotient (ISQ) at the placement and healing sites. Bilateral maxillary sinus augmentation was performed in 10 patients in a split-mouth design using a bobine HA (BBM) as a control and porcine HA (PBM). Six months after sinus lifting, 60 implants were placed in the posterior maxilla. The ISQ was recorded on the day of surgery from RFA at T1 (baseline), T2 (3 months), and T3 (6 months). Statistically significant differences were found in the ISQ values during the evaluation period. The ISQ (baseline) was 63.8±2.97 for BBM and 62.6±2.11 for PBM. The ISQ (T2) was ~ 73.5±4.21 and 67±4.99, respectively. The ISQ (T3) was ~ 74.65±2.93 and 72.9±2.63, respectively. All the used HAs provide osseointegration and statistical increases in the ISQ at baseline, T2 and T3 (follow-up), respectively. The BBM, sintered at high temperature with high crystallinity and low porosity, presented higher stability, which demonstrates that variations in the physico-chemical properties of a bone substitute material clearly influence implant stability.

The clinical requirement for a good esthetic result for immediate implant placement is the absence of dehiscence in the anterior facial alveolar bone. In the presence of a dehiscence, it is recommend-ed to use a connective tissue graft in addition to immediate implant placement or to change to ear-ly implant placement. However, the literature focusing on dehiscence is scarce, and the influence of different placement times and combined use of connective tissue graft on postoperative esthetics in cases with dehiscence is unclear. Therefore, we quantitatively evaluated the pre-extraction de-hiscence morphology and postoperative changes in the facial tissue of implants in three groups: immediate implant placement (Group I), immediate implant placement with connective tissue graft (Group IC), and early implant placement (Group E). Fifty-two implants were obtained (20 in Group I, 16 in Group IC, and 16 in Group E). A wider dehiscence increases the risk of soft tissue regression, which was one reason for choosing early implant placement. A combination of imme-diate implant placement and connective tissue graft, or early implant placement, tended to result in less soft tissue regression due to the thicker postoperative facial soft tissue volume.

The present investigation has been conducted on one hundred tissue fragments of breast cancer, collected and immediately cryopreserved following the surgical resection. The fragments were selected from patients with invasive ductal carcinoma of the breast, the most common and potentially aggressive type of mammary cancer, with the objective to increase the knowledge of breast cancer molecular markers, useful for diagnostic and prognostic categorization of patients, in assessing post-surgical therapeutic regimes. The proteomic screening, by 2D-IPG and mass spectrometry, allowed us to identify two main classes of protein clusters: proteins expressed ubiquitously at high levels in all patients, and proteins expressed sporadically among the same patients. Within the group of ubiquitous proteins, glycolytic enzymes and proteins with anti-apoptotic activity were predominant. Among the sporadic ones, proteins involved in cell motility, molecular chaperones and proteins involved in the detoxification appeared prevalent. The data of the present study indicates that the primary tumor growth is generally supported by two concurrent pathways: the inhibition of apoptosis and the stimulation of cellular proliferation. The second phase of the evolution of the tumor can be prematurely scheduled by the occasional presence of proteins involved in cell motility and in the defenses of the oxidative stress. To our knowledge this report on large-scales proteomics of breast cancer is currently a unique approach in the literature that offers the opportunity to evaluate the presence and recurrence of proteins to be used as prognostic indicators and susceptibility to metastasis in patients operated on for invasive ductal carcinoma of the breast.

Surface treatment of implants facilitates osseointegration, with nanostructured surfaces exhibiting accelerated peri-implant bone regeneration. This study compared bone-to-implant contact (BIC) in implants with hydroxyapatite (HA), sand-blasted and acid-etched (SLA), and SLA with calcium (Ca)-coated (XPEED®) surfaces. Seventy-five disk-shaped grade 4 Ti specimens divided into three groups were prepared, with 16 implants per group tested in New Zealand white rabbits. Surface characterization was performed using X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), digital microscopy, and a contact angle analyzer. Cell viability, proliferation, and adhesion were assessed using MC3T3-E1 cells. Apatite formation was evaluated using modified simulated body fluid (m-SBF) incubation. After 4 weeks of healing, the outcomes reviewed were BIC, bone area (BA), removal torque tests, and histomorphometric evaluation. Microstructure analysis revealed irregular pores across all groups, with the XPEED group exhibiting a nanostructured Ca-coated surface. Surface characterization showed a crystalline CaTiO3 layer on XPEED surfaces, with evenly distributed Ca penetrating the implants. All surfaces provided excellent environments for cell growth. The XPEED and SLA groups showed significantly higher cell density and viability with superior osseointegration than HA (p &lt; 0.05); XPEED exhibited the highest absorbance values. Thus, XPEED surface treatment improved implant performance, biocompatibility, stability, and osseointegration.

Using UAV-based multispectral images for quickly and accurately monitoring chlorophyll content is critical for field management and yield estimation. However, the lower model accuracy and the poor robustness of the estimation models are still preventing the widespread application of UAV-based multispectral images. We carried out two field trials at various experimental sites to further enhance the precision and applicability of the model used to estimate the chlorophyll content of potato plants. Firstly, the texture features and vegetation indices derived from multispectral images were screened using the Pearson correlation coefficient method, and Normalized difference red edge (NDRE) performed the best over the two growth periods. Secondly, principal component analysis (PCA) was applied to recombine five bands of multispectral images, and third PCA results (PCA3) was selected to combined with NDRE according to the construction principle of NDRE, and the newly constructed parameter was named improved NDRE (INDRE). Finally, INDRE was used to establish a chlorophyll content estimation model of potato plants, and compared with some traditional parameters. The results demonstrated that the INDRE had the maximum accuracy (R2 = 0.7865, RMSE = 2.1378), and corresponding R2 increased by 0.1481 and RMSE decreased by 1.2994 than NDRE. Additionally, the model was validated using independent data from Experiment 2, and INDRE considerably increased estimation accuracy compared to other factors. In conclusions, the INDRE suggested in this study significantly enhances the accuracy and applicability of the chlorophyll content inversion model and can serve as an additional reference for fertilization management.

As medical care aiming to maintain the quality of life for elderly patients is increases, implant treatment for elderly patients is increasing worldwide. Therefore, we aimed to investigate implant stability and the reliability of different measuring devices according to implant placement site and duration in patients aged over 65 years. The study evaluated 60 implants in 60 patients aged ≥ 65 years. The implant placement sites were divided into six evenly distributed sections (n=10) i.e., maxillary right- posterior, A; maxillary anterior, B; maxillary left-posterior, C; mandibular right-posterior, D; mandibular anterior, E; mandibular left-posterior, F. Participants visited the hospital seven times: preoperatively, 1V; implant surgery, 2V; stitch removal, 3V; 1-month follow-up, 4V; 2-months follow-up, 5V; before final-restoration delivery, 6V; and after final-restoration delivery, 7V. The implant stability was evaluated with the Osstell Mentor (ISQ), Periotest M (PTV), and Anycheck (IST). The mean values of ISQ, PTV, and IST were analyzed (α=.05). ISQ, PTV, and IST results of 5V and 6V were significantly higher than those of 2V (P<.05). The lowest ISQ results occurred in E location at 5V and 6V (P<.05). In all mandibular locations, IST results of 7V were significantly higher than those of 2V, 3V, 4V, and 5V (P<.05). ISQ results were negatively correlated with PTV and positively correlated with IST, and PTV was negatively correlated with IST. By considering various factors that affect implant stability, the appropriate implant load application time was determined. This could help increase the implant success rate in elderly patients. And as a diagnostic device for implant stability for evaluation of osseointegration in elderly patients, Anycheck was also able to prove its relative reliability compared to Osstell ISQ Mentor and Periotest M.

Congenital breast asymmetry represents a particular challenge to the classical techniques of plastic surgery due to a young group of patients. This study compares traditional breast augmentation using silicone implants to the more innovative lipograft technique regarding long-term results. To achieve this, we not only captured subjective parameters like satisfaction with outcome and symmetry, but also objective parameters such as breast volume and anthropometric measurements. Objective examination was performed manually and by using the Vectra® H2 photogrammetry scanning system. Patients who underwent implant augmentation and lipograft both showed no significant differences in patient´s satisfaction with surgical outcome (p = 0.55) and symmetry (p = 0.69). Furthermore, a breast symmetry of 93 % in both groups was reported. Likewise, no statistically significant volume difference between left and right breast was observed in both groups (p<0.41). However, on average, lipograft patients needed 1.3 procedures more until the desired result was achieved. In contrast, patients treated with implant-based breast augmentation usually need several implant changes during their life. In conclusion, both methods should be considered for patients with congenital breast asymmetry.

The erythropoietin-producing hepatocellular carcinoma (Eph) receptors are the largest receptor tyrosine kinases family. EphB4 is essential for cell adhesion and motility during embryogenesis. Pathologically, EphB4 is overexpressed and contributes to poor prognosis in various tumors. Therefore, sensitive monoclonal antibodies (mAbs) should be developed to predict the prognosis for multiple tumors with high EphB4 expression, including breast and gastric cancers. This study aimed to develop highly sensitive and specific anti-EphB4 mAbs for several applications using the Cell-Based Immunization and Screening (CBIS) method. EphB4-overexpressed Chinese hamster ovary (CHO)-K1 (CHO/EphB4) cells were immunized into mice, and we established an anti-EphB4 mAb (clone B4Mab-7), which is applicable for flow cytometry, western blotting, and immunohistochemistry. B4Mab-7 reacted with endogenous EphB4-positive breast cancer cell lines, MCF-7 and MDA-MB-468, but did not react with EphB4-knockout MCF-7 (BINDS-52) in flow cytometry. Dissociation constant (KD) values were determined to be 2.9 × 10‑9 M, 1.3 × 10‑9 M, and 3.3 × 10‑9 M by flow cytometric analysis for CHO/EphB4, MCF-7, and MDA-MB-468 cells, respectively. B4Mab-7 detected the EphB4 protein bands from breast cancer cells in western blotting, and stained breast cancer tissues immunohistochemistry. Altogether, B4Mab-7 demonstrated high sensitivity and specificity against EphB4 in various applications.

Chlorhexidine digluconate (CHX) has shown the ability to significantly reduce inflammation and marginal bone loss (MBL) at 1-year follow-up but limited data exists regarding its long-term efficacy in peri implant stability. The objective was to compare the long-term effects of a placebo gel (16 patients in Group A) or a 0.20% CHX gel (15 patients in Group B) used at each previous surgical and prosthetic stage. Follow-ups were conducted in 2022, investigating by biological, radiological, clinical, mechanical evaluation the long-term effects. Data were statistically analyzed. The research achieved a 96.7% implant success rate over five years, but 41.9% of patients didn't attend annual oral hygiene check-ups. The average MBL was 1.04 ± 0.39 mm, with no significant differences between the two groups. Notably, patients who attended regular periodontal check-ups experienced significantly less MBL than those who didn't (p &lt;0.05). At five years, the effects of CHX were reduced, with both groups showing moderate bone loss. The results suggest early disinfection could enhance both short and long-term outcomes. In fact, patient with initial minor MBL preserve this advantage also at 5 years of follow-up. Additionally, the data underscore the importance of annual check-ups in early detection and management of biological and mechanical complications.

Surface chemistry evaluation plays a crucial role in assessing the efficacy of chemical decontamination products for titanium implants. This study aimed to investigate the effectiveness of chemical decontamination solutions in cleaning a contaminated dental implant surface and to evaluate the potential of combining Pluronic gel with hydrogen peroxide (NuBone®Clean) by evaluating pellicle disruption and re-formation on implant surfaces. In addition, ensuring safety with in- vitro and human testing protocols. X-ray Photoelectron Spectroscopy (XPS) was utilized for surface analysis. All the tested gels had some effect on the surface cleanness except for PrefGel®. Among the tested chemical decontamination candidates, NuBone®Clean demonstrated effectiveness in providing a cleaner titanium surface. Furthermore, none of the tested chemical agents exhibited any cytotoxic effects, and the safety assessment showed no adverse events. The results of this study highlight the significance of conducting comprehensive evaluations, encompassing safety and efficacy, before introducing new chemical agents for dental treatments. The findings suggest that NuBone®Clean shows potential as a chemical decontamination solution for implant surfaces. However, further investigation through randomized clinical trials is necessary. By adhering to rigorous testing protocols, the development of safe and efficient chemical decontamination strategies can be advanced, benefiting patients and promoting progress in the field of implant dentistry.

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.

Cancer cells are adept at reprogramming energy metabolism and the precise manifestation of this metabolic reprogramming exhibits heterogeneity across individuals (and from cell to cell). In this study, we analyzed the metabolic differences between interpersonal heterogeneous cancer phenotypes. We used divergence analysis on gene expression data of 1156 breast normal and tumor samples from The Cancer Genome Atlas (TCGA) and integrated this information with a genome-scale reconstruction of human metabolism to generate personalized, context-specific metabolic networks. Using this approach, we classified the samples into four distinct groups based on their metabolic profiles. Enrichment analysis of the subsystems indicated that amino acid metabolism, fatty acid oxidation, citric acid cycle, androgen and estrogen metabolism and ROS detoxification distinguished these four groups. Additionally, we developed a workflow to identify potential drugs that can selectively target genes associated with the reactions of interest. MG-132 (a proteasome inhibitor) and OSU-03012 (a celecoxib derivative) were the top-ranking drugs identified from our analysis and known to have anti-tumor activity. Our approach has the potential to provide mechanistic insights into cancer-specific metabolic dependencies, ultimately enabling the identification of potential drug targets for each patient independently, contributing to a rational personalized medicine approach.

Close to half (45.4%) of 2.3 million breast cancers (BC) diagnosed in 2020 were from Asia. While the burden of breast cancer has been examined on the level of broad geographic regions, literature on more in-depth coverage of the individual countries and subregions of the Asian continent is lacking. This review examines the breast cancer burden in 47 Asian countries. Breast cancer screening guidelines and risk-based screening initiatives are discussed.

We report the case of a 61-year-old woman who was referred to the Oral Surgery and Implantology Unit of the University Hospitals of Geneva to take care edentulous sites after dental avulsions of teeth 11 and 21 following traumatic shock due to endotracheal intubation under general anaesthesia. The dental history revealed that the patient had a history of generalized chronic periodontitis that had been treated several years earlier. Treatment consisted, for the first time to our knowledge, of immediate insertion of implants at sites 11 and 21 with simultaneous bone augmentation in a single surgical procedure and immediate restorations.

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.

Keywords: Artificial Intelligence in Implantology; AI in Dental Implantology; Machine Learning in Dental Implantology; Deep Learning in Implant Dentistry; Robotics in Dental Implantology; AI-Based Implant Planning.

Background: After the increasingly common anterior cruciate ligament reconstruction (ACLR) procedure in competitive athletes, rehabilitation is crucial for facilitating a timely return to sports (RTS) and preventing re-injury. This pilot study investigates the biomechanical and psychological outcomes of postoperative rehabilitation in competitive athletes, comparing supervised rehabilita-tion (SVR) and home-based rehabilitation (HBR). Methods: After ACLR, 60 (out of 74 screened) athletes were recruited and equally divided into 2 groups using non-probability convenience sam-pling: 30 HBR and 30 SVR (each group comprising 15 males and 15 females). Rehabilitation out-comes in respective groups were evaluated at 8 months using measures (Tegner-Activity-Scale [TAS], International Knee Documentation Committee subjective knee form [IKDC-SKF], ACL Return to Sport after Injury [ACL-RSI]) and objective parameters (isometric muscle strength, hamstring/quadriceps asymmetry). RTS was evaluated at 9 months; with ACL re-injury rates rec-orded approximately 6 months post-RTS. Results: Both groups exhibited decreased TAS scores (HBR: 8 to 6, SVR: 8 to 7), with the SVR group demonstrating superior post-operative IKDC-SKF scores (81.82 vs. 68.43) and lower ACL-RSI scores (49.46 vs. 55.25). Isometric and isokinetic mus-cle strength, along with asymmetry values, favored the SVR group 8 months post-ACLR (p

The aim of this study was to evaluate the use of a flexible synthetic polymer bone graft to provide implant stability in the absence of implant stability during implant placement in a dense cortical bone model. Sockets were prepared on polyurethane blocks according to the standard implant socket drilling protocol in the control group, both oversizing and deepening in group 2, and oversizing only in group 3. In groups 2 and 3, flexible synthetic polymer bone grafts were placed in the sockets prior to implant placement. The implants were placed at bone level in all groups. The highest torque value obtained was recorded as the insertion torque. 75 implant sites in 3 groups were included in the study. The torque values of the implants in the control group were significantly higher than those of the implants with the oversized and deepened sockets and the oversized-only sockets (p&lt;0.05; p&lt;0.01).The torque values of the implants with the oversized and deepened sockets were significantly higher than those of the implants with the oversized-only sockets (p&lt;0.01). In this study, flexible synthetic polymer bone graft was shown to be effective in achieving implant stability in the management of implants with loss of primary stability.

In previous studies regarding the osseointegration of zirconia (ZrO2) implants, a lack of consistency was observed in the surface topographies of the ZrO2 and Ti samples because of the difficult processability of ZrO2 surfaces. To resolve this problem, we used the molecular precursor method (wet process), which is a surface-modifying technique that can easily change the surface chemistry without changing the surface topography. A roughened Ti surface was prepared using sandblasting (large-grit) and acid treatment. We were able to create ZrO2-coated Ti implants with the same topography as that of roughened Ti substrates using the molecular precursor method, which solution contained a Zr complex. The uniform presence of tetragonal Zr was confirmed, and the apparent zeta potential of the surface of the ZrO2-coated Ti implant was higher than that of Ti. In animal experiments, ZrO2-coated Ti implants showed an equivalent or higher bone-to-implant contact ratio compared to that of the non-coated implants inserted into the femur bone defects of the rats. ZrO2 with the same surface topography as that of roughened Ti exhibits a promotion of osteogenesis equivalent to or better than that of Ti in the early stages of bone formation.

This study assessed the performance of low-dose CT lung scans across various acquisition parameters and examined the impact of iterative reconstruction (IR) algorithms on image quality for lung cancer screening. The performance of multi-slice CT scanners was assessed by using a Catphan 600 phantom, specifically within the CTP404 test module that contains materials like Teflon, Delrin, Acrylic, Polystyrene, LDPE, PMP, Air, and water. Three protocols were selected and categorized into standard, low dose, and ultra-low dose. The standard protocol featured a tube voltage of 100 kVp for single-detector CT, a pitch of 0.75, detector collimation of 0.60 mm, and a gantry rotation time of 0.33 seconds, with 5 mm slice thickness. Images were reconstructed using standard kernels like B80f and 170f, combined with either FBP or various IR algorithms. Findings indicated that the noise power spectrum (NPS) peak value (HU2mm2) increased with higher IR levels, with FBP showing the highest peak. Additionally, NPS spatial frequency diminished as IR levels rose. Optimizing contrast and spatial resolution for both background and regions of interest involved adjusting the target transfer function (TTF) and contrast-to-noise ratio (CNR), crucial for protocol optimization. Proper adjustment of IR levels is vital, as higher levels can alter image texture and affect NPS spatial frequency. The results of this study showed that the use of IR algorithms in low-dose CT lung scans significantly improved image quality, particularly in terms of noise reduction and spatial resolution. However, the choice of acquisition parameters also played a crucial

Abstract: With a resurgence in ITRT (Immediate Tooth Replacement Therapy) as a method of preserving both hard and thus soft tissues for improved aesthetic outcomes, this multi-centre, retrospective study will look at two novel products and their effect on these outcomes. A new synthetic particulate graft material along with a novel Implant design was utilized in the study and a 1 year follow up assessment, analysed for hard and soft tissue regeneration.

Background: The absence of interdental papillae in dental prosthetics often results in unsatisfactory esthetic outcomes, such as black triangles and elongated clinical crowns. Although previous research has shown that gingival papillae can regenerate in a coronal direction, the mechanisms behind this phenomenon are not fully understood. Various theories have been proposed as potential explanations. Materials and Methods: This study evaluated several factors potentially influencing papilla growth, including adjacent elements, buc-cal-lingual papilla width, contact point position, convergent neck, crown overcontour, and intraoral negative pressure. A conceptual map was created to organize these factors, followed by their classification using a modified Overton Window. The principle of parsimony (Occam's Razor) was applied to identify the most plausible cause-related factors, categorizing them as causal relationship factors, filtered out factors, essential factors, or influencing factors. A mind map was used for visual grouping. Results: The analysis identified intraoral negative pressure as the most plausible cause-related factor for spontaneous papilla growth. Factors such as inflammation and drug-induced hyperplasia were excluded due to their association with unhealthy tissue. Other factors were classified as essential or influencing, but without direct causal links to papilla growth. Conclusions: Intraoral negative pressure is likely a key contributor to spontaneous papilla growth around implants. This finding, supported by abductive reasoning and the exclusion of less plausible factors, offers a new direction for enhancing esthetic outcomes in dental prosthetics, though further research is needed to confirm this causal relationship.

Although the connection of implant abutments to implant analogs and implant bodies has been evaluated separately, comparative evaluation of connections to implant analogs and implant bodies has not been evaluated. The objective of this study was to identify whether torque applied during laboratory manufacturing and during restoration cementation affects the compatibility between the implant body-abutment and the implant analog-abutment, as well as to spot any structural differences. Three different implant system with internal conical connection (Bioinfinity, Dant, and Dentist) were used. For each group, straight abutments (n=20) were tightened to implant analogs (n=10) and implant bodies (n=10) with hand tightening and using torque wrench device. The fitting of componenets were evaluated for each group using linear and volumetric micro-CT analysis. For linear analysis, when the mean differences (difference between measurements of the linear distance of abutments during hand tightening and applying torque) values between implant analog and implant body were compared within groups, There was no statistically significant difference observed in all groups (p&gt; 0.05). Throughout the fabrication and clinical phases, it is recommended to tighten the abutments on the analogs with a torque wrench instrument to minimize the risk of prosthetic incompatibility.

This comprehensive review elucidates the profound relationship between the human microbiome and breast cancer managrement. Recent findings highlight the significance of microbial alterations in tissues, such as the gut and the breast, and their role in influencing breast cancer risk, development, progression, and treatment outcomes. We delve into how the gut microbiome can modulate systemic inflammatory responses and estrogen levels, thereby impacting cancer initiation and therapeutic drug efficacy. Furthermore, we explore the unique microbial diversity within breast tissue, indicating potential imbalances brought about by cancer and highlighting specific microbes as promising therapeutic targets. Emphasizing a holistic One Health approach, this review underscores the importance of integrating insights from human, animal, and environmental health to gain a deeper understanding of the complex microbe-cancer interplay. As the field advances, strategic manipulation of the microbiome and its metabolites presents innovative prospects for enhancing cancer diagnostics and therapeutics. However, rigorous clinical trials remain essential to confirm the potential of microbiota-based interventions in breast cancer management.

The aim of this study was to evaluate the effect of two different insertion speeds at 8 different insertion torque values ranging from 25-60 during implantation in a dense polyurethane D1 bone model on the placement status and removal torque of dental implants. In this study, 50 pcf single layer polyurethane plates were used. In the study, a total of 320 implant sockets were divided into 2 groups as Group 1 (30 rpm) and Group 2 (50 rpm) in terms of insertion speed. Group 1 and Group 2 were divided into 8 subgroups as 25, 30, 35, 40, 45, 50, 55 and 60 torques. There were 20 implant sockets in each subgroup. During the implantations, implant placement status and removal torque values were assessed. There was a statistically significant difference between the 30 and 50 RPM groups in terms of overall implant placement status (p&lt;0.01). It was found that the removal torque values at 50 RPM were statistically significantly higher than those at 30 RPM (p&lt;0.01). This study showed that in dense D1 bone, the minimum parameters at which all implants could be placed at bone level were 50 torque at 30 rpm and 40 torque at 50 rpm.

Achieving the best aesthetic result is a key objective of implant-prosthetic therapy. To maximize the aesthetic outcome, ensuring that implant-supported restorations are in harmony with the peri-implant soft tissues and bone is essential. A comparative analysis of zirconia and titanium dental implants revealed that both materials offer high success rates; however, they present distinct advantages and limitations in clinical practice. Titanium implants, with surface modifications but without chemical composition changes, boast remarkable long-term survival. In contrast, zirconia implants, while presenting high aesthetic and biocompatibility qualities, have a relatively high incidence of material-specific failure, ranging from 4% to 2% after 5-10 years. While titanium implants generally show superior long-term performance, zirconia implants benefit from ongoing advancements aimed at improving their osseointegration and longevity. This study emphasizes the need for short-term and long-term studies, complemented by randomized controlled trials (RCTs), which are essential for optimizing implant materials and ensuring patient satisfaction. Continued innovation and research are crucial for advancing dental implant technology and enhancing the quality of life for patients requiring dental restorations. Finally, it is important to understand that all materials have both advantages and disadvantages, so the choice of the optimal material should be based on the specific purpose.

Peri-implant infective diseases seem to be the most common cause for the late dental implant failure. Therefore, peri-implant microbiota has been intensively studied in modern implantology. Many studies showed a presence of extremely varied microflora in cases of peri-implant infective diseases. The main scope of this observational single-blind study was to analyze the presence of some microbial species in a group of patients with clinical signs of peri-implant mucositis compared to two other groups (patients treated with dental implants but without any clinical signs of peri-implant inflammation and patients treated with no dental implants). The identification of microorganisms was followed by an antibiogram in order to find their sensitivity to various antibiotics. The results showed a microbiota not necessarily specific for each situation (peri-implant infective diseases, healthy tissues around dental implants and healthy natural teeth and gums) with species like Candida albicans, Neisseria mucosa, Prevotella, Staphylococcus aureus, Streptococcus and others. Peri-implant infective diseases presented more bacterial species than other conditions.

Purpose: To compare the efficacy and safety of trabeculectomy with a collagen matrix implant (Ologen®) versus trabeculectomy with mitomycin C (MMC) versus trabeculectomy with both Ologen® and MMC (OLO+MMC). Methods: This non-randomized study included 119 eyes of 101 patients with uncontrolled open-angle glaucoma who underwent trabeculectomy, either alone or combined with phacoemulsification. Data were initially registered following a standard surgical protocol and using an electronic database with structured fields. Patients were divided into three groups: 44 received trabeculectomy with adjunctive MMC (MMC group), 34 with Ologen® (OLO group), and 41 with both Ologen® and MMC (OLO+MMC group). The main outcome measures were the change in intraocular pressure (IOP), change in number of medications needed, complete success rate (defined as IOP≤20 mmHg and at least 20% IOP reduction without hypotensive medications), rate of complications, and rate of postoperative interventions. The follow-up period was 36 months.
 Results: IOP significantly decreased (p=0,01) in all groups across all study visits, decreasing from 19.8 ± 4.6 mmHg to 12.7 ± 4.2 mmHg in the MMC group, from 20.5 ± 4.7 mmHg to 13.9 ± 3.5 mmHg in the OLO group, and from 23.5 ± 6.1 mmHg to 13.1 ± 3.5 mmHg in the OLO+MMC group. After correcting for baseline IOP, only the first two postoperative visits (first week and first month) showed significantly greater IOP reduction in the OLO+MMC group. The number of hypotensive medications was significantly reduced from 3.1±0.6 to 0.56±1.1 in the MMC group, from 2.9±0.4 to 0.83±1.1 in the OLO group, and from 3.0±0.6 to 0.45±0.95 in OLO + MMC group, with no statistically significant differences among the groups (p=0,57). Complete success rates were 63,6% in the MMC group, 67,6% in the OLO group, and 80,5% in the OLO +MMC group, with no statistically significant differences among the groups (p=0,21). Suture release was significantly more frequent in the MMC group (86,1%) than in the OLO group (62,1%) and in the OLO + MMC group (45,9%; p=0,02). Bleb needling, with (33.3%; p=0.005) or without (66.7%; p=0.0001) 5-Fluorouracil injection (5-FU), was significantly more common in the MMC group. The highest complete-success rate (61%) was offered by the OLO+MMC group. Conclusion: The use of Ologen® and Mitomycin C provided similar surgical IOP reduction in glaucoma surgery compared with MMC or Ologen® either alone but significantly reduced the need for postoperative interventions.

Background: Fiber-reinforced composites (FRCs) have been proposed as an alternative to traditional metal alloys for the realization of frameworks in full-arch implant supported prostheses. The aim of the present in vitro study was to evaluate the deflection under load of seven prostheses endowed with frameworks made of different materials, including different types of fiber reinforced composites (FRCs). Methods: A master cast with four implant analogues in correspondence of the two lateral incisors and the two first molars was used to create full-arch fixed prostheses with the same shape and different materials. Prostheses were made in different materials (framework+veneering material): gold alloy+resin (Au+R), titanium+resin (Ti+R), FRC with multi-directional carbon fibers+resin (ICFRC+R), FRC with unidirectional carbon fibers+composite (UCFRC+C), FRC with glass fibers+resin (GFRC+R), FRC with glass fibers+composite (GFRC+C), resin (R, full-acrylic prosthesis). Flexural tests were conducted using Zwick/Roell Z 0.5 machine and the deflection of the lower surface of the prosthesis was measured in order to obtain load/deflection graphs. Results: Greater rigidity and less deflection were recorded for UCFRC+C, GFRC+C, followed by Ti+R, and Au+R. The greatest deformations were observed for resin alone, ICFRC+R and GFRC+R. The results were slightly different in the incisal region probably due to the greater amount of veneering material in this area. Conclusions: When used to realize full-arch frameworks, Au and Ti allow a predictable mechanical behavior with gradual deformations with increasing load. UCFRC also demonstrated good outcomes and less deflection than ICFRCs when loaded. The GFRC full-arch framework may be a valid alternative, however showed greater deflections. Further studies are needed in order to evaluated how different prosthesis design and material thickness might affect the outcomes.

In implantology, among the key choices, to obtain predictable results, it’s essential to establish, using CBCT, the bone site where to insert the implants; these sites must be identified on the mucosa and secondarily, during the surgical phase, on the cortical bone. Surgical templates are a valid aid especially in complex cases which require sev-eral implants. In cases of single implant, on the other hand, surgical guides are rarely used and the implant is inserted freehand and the identification of the implant site on the oral mucosa is more difficult; for this reason the clinician uses the teeth in the arch as a ref-erence. This experimental study is based on the use of a thermo-printed mask, con-taining radiopaque references which, worn by edentulous patients during the execu-tion of the CBCT, helps to evaluate the identification of the implant sites on the patient when surgical guides are not used and the free hand technique is adopted. This method is certainly reserved for experienced operators capable of identifying the correct angle of the implants with the freehand technique. The level of experience remains fundamental in the clinician's decision whether or not to use surgical guides; in fact, doctors with little experience should use surgical guides even in the simplest cases to reduce the risk of error.

Background: By using outcome prediction scores, it is possible to distinguish between good and poor performers with cochlear implants (CI) after CI implantation. The reasons for poor performance, despite good basic conditions, can be manifold. On the one hand, the postoperative fitting may be inadequate; on the other, neurophysiological disease processes may impair speech understanding with a CI. These disease processes are not yet fully understood. In acoustics, it is known that the auditory brainstem responses (ABR) and their latencies and amplitudes allow differential diagnosis based on reference values for normal-hearing individuals. The aim of this study was to provide reference values for electrically evoked brainstem responses (EABRs) in terms of rate-dependent latencies and amplitudes. Methods: 20 experienced adult CI recipients with a predicted and measured good postoperative word recognition score were recruited from the clinic’s patient pool. In the same stimulation mode and intensity we measured latencies and interpeak-latencies of EABRs and electrically evoked compound action potentials (ECAPs). With a defined supra-threshold stimulation intensity above the individual ECAP threshold, we applied stimulation at several rates between 11 and 91 stimuli per second. Results: We found rate dependences for EABR latency t3 and t5 in the order of 0.19 ms and 0.37 ms respectively, while ECAP was not affected by rate. Correspondingly, the interpeak intervalls’ rate dependences for t5-t1, t5-t3 and t3-t1 were of the order of 0.37 ms, 0.18 ms and 0.19 ms. Comparing the EABR amplitudes between the stimulation rates 11/s and 81/s, we found that at 81/s the amplitudes were significantly reduced down: to 73% for A3 and 81% for A5. These rate dependences of latency and amplitude in EABR have characteristics comparable to those of acoustic ABR. Conclusions: These data may serve to provide reference values for EABR and ECAP latencies, interpeak intervals and amplitudes with respect to stimulation rate. Altered response patterns of ECAPs and EABRs to normalised stimulation modes could be used in the future to describe and classify neuropathological processes in a better-differentiated way.

In implantology, among the key choices, to obtain predictable results, it is essential to establish, on the basis of radiographic examinations, the bone site where to insert the implants; these selected locations must be identified first on the mucosa and then on the cortical bone. Surgical guides represent a valid aid especially in complex cases with more than 3 or 4 implants, whereas in single implant cases they are rarely used. This study evaluates the clinical precision with which the implant sites, on the patient's mucosa, are identified in surgical procedures planned without any templates. The verification of this precision is carried out through thermo-printed templates with radiopaque references which could however help the clinician to identify these sites in a simple, rapid and economical way.

The ACEtabular rim eXtension (ACE-X) implant is a custom-made 3-dimensional-printed titanium device designed for the treatment of canine hip dysplasia. Thirty-four dogs (61 hips) underwent ACE-X implantation, and assessments were conducted using computed tomography, force plate analysis, Ortolani’s test, and Helsinki Chronic Pain Index (HCPI) questionnaires at five intervals: pre-operative day, surgery day, 1.5-month, 3-month, and 12-month follow-up. Statistically significant increases in femoral head coverage with negative Ortolani subluxation test were observed immediately after surgery and persisted throughout the study. Osteoarthritis (OA) scores remained stable, but osteophyte size significantly increased between the surgery day and the 12-month follow-up, especially in hips with a baseline OA score of 2 compared to those with a score of 1. Force plate data showed no significant changes during the study. The HCPI demonstrated a significant decrease in pain score from pre-operative value to 6-week follow-up and gradually decreased over time. Major complications were identified in 6 hips (9.8%) of 4 dogs. In conclusion, the ACE-X implant effectively increased femoral head coverage, eliminated subluxation, and provided long-term pain relief with minimal complications, benefiting over 90% of the study population. The study supports the ACE-X implant as a secure and valuable treatment for canine hip dysplasia.

This systematic review investigates the failure rate and marginal bone loss (MBL) of dental implants placed in Solid-organ transplant (SOT) patients compared to healthy controls. Three databases (PubMed, Web of Sciences and the Cochrane Library) were searched up to June 2020 (PROSPERO CRD42019124896). Case-control and cohort studies reporting data failure rate and marginal bone loss (MBL) of dental implants placed in SOT patients were included. The risk of bias of observational studies was assessed through the Newcastle-Ottawa Scale (NOS). Four case-control studies fulfilled the inclusion criteria, all of low risk of bias. Meta-analyses revealed consistently lower implant failure rate than control populations at patient and implant levels. SOT patients had a significant difference of -18% (p-value <0.001) of MLB towards healthy patients. SOT status poses no serious threat to implant survival. Overall, this group of patients presented lower levels of dental implant failure rate and marginal bone loss compared to otherwise healthy patients. Further intervention trials with wider sample size and longer follow-ups are necessary to confirm these summary results.

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.

Telehealth is the delivery of many health care services and technologies to individuals at different geographical areas and is categorized as asynchronously or synchronously. The coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions in health care delivery to breast cancer (BCa) patients and there is increasing demand for telehealth services. Globally, telehealth has become an essential means of communication between patient and health care provider. The application of telehealth to the treatment of BCa patients is evolving and increasingly research has demonstrated its feasibility and effectiveness in improving clinical, psychological and social outcomes. Two areas of telehealth that have significantly grown in the past decade and particularly since the beginning of the COVID-19 pandemic are telerehabilitation and teleoncology. There two technological systems provides opportunities at every stage of the cancer care continuum for BCa patients. We conducted a systematic literature review that examined the use of telehealth services via its various modes of delivery among BCa patients particularly in areas of screening, diagnosis, treatment modalities, as well as satisfaction among patients and health care professionals. The advantages of telehealth models of service and delivery challenges in delivery to patients in remote arears are discussed.

(1) Background : When placing implants in the maxillary posterior region with insufficient alveolar bone, a maxillary sinus elevation is necessary. Autogenous bone, though biologically ideal, poses risks and discomfort due to donor site harvesting. Block-type autogenous tooth bone graft material, made from the patient’s own extracted tooth, offers similar biological stability without these drawbacks; (2) Methods : This study observed the progress of 19 implant patients who were treated with maxillary sinus elevation procedures using block-type autogenous tooth bone graft material at the Daegu Catholic University Medical Center. Extracted teeth were processed into demineralized tooth block bone. After elevating the sinus membrane, implants and the tooth bone graft material were placed in the space, and the bony window was repositioned. Postoperative evaluations through clinical observation and radiographic imaging assessed sinus membrane elevation, alveolar bone height increase, and implant osseointegration; (3) Results : Results showed proportional increases in alveolar bone height to the graft material size, with long-term stability. No postoperative complications occurred, even with sinus membrane perforation, and implants remained stable; (4) Conclusions : The study concludes that maxillary sinus lifts using block-type autogenous tooth bone graft material provide excellent bone induction and biocompatibility, making it a highly beneficial method for both dentists and patients.

Background and Objectives: This study aimed to evaluate the histological and biochemical ef-fects of capsaicin on implant osseointegration and oxidative stress. Materials and Methods: Male Wistar albino rats weighing between 250 and 300 grams were used in this study. Twenty-four rats were randomly divided into three equal groups: implant + control (n= 8), implant + capsai-cin-1 (n= 8), and implant + capsaicin-2 (n= 8). 2.5 mm diameter and 4 mm length titanium im-plants were surgically integrated into the corticocancellous bone parts of the femurs. In the treatment groups, rats were injected intraperitoneally with 25 mg/kg (implant + capsaicin-1) and 50 mg/kg (implant + capsaicin-2) of capsaicin. No additional applications were made in the con-trol group. Three rats in totally were died during and after the experiment, as a result of the an-alyzes performed on 21 animals. Results: The highest total antioxidant status value was found in capsaicin dose 2, according to the analysis. The control group had the highest total oxidant status and oxidative stress index values, while group 2 of capsaicin had the lowest. After analysis, we found that there was no observed positive effect on osteointegration in this study (p> 0.05), alt-hough the bone implant connection was higher in the groups treated with capsaicin. Conclusi-ons: A positive effect on osteointegration was not observed in this study. This may be due to os-teaclast activation. However it was found that it has a positive effect on oxidative stress. Osteo-clast activation may be the cause of this phenomenon. Capsaicin was found to have a positive effect on oxidative stress (p

Implantation of two electrical stimulators of different cranial nerves in one patient is rare. We report the case of a forty-seven-year-old patient already implanted with a trigeminus nerve stimulator. In addition, this patient suffered from hearing problems. In one ear, the patient was deaf. On the other side, the patient wore a bone conduction hearing aid to improve hearing. In this complex situation, we decided to check the possibility of cochlear implantation on the deaf side. Finally, we managed to provide electrical stimulation of the auditory pathway of the deaf ear to improve the patient’s hearing tests. In addition, this case report shows how the trigeminus stimulator interferes with the electrical stimulation in auditory evoked potentials measurements of the auditory brainstem and cortex via EABR (evoked auditory brainstem response) resp. EALR (evoked auditory late response).

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.

Despite the high biocompatibility of titanium and its alloys, the need to remove titanium implants is increasingly being debated due to the potential for adverse effects associated with long-term retention. Therefore, new solutions are being sought to enhance the biocompatibility of titanium implants. One of them is to increase the thickness of the passive layer of the implant made of titanium dioxide. We were the first to evaluate the effect of hard-anodized (type II) Ti-6Al-4V alloy discs on the cytotoxicity, mitochondrial function and redox balance of mitochondrial fibroblasts compared to standard-anodized (type III) and non-anodized discs. The study used fibroblasts obtained from human gingival tissue. The test discs were applied to the bottom of 12-well plates. Cells were cultured for 24h and 7; 14 and 21 days and mitochondria were isolated. We demonstrated the occurrence of oxidative stress in the mitochondria of fibroblasts of all tested groups, regardless of the presence and type of anodization. Type II anodization prevented changes in complex II activity (vs. control). The lowest degree of citrate synthase inhibition occurs in mitochondria exposed to titanium discs with type II anodization. In the last phase of culture, the presence of type II anodization reduces the degree of cytochrome c oxidase inhibition compared to the other tests groups and the control group, and prevents apoptosis. Throughout the experiment, the release of titanium, aluminium and vanadium ions from titanium discs with a hard-anodized passive layer was higher than from the other titanium discs, but decreased with time. The obtained results prove the existence of dysfunction and redox balance in the mitochondria of fibroblasts exposed to hard-anodized titanium discs, suggesting the need to search for new materials perhaps biodegradable in tissues of the human body.

Titanium (Ti) and Ti-based alloys are commonly used in dental implants, and surface modifications of dental implants are important for achieving osseointegration (i.e., direct connection between the implant surface and bone). This study investigated the effect of an eco-friendly etching solution—a hydrogen peroxide–sodium bicarbonate mixture—on the surface properties and contact angles of and osteoblast adhesion and proliferation on Ti surfaces. Disk-shaped Ti specimens were prepared using different surface treatments (machining, sandblasting, and sandblasting/acid-etching), and they were immersed in the etching solution and then ultrasonically cleaned. Surface characterization was performed using scanning electron microscopy, digital microscopy, contact angle analysis, and X-ray photoelectron spectroscopy. MG-63 osteoblasts were cultured on the specimens, and their adhesion to the specimen surface and their proliferation were examined using staining and the MTT assay, respectively. Additional etching with the etching solution caused the formation of nano/micro hierarchical structures, increased the surface roughness, and enhanced the hydrophilicity. Osteoblast adhesion and proliferation were found to improve on the modified surfaces. The eco-friendly etching method has the potential to enhance the biological properties of Ti implant surfaces and to thereby improve the dental implant performance.

Introduction. “Vein definition” for locally advanced pancreatic ductal adenocarcinoma (LA PDAC) assumes portal-to-superior mesenteric vein (PV/SMV) unreconstructability due to tumor involvement or occlusion. Radical pancreatectomies with SMV resection without PV/SMV reconstruction are scarcely discussed in the literature. Retrospective analysis of 19 radical pancreatectomies for “low” LA PDAC with SMV and all its tributaries resection without PV/SMV reconstruction has shown zero mortality, overall morbidity – 56%, Dindo-Clavien – 3-10,5%, R0- rate – 82%, mean operative procedure time – 355±154 min, mean blood loss – 330±170 ml, delayed gastric emptying– 25%, clinically relevant postoperative pancreatic fistula – 8%. In three cases surgery was associated with superior mesenteric (n2) and common hepatic artery (n1) resection. Surgery was completed without vein reconstruction (n13) and with inferior mesenteric-to-splenic anastomosis (n6). There were no cases of liver, gastric, or intestinal ischemia. A specific complication of the SMV resection without reconstruction was 2-3 days-long intestinal edema (48%). Median overall survival – 25 months, median progression-free survival – 18 months. All the relapses, except two, were distant. The possibility of successful SMV resection without PV/SMV reconstruction can be predicted before surgery by CT-based reconstructions. The mandatory anatomical conditions for the procedure were: 1) preserved SMV-SV confluence; 2) occluded SMV for any reason (tumor or thrombus); 3) well-developed inferior mesenteric vein collaterals with dilated intestinal veins; 4) no right-sided vein collaterals, and 5) no varices in the upper abdomen. Conclusion: “Low” LA PDACs involving SMV with all its tributaries can be radically and safely resected in highly and specifically selected cases without PV/SMV reconstruction with an acceptable survival rate.

Background/Objectives: Dental implants have become a cornerstone of restorative dentistry, providing a long-lasting method for tooth replacement. The level of osseointegration has a big impact on the biomechanical stability at the bone-implant contact (BIC), which determines how long these implants will work. However, the exact consequences of changing osseointegration levels on different implant designs, especially in bones with variable densities, are not well known. Three short dental implants were tested in this study: BioMet 3iT3, Straumann® Standard Plus Short Regular Neck (SPS-RN), and Straumann® Standard Plus Short-Wide Neck (SPS-WN). 3D finite element analysis (FEA) was used to look at how well they worked biomechanically. This paper tests the implants at four stages of osseointegration: 25%, 50%, 75%, and 100% in both high-density (Bone Type III) and low-density (Bone Type IV) cancellous bone. It also created and examined realistic CAD models under static occlusal loading conditions to assess stress distribution and major strains at the bone-implant contact.; Results: The study discovered that as osteointegration increases, von Mises stress and principal strains go down significantly for all implant types. The SPS-WN implant had the lowest strain values, especially for bone with low density. These reductions demonstrate increased mechanical stability as the bone-implant inter-face becomes more capable of dispersing mechanical stresses, minimizing the potential for localized deformation and bone resorption.; Conclusions: The results highlight the importance of achieving optimum osseointegration to reduce mechanical stress and increase the lifespan of dental implants. The SPS-WN type implant performed better in biomechanical tests than the others, especially when bone conditions were not ideal. This makes it a great choice for clinical applications that need long-term implant success.

Introduction Cochlear implants are a modern approach for the treatment of multiple cases of profound sensorineural hearing loss. Factors such as the ethiology of hearing loss and the potential for achieving good postoperative outcomes are considered in cochlear implantation. Additionally, surgical strategies, protocols, the experience of the surgeon and audiologist, and the presence of postoperative issues and risks that may require revision surgery should also be taken into account. The surgeon specialized in cochlear implantation must inform the patient and his relatives not only about the surgical technique but also about possible complications. The literature shows different rates of complications evaluated both in adults and in children. An evaluation of adverse events in order to prevent complications can be made if the definition of medical complications and mistakes is strictly approached based on the CLAVIEN-DINDO classification system. The rate of complications can be compared with existing literature. Studies demonstrate the need for preoperative vaccination for pneumococcus, which can prevent complications, especially in patients with inner ear malformations who present an increased postoperative risk Relevant Sections This review is structured around the collection of specialized literature from PubMed, organized into subchapters related to intraoperative complications such as Gusher syndrome, foreign body reaction, endocochlear inflammation phenomena, issues related to electrode positioning and associated complications, vestibular phenomena related to cochlear implantation, as well as late complications related to the surgical wound and cochlear implant extrusion. The important sections in this review are: Inner Ear Malformations and Gusher Syndrome: Intraoperative Complication Risks, Electrode Insertion and Positioning Issues, Intracochlear Inflammation, Foreign Body Reaction, and Intracochlear Fibrosis: Phenomena That Can Occur with Cochlear Implantation, Vestibular Disorders, Tardive Postoperative Complications: Wound Injuries and Cochlear Implant Extrusion and Otitis Media and Cholesteatoma as Complications of Cochlear Implantation Conclusions: Postoperative complications, although considered quite rare. The surgical limits and long-term evolution of cochlear implants cannot be concretely established, despite the fact that this intervention is considered safe in the medium and long term. Future directions Given that cochlear implants represent the most modern surgical technique for auditory rehabilitation in adults and children, with massive implications for quality of life, there is a tendency to extend surgical indications in the future, and especially to inform doctors in related specialties about the benefits of this medical device. Surgeons must be knowledgeable about cochlear implantation methods, as well as the methods for managing complications that can arise immediately postoperatively, as well as in the medium and long term.

(1) Background: This study aimed to compare the effect of polyetheretherketone (PEEK) and titanium abutments on implant prosthetic systems and supporting bone using three-dimensional finite element analysis (FEA); (2) Methods: A three-dimensional finite element analysis was conducted using CATIA and Abaqus software to model mandibular first molar implant systems with titanium and PEEK abutments. Under external loading conditions, finite element analysis was conducted for the stresses in implant components and surrounding bones of each group; (3) Results: The implant fixture of the PEEK model exhibited the highest von Mises stress (VMS). The lowest VMS was observed in the abutment screw of the titanium model. Both implant systems demonstrated similar stress distribution and magnitudes in cortical and cancellous bones; (4) Conclusion: PEEK abutments show similar stress distribution in surrounding bone compared to titanium. However, PEEK absorbs the stresses within the implant system and exhibits the highest VMS values due to its low mechanical and physical properties. Therefore, PEEK abutments need improved mechanical properties for better clinical application.

The first treatments with dental implants had low success rates (75%). Nowadays, oral rehabilitation with titanium dental implants has a high success rate (95-98%). The success rate significantly increases due to increased scientific knowledge about osseointegration, changes in surgical techniques, and the development of implant surface treatments. Despite the high success rate of implants, no protocol defines the time for the prosthesis to be installed and loaded after surgery. This work compares a new dental implant's primary (mechanical) and secondary (osseointegration) stability. Dental implant with micro- and nano-roughness surface was placed in 24 patients with a minimum of 35 N.cm and a maximum of 60 N.cm. Primary stability was quantified with a torque wrench and Ostell Mentor. The secondary stability 45 and 60 days after surgery was measured with Ostell. The results showed no statistical difference in secondary stability at 45 and 60 days postoperatively among implants. The success rate of dental implants can be associated with the surface morphology with micro and nano-roughness and the shape of the fillets of the implant threads. When the manufacturer's guidelines are followed, it is possible to prosthetically rehabilitate the patient with an implant 45 days after surgery.

In recent decades, the requirements for implantable medical devices increased, but the risks of implant rejection still exist. These issues are primarily associated with poor osseointegration, leading to biofilm formation on the implant surface. This study focuses on addressing these issues by developing a biomaterial for implant coatings. 45S5 Bioglass has been widely used in tissue engineering due to its ability to form a hydroxyapatite layer, ensuring a strong bond between the hard tissue and the bioglass. In this context, 45S5 bioglasses, modified by the incorporation of different amounts of copper oxide, from 0 to 8 mol%, were synthesized by the melt-quenching technique. The incorporation of Cu ions does not show a significant change in the glass structure. Since the bioglass exhibited the capacity of being polarized, and therefore promoting the osseointegration effectiveness, the electrical properties of the prepared samples were studied using the impedance spectroscopy method, in the frequency range of 102-106 Hz and temperature range of 200-400 K. The effects of CuO on charge transport mobility were investigated. Additionally, the bioactivity of the modified bioglasses was evaluated through immersion tests in simulated body fluid. The results revealed the initiation of a Ca-P-rich layer formation on the surface within 24 h, indicating the potential of the bioglasses to enhance the bone regeneration process.

Peri-implantitis continues to be one of the major reasons for implant failures. We propose a new approach for incorporating MTA into Zirconia implant surfaces with Nd:YAG laser and investigate the biological response of peri-implant cells as well as the microbiological response. Discs of Zirconia stabilized with Yttria and Titanium were produced according 4 tested groups: Nd:YAG laser textured Zirconia coated with MTA (Zr MTA); Nd:YAG laser textured Zirconia (Zr Textured); Zirconia and Titanium discs (Zr and Ti ). Contact profilometry was used to evaluate surface roughness. Human osteoblasts, gingival fibroblasts and S. oralis were cultured on samples. Cell adhesion and morphology, cell viability, cell differentiation markers and bacterial growth were assessed. Zr Textured roughness was significantly higher compared to all other groups. Cellular adhesion was observed at 1 day in all samples in both cell lines. Osteoblasts viability was lower in Zr MTA group, unlike fibroblasts viability was shown to be higher in Zr MTA group compared to Zr Textured group at 3 and 7 days. Osteocalcin and IL-8 release by osteoblasts were higher in Zr MTA. Zr Textured showed higher IL-8 values released by fibroblasts. No differences in S. oralis CFUs were observed between groups. The results suggest that Zirconia implant surfaces coated with MTA seems to promote fibroblasts proliferation and osteoblasts differentiation, however does not appear to have antibacterial properties.

Purpose To investigate secondary glaucoma resulting from uveitis in a patient infected with Human T-cell Leukemia Virus Type 1 (HTLV-1) pathologically and discuss the management of glaucoma with recurrent uveitis. Clinical course An octogenarian woman diagnosed as a carrier of HTLV-1 experienced recurrent uveitis and a sudden rise in intraocular pressure (IOP) in both eyes. Due to the uncontrolled IOP and severely damaged visual field in her left eye, a combined procedure of trabeculectomy and DGIS (Glaucoma drainage implant surgery, Baerveldt 350) was performed. The presence of HTLV-1 provirus was detected in the aqueous humor. Her trabeculectomy sample was processed for light microscopic observation. Following an irregular follow-up, she presented with a sudden decrease in vision and pain in her fellow eye, four years after the glaucoma surgeries. Her right eye exhibited a significant accumulation of mutton-fat-like keratic precipitates. Results Clinical manifestations revealed the presence of granulomatous uveitis. The combined glaucoma surgery, along with continuous topical corticosteroid medication post-surgery in her left eye, effectively suppressed the high IOP spikes and the recurrence of uveitis for 4 years. The pathological examination of the outflow pathways showed a range of damages in Schlemm's canal (SC), including SC endothelial loss, narrowing, and occlusion, as well as loss of trabecular meshwork (TM) cells and fused TM beams. Conclusion Combined GDIS and trabeculectomy represents a promising approach for managing such refractory cases of secondary glaucoma. The continuous topical corticosteroid medication is strongly recommended to prevent irreversible changes in SC and TM associated with granulomatous uveitis.

Backround Cochlear implant is the first approved cranial nerve stimulator that works by directly stimulating the cochlear nerve. Various attempts have been made to evaluate the dimensions of the cochlea related to cochlear implantationThe preoperative computed tomographic examination is essential in assessing the anatomical aspect of the cochlea, but also in determining its dimensions, in order to choose an appropriate electrode, in order to obtain the best possible audiological performance. Method In the present paper, we aimed to carry out an observational study, regarding the role of cochlear measurements in the preoperative evaluation of patients proposed for cochlear implant. The purpose of the study was to measure the cochlea and to establish the existence of a correlation between the size of the cochlea and the age and gender of the patients. Results From the group of 35 examined patients, 54% (n= 19) were male and 46% (n=16) female. The average length of the cochlea in the age group 0-4 years is 7.82 mm in the left ear and 7.86 in the right ear, in the age group 4-7 years it is 7.82 mm and 7.94 mm respectively, for the age group 7-14 years the dimensions increase to 8.48 and 8.77 mm respectively, and after 14 years these dimensions reach 9.12, respectively 9.18 mm. Comparative measurements of the length of the cochlea by age groups show an increase in length with the patient's age, but this increase does not exceed 1.5 mm for both the right and left ears. The measurements of the width of the cochlea, by age group, start from 6.84 mm left ear and 6.81 mm right ear at 0-4 years, 6.94 mm and respective 6.97 mm at the group 4-7 years, 7.71 mm and respective 7.55 mm at 7-14 years , and reaching 8.19 mmm and 8.12 mm at the age of over 14 years. Conclusions From the study carried out it can be concluded that the evaluation of the dimensions of the cochlea is important for cochlear implantation, the size variables, although small, are still an element to be considered in correlation with the age of the patient and the implanted ear. This increase is statistically insignificant, but it still exists, even if from a theoretical point of view, it is considered that the dimensions of the cochlea remain constant.

The purpose of this study was to evaluate the outcomes of implants placed in horizontally augmented alveolar ridges using porcine bone grafts and to investigate the long-term stability of the porcine bone grafts. A retrospective analysis was conducted on 55 sites that underwent horizontal ridge augmentation using porcine bone grafts and implant placement with a follow-up period longer than 5 years. Furthermore, additional analysis was conducted on 24 sites where porcine bone grafts were used exclusively and implants were placed simultaneously with horizontal ridge augmentation. The mean follow-up period after prosthesis loading was 67.3 months, with a mean marginal bone loss of 0.18 mm at 1 year and a cumulative mean marginal bone loss of 0.37 mm over the entire follow-up period. Of the 55 implants, 2 were lost and 4 did not meet the success criteria, resulting in a survival rate of 96.4% and a success rate of 89.1%. In 24 sites, the mean marginal bone loss was 0.22 mm at 1 year and 0.40 mm at 65.8 months, with 100% survival and success rates. Porcine bone grafts can be successfully used in horizontal ridge augmentation for implant placement in cases of ridges with insufficient horizontal width.

Background: In order to achieve the best possible hearing and understanding with a cochlear implant (CI), regular hearing speech therapy treatment is necessary after implantation. This treatment should also be accessible to the growing proportion of hearing-impaired people with a migration background. This requires an alternative to therapy in the therapist's native language. The aim of this study was to evaluate six multilingual conversation applications with regard to their usefulness for therapy. Material and Methods: The six most commonly used applications were reviewed in terms of accuracy of content and grammatical translation, as well as pronunciation for English, Spanish, Arabic, Turkish, and Russian by native speakers. The number of available languages, availability, cost, and additional features were also analyzed. The accuracy of the content and grammatical translation as well as the pronunciation were statistically evaluated, and the differences were highlighted. The results of the different applications were compared with the performance of a native speaker. Results: All applications tested differed significantly from the native speaker level, with Google Translator showing the closest approximation to the native speaker level. All apps offer translations for multiple languages and, with exceptions, are available in both app stores. Furthermore, all apps have additional therapist-facilitating features. Conclusion: Multilingual conversation apps can make speech therapy in a foreign language much easier when used with patients. An adaptation of the software to the specific requirements of a hearing speech therapy is necessary to achieve a linguistic level that corresponds to the native language of the therapist and to enable an easy use in the therapy.

Background: The treatment plan of prosthetic restorations supported by dental implants require comprehensive scientific knowledge to deliver prostheses with good prognosis, even before the implant insertion. This review aims to analyze the main prosthetic determinants of the prognosis of implant-supported prostheses. Methods: A systematic review of the literature was conducted with a PICO question: "For partially or complete edentulous subjects treated with implant-supported prostheses, which prosthetic factors could affect clinical outcomes?". A literature search was performed electronically in PubMed (MEDLINE), Scopus and Cochrane Library with the following equation [PROGNOS* OR RISK] FACTOR IMPLANT DENTAL, and by hand search in relevant journals and throughout the selected papers. Results: This revision was carried out based on 50 papers focused on several prosthodontics-related risk factors that were grouped as follows: implant-connection, loading protocol, transmucosal abutments, prosthetic fit, provisionalization, type of retention, impression technique, fabrication technique, and occlusion. More than a half of the studies were systematic reviews (30%), meta-analysis (16%) or prospective evaluations of prosthesis with various kinds of events (18%). But also narrative reviews of literature (14%) and in vitro/animal studies (16%) were found. Conclusions: The current literature provides insufficient evidence for most of the investigated topics. However, based on the accumulated data, it seems reasonable to defend that the best treatment approach is the use of morse taper implants with transmucosal abutments, recorded by means of rigidly splinted copings through the pick-up technique, and screwed by milled prosthesis occlusally adjusted to minimize functional overloading.

Biologic scaffolds have become an attractive approach for repairing the infarcted myocardium and have been shown to facilitate constructive remodeling in injured tissues. This study aimed to investigate the possible utilization of bacterial cellulose membrane patch containing cocultured cells to limit the myocardium's post-infarction pathology. Myocardial infarction was induced by ligating the left anterior descending coronary artery in 45 Wistar rats, and patches with or without cells were attached to the hearts. After one week, the animals underwent echocardiography for assessing ejection fraction and left ventricular end-diastolic and end-systolic volumes. Following the patch formation, cocultured cells retained viability of >90% over 14 days in culture. The patch was applied to the myocardial surface of the infarcted area after staying 14 days in culture. Interestingly, the bacterial cellulose membrane without cellular treatment showed higher preservation of cardiac dimensions; however, we did not observe improvement in the left ventricular ejection fraction of this group compared to coculture treated membranes. Our results demonstrated an important role for bacterial cellulose in supporting cells known to produce cardioprotective soluble factors and may thus provide effective future therapeutic outcomes for patients suffering from ischemic heart disease.

Background: Actually, resonance frequency analysis (RFA) is the most extended method for measuring implant stability. The implant stability quotient (ISQ) is the measure obtained by the different RFA devices, however, inter- and intra- rater reliability and validity of some devices remains unknown. Methods: Thirty implants were placed in 3 different pig mandibles. ISQ was measured axial and parallel with Osstell® Beacon, Penguin® and MegaISQ® by 2 different operators and one operator performed a test-retest. Intraclass correlation coefficient was calculated to assess the intra- and inter-rater reliability. Pearson correlation coefficient was used to assess the validity. Results: The higher inter- and intra- rater reliability was obtained by Penguin® when measuring axial. The highest ISQ values were obtained using Penguin® in an axial measurement; the lowest, using the MegaISQ® in an axial measurement. The highest correlation values with the other devices were obtained by MegaISQ® measuring axially. Conclusion: Penguin® had a good reliability for measuring ISQ both inter- and intra- rater. Osstell® had good validity for measuring ISQ both axial and parallel and MegaISQ® had the best validity for measuring ISQ axial.

This study evaluated the mechanical strengths of three types of orthodontic micro-implants by analyzing their structural configurations. Thirty micro-implants of three types (diameter 1.5 mm, Types A, B, C) were assessed. All micro-implants were manually driven into artificial bones at an 8-mm depth. The insertion torque (IT), pullout strength (PS), and gripping volume (GV) of each type were measured. Intergroup comparisons and intragroup correlation were investigated by statistical analysis. Type B had the greatest inner–outer diameter ratio (0.67), and Type A had the smallest (0.53). The IT of Type A (5.26 Ncm) was significantly (p = 0.038) lower than that of Type C (8.8 Ncm). There was no significant difference in the pullout strength (p = 0.868). The GV of Type A (9.7 mm3) was significant (p < 0.01) greater than Type C (8.4 mm3). Type C was significant (p < 0.01) greater than Type B (7.2 mm3). Spearman’s rho rank correlation test showed that PS of Type B was correlated significantly with GV. In conclusion, the design of thread and its GV were the important factors on the mechanical strengths of micro-implant.

Breast cancer is the most common cause of death for women worldwide. Thus, the ability of artificial intelligence systems to predict and classify breast cancer is very important. In this paper, a hybrid ensemble method classification mechanism is proposed based on a majority voting mechanism. First, the performance of different state-of-the-art machine learning classification algorithms for the Wisconsin Breast Cancer Dataset (WBCD) were evaluated. The three best classifiers were then selected based on their F3 score. F3 score is used to emphasize the importance of false negatives (recall) in breast cancer classification. Then, these three classifiers, simple logistic Regression learning, stochastic gradient descent learning and multilayer perceptron network, are used for ensemble classification using a voting mechanism. We also evaluated the performance of hard and soft voting mechanism. For hard voting, majority-based voting mechanism was used and for soft voting we used average of probabilities, product of probabilities, maximum of probabilities and minimum of probabilities-based voting methods. The hard voting (majority-based voting) mechanism shows better performance with 99.42% as compared to the state-of-the-art algorithm for WBCD.

Aim: This study aimed to investigate whether baseline 18F-FDG PET-derived semiquantitative parameters could predict disease-free survival in patients with grade III breast cancer of different molecular subtypes undergoing neoadjuvant chemotherapy (NAC). Materials and Methods: Patients were retrospectively retrieved from the databases of two Italian hospitals (University of Padua and University Hospital of Ferrara). Inclusion criteria were: 1) histologically proven diagnosis of grade III breast cancer; 2) history of NAC; 3) execution of a baseline 18F-FDG PET/CT scan before the start of NAC; 4) adequate follow-up time to compute the 3Y-DFS. For each 18F-FDG-PET/CT scan, the following parameters were calculated in the primary tumor (SUVmax, SUVmean, MTV, TLG) and whole-body (WB_SUVmax, WB_MTV, and WB_TLG). Receiver operating characteristic (ROC) analysis was used for each parameter to assess the prediction capability for 3Y-DFS. DFS differences between groups were assessed using Kaplan-Meier curves and compared by log-rank test. Results: Ninety-five grade III breast cancer patients with different molecular types were retrieved (luminal A: 5; luminal B: 34; luminal B-HER2: 22; HER2-enriched: 7; triple-negative: 27). In the whole group of patients, WB_SUVmax was the best predictor of recurrence (AUC: 0.66; best cut-off: WB_SUVmax>9.43; SS: 96%; SP: 38.1%; p<0.008). Patients with luminal A and Her-2-enriched breast cancer types were excluded from the molecular subgroup analysis due to the small study samples (5 and 7, respectively). In luminal B patients (n=34), WB_MTV (AUC: 0.75; best cut-off: WB_MTV>195.33; SS: 55.56%, SP: 100%; p=0.002) and WB_TLG (AUC: 0.73; best cut-off: WB_TLG>1066.21; SS: 55.56%, SP: 100%; p=0.05) were the best predictors of 3Y-DFS. Patients had a higher probability of DFS in case of a WB_MTV≤195.33 (3429±210 vs. 446±144 days; p<0.001) or WB_TLG≤ 1066.33 (937.35±19 vs. 496±131 days; p<0.001). In luminal B-HER2 patients (n=22), WB_SUVmax was the only predictor of 3Y-DFS (AUC: 0.857; best cut-off: WB_SUVmax>13.12; SS: 100%; SP: 71.43%; p<0.001); patients with WB_SUVmax≤13.12 had a significantly longer DFS (3857 days) than patients with a WB_SUVmax >13.12 (1693±430 days; p<0.004). No parameter resulted significant in the prediction of 3Y-DFS in patients with grade III triple-negative cancer. Conclusion: Volume-based parameters, extracted from baseline 18F-FDG PET, seem to be promising tools in the prediction of recurrence within 3 years in patients with grade III luminal B and luminal B- HER2 breast cancer undergoing NAC. Larger study samples are needed to confirm these preliminary findings.

Resonance inductive coupling is widely used for wireless power transfer (WPT) in medical applications. In this paper, we analyze the LCL-compensated WPT structure and propose a novel constant voltage transmission system based on gain estimation, without any extra feedback from the receiver. The system is capable for amplitude-modulated implant neural stimulation where the load impedance and the coupling coefficient are both variable. Compared to existing methods for constant voltage transmission, our approach offers advantages in compact size and the compatibility with the industrial, scientific and medical (ISM) band. We validate the load-independent resonant characteristic and the feasibility of constant voltage transmission using an experimental prototype working at 6.78MHz. Finally, we discuss the structure of the implant stimulator and methods of applying the proposed WPT system.

Resonance inductive coupling is widely used for wireless power transfer (WPT) in medical applications. In this paper, we analyze the LCL-compensated WPT structure and propose a novel constant voltage transmission system based on gain estimation, without any extra feedback from the receiver. The system is capable for implant neural stimulation where the load impedance and the coupling coefficient are both variable. Compared to existing methods for constant voltage transmission, our approach offers advantages in compact size and the compatibility with the industrial, scientific and medical (ISM) band. We validate the load-independent resonant characteristic and the feasibility of constant voltage transmission using an experimental prototype working at 6.78MHz. Finally, we discuss the structure of the implant stimulator and methods of applying the proposed WPT system.

Background/Objectives: To evaluate incidental findings in the mandible after the placement of dental implants using a new cone-beam computed tomography (CBCT) software. Methods: The initial sample consisted of 2,872 CBCT scans of patients of both sexes. The parameters evaluated in this study were the location of the implants in the mandible, implant length, anatomical relationship of the implant with the mandibular canal, presence or absence of damage to the adjacent teeth, presence or absence of implant fractures, and presence or absence of bone support. Fisher's exact test was performed to compare the variables. The significance level was set at p = 0.05. Results: Out of 2,872 CBCT scans, 214 images of patients with an average age of 44.5 years were included. The most frequent location of the implants was the posterior region (93.5%), with 54% of the implants having a length between 9 and 14 mm. It was found that 92% of the implants were positioned above the mandibular canal. Three damage to adjacent teeth was observed, with no correlation with the implant positioning (p = 0.999). In 100% of cases of implants in the anterior region, there was bone support. Fracture was observed in 1.7% of implants with a length between 9- and 14-mm. Conclusions: The installation of implants in the mandible occurs more frequently in the posterior region, with a high presence of bone support and a low incidence of damage to adjacent teeth, anatomical structures, and fractures.

Dental implant fracture is closely connected to the stress buildup surrounding the implant system during static loading. In areas where the cross section of the implant rapidly changes or where the geometry of the implant system has discontinuities, stress concentrations arise. Therefore, the implant's design is crucial in preventing early failure of the implant system, including fracture, screw loosening, and increased leakage, in addition to reducing stresses at the implant-abutment interface. In the current work, three-dimensional (3D) models of mechanically connected Ti6Al4V implant systems in various dimensions were constructed. Finite Element Analysis (FEA) was used to conduct a stress study of the created implants under actual acting forces static loading conditions in accordance with ISO 14801. In the created models, design elements including implant screw type, thickness, and taper angle of abutment were modified in order to increase the longevity of the implants. The results show that the equivalent stress level is dramatically reduced from 596.22 MPa to 212.72 MPa in the implant model, which exhibit more homogeneous stress pattern under static loading conditions. Furthermore, the relatively smoother stress transmission observed in this model holds promise for the development of new implants capable of withstanding the forces encountered in the oral environment.

Insufficient oral ridge tissue presents a challenge in the treatment of dental implants. One method to enhance alveolar crest dimensions is guided bone regeneration (GBR); however, existing membranes have certain limitations. To address this issue, we aimed to compare the effectiveness of a resorbable bilayer membrane composed of poly(l-lactic acid) and poly(-caprolactone) （PLACL）with that of a collagen membrane（COL） in a rat GBR model. The rat calvaria was used as an experimental model by placing a plastic cylinder. Forty male Fisher rats underwent surgery, and micro-computed tomography and histomorphometric analyses were performed to assess bone regeneration. The results showed that bone regeneration was similar across all the groups. However, after 24 weeks, the PLACL membrane demonstrated significant resilience, occasional partial degradation, and intermittent air bubble formation. This extended preservation of the barrier effect has great potential to facilitate optimal bone regeneration. In conclusion, this study shows that the PLACL membrane is a promising alternative to GBR. By providing a durable barrier and supporting bone regeneration over an extended period, this resorbable bilayer membrane may address the limitations of the current membranes. Further studies and clinical trials are warranted to validate the efficacy and safety of this drug in humans.

The objective of this study was to compare the distribution of stress in the maxillary bone, dental implants, and prosthetic components supporting implant-supported maxillary overdentures with partial palatal coverage, in both splinted and unsplinted designs. Two models of maxillary overdentures were designed using the Exocad Dental CAD program, which included cancellous and cortical bone. The complete denture design and abutments (locator abutments in the unsplinted and Hader bar with Vertix attachments placed distally in the splinted variant) were also designed. The denture material was PEEK (Polyetheretherketone), and the method used to analyze patient-specific 3D X-ray scans was 3D QCT/FEA (Three-dimensional Quantitative Computed Tomography-Based Finite Element Analysis). Loading was divided into three load cases: frontal region (both incisors of the denture) and distal region (both molars and first premolar of the denture). The forces applied were 150 N with an oblique component with a buccal inclination of 35° in the frontal region, and 600 N with a buccal inclination of 5° (molars) or solely vertical (premolar) in the distal region. The model with locator abutments showed higher stresses in all load cases in both analyzed implant variants and in the maxilla. The differences in stress distribution between the splinted and unsplinted variants were more significant in the distal region. According to the results of the present study, the amount of stress in bone tissue and dental implant parts was smaller in the splinted, bar-retained variant. The findings of this study can be useful in selecting the appropriate prosthetic design for implant-supported maxillary overdentures with partial palatal coverage.

Background: Implant surface topography is a key element in achieving osseointegration. Nanostructured surfaces have shown promising results in accelerating and improving bone healing around dental implants. The main objective of the present clinical and histological study is to compare, at 4 and 6 weeks, (w) bone-to-implant contact in implants having either machined surface (MAC), SLA medium roughness surface or a Nanostructured Calcium-Incorporated sur-face (XPEED®). Methods: 35 mini-implants with 3 different surface treatments (XPEED® (n=16) – SLA (n=13) – Machined (n=6), were placed in the posterior maxilla of 11 patients then, retrieved at either 4 or 6w in a randomized split-mouth study design. Results: The BIC rate measured at 4 and 6w respectively, was: 16.8 % (±5.0) and 29.0 % (±3.1) for MAC surface; 18.5 % (±2.3) and 33.7 % (±3.3) for SLA surface; 22.4 % (±1.3) and 38.6 % (±3.2) for XPEED® surface. In all types of in-vestigated surfaces, the time factor appeared to significantly increase the BIC rate (p < .05). XPEED® surface showed a significantly higher values when compared to both SLA and MAC values at 4w (p < .05). Also, at 6w, both roughened surfaces (SLA and XPEED® ) showed signifi-cantly higher values (p < .05) than turned surface (MAC). Conclusion: Nanostructured Calcium titanate coating is able to enhance bone deposition around implants at early healing stages.

An ongoing EU Horizon 2020 Project called BionicVEST is investigating the effect of constant electrical stimulation (ES) of the inferior vestibular nerve in patients with bilateral vestibular dysfunction (BVD)[1]. The evidence is that constant ES results in improved postural stability and gait performance and so the question of central importance is how could constant ES of mainly saccular afferents in these BVD patients cause this improved performance? We suggest that the constant ES is substituting for the absent saccular neural input to the vestibular nuclei and the cerebellum in these BVD patients and indirectly via these structures to other structures which have been of great recent interest in motor control. One target area, the anterior midline cerebellum (the uvula) has recently been targeted as a location for deep brain stimulation in human patients to improve postural stability and gait. There are projections from midline cerebellum to basal ganglia including the striatum, structures involved in the initiation of gait. It may be that the effect of this activation of peripheral saccular afferent neurons is analogous to the effect of deep brain stimulation (DBS) by electrodes in basal ganglia acting to help alleviate the symptoms of patients with Parkinson's disease.

Cadaver bone is possibly the most common transplant material used today. Common types of cadaver bone transplants are freeze dried bone allografts and xenografts. In the case of freeze dried bone allograft transplants, it was theorized that these materials mineralize by way of osteoinduction and stimulating osteogenesis. However, these theories have been proven false. It has been proposed that these materials mineralize via osteoconduction however, there are no studies to support this hypothesis. This study was undertaken to determine how these transplants mineralize and what type of bone they produce. Materials and Methods: This study is a histological analysis of human cadaver bone graft healing from the incipient stages of mineralization through completed mineralization. All cadaver bone grafts used for evaluation in this study were particulate bone graft materials in the maxilla or mandible. No block grafts were evaluated. Results: The mineralization of cadaver bone transplants was produced by an inflammatory response to the transplanted tissue. The histologic findings of the mineralized bone produced by this process was sclerotic bone. No resorption of cadaver bone graft particles was found. When loaded the sclerotic bone was found to fail through an accumulation of microfractures.Conclusions: Particulate freeze-dried bone allografts and xenografts do not heal via the normal processes of mineralization. Cadaver bone grafts produce significant inflammation and are hypothesized to mineralize by a process termed antigenic ossification. The process of antigenic ossification produces sclerotic bone that is not capable of self-repair which can ultimately lead to bone failure.

Implant-supported-screw-retained prostheses are really popular. Some of the most frequent complications have been mechanical complications. These include abutment screw loosening or even screw fracture. Using an intermediate abutment can offer several advantages. However, little literature has been found regarding how this affects the mechanical behavior of dental restorations. This study focuses on understanding the mechanical behavior of implant-supported restorations with a transepithelial component compared to those with a direct implant-supported restoration. It was carried out by using the Finite Element Method (FEM) and was experi-mentally validated. The results showed that in the case of transepithelial-supported restoration, the prosthetic screw mounted over the transepithelial component suffers higher stress than the one screwed directly to the implant. After applying a cyclic fatigue load, it is experimentally proven that, in the transepithelial-supported restorations, the fuse changes from being the screw that goes to the implant, to being the upper one. As a conclusion we can say that the use of an intermediate abutment in dental restoration not only provides better protection to the rest of the dental restoration but also allows easier repair in the event of a fracture. This can potentially lead to more efficient procedures and improved patient outcomes.

Breast cancer is the most common cancer in women globally, often necessitating mastectomy and subsequent breast reconstruction. Silicone mammary implants (SMIs) play a pivotal role in breast reconstruction, yet their interaction with the host immune system and microbiome remains poorly understood. This study investigates the impact of SMI surface topography on host antimicrobial responses, wound proteome dynamics, and microbial colonization. Biological samples were col-lected from ten human patients undergoing breast reconstruction with SMIs. Mass spectrometry profiles were analyzed for acute and chronic wound proteomes, revealing a nuanced interplay between topography and antimicrobial respondseproteins. 16S rRNA sequencing assessed mi-crobiome dynamics, unveiling topography-specific variations in microbial composition. Surface topography alterations influenced wound proteome composition. Microbiome analysis revealed heightened diversity around rougher SMIs, emphasizing topography-dependent microbial inva-sion. In vitro experiments confirmed staphylococcal adhesion, growth, and biofilm formation on SMI surfaces, with increased texture correlating positively with bacterial colonization. This comprehensive investigation highlights the intricate interplay between SMI topography, wound proteome dynamics, and microbial transmission. The findings contribute to understanding host-microbe interactions on SMI surfaces, essential for optimizing clinical applications and minimizing complications in breast reconstruction.

Background: In most cases, intra-labyrinthine schwannoma (ILS) occurs in patients with unilateral hearing deterioration or neurofibromatosis type II (NF II). The pattern of localization of these tumors is various but affects mostly the cochlea. Extirpation of the ILS, if hidden by the cochlea modiolus, is difficult under the aspect of complete removal. Therefore, a tissue removal device (TRD) was designed and tested in temporal bones. The principle of handling the new device is a pushing and pipe cleaner handling inside the cochlea. This present study aimed to describe the first in vivo experience with the newly developed TRD for removing cochlear intra-labyrinthine schwannoma. Methods: In three patients, the TRD was used for the tumor removal of ILS. In two patients with a cochlear schwannoma in combination with a cochlea implantation and one patient suffering from NF II, a cochlear schwannoma was removed with the TRD. The access was performed with a posterior tympanotomy, an enlarged round window approach, and an additional second-turn access. The device was inserted and extracted gradually from the second turn access until the rings were visible in the second turn access. By pushing and pipe cleaner handling, the tumors were removed. An MRI control was performed on the day postoperatively with a T1 GAD sequence. Results: Tumor removal with the TRD was performed in a 15-minute procedure. MRI control confirmed a complete removal on the postoperative day in both cases. Conclusion: In vivo handling of the device confirmed a straightforward handling for tumor removal. MRI scanning showed a complete removal of the tumor by the TRD.

Among hearing aid (HA) users, there is a considerable variability in word-recognition scores (WRS). This variability is most pronounced among individuals with moderately severe to severe hearing loss. The variability cannot be adequately explained by factors such as the pure-tone audiogram, audiogram type, or age. This prospective study was designed to investigate the relationship between tone decay (TD) and WRS in a group of HA users with corresponding pure-tone hearing loss. The study population included 22 patients with hearing loss between 50 and 80 dB HL. Aided WRS, unaided WRS and TD were assessed for both ears. TD was found to be frequency-dependent. TD and WRS were correlated, with up to R=–0.66. The TD test was revealed as a feasible method for explaining the variability in WRS among HA users with hearing loss below 80 dB. This may contribute to improved differential diagnostics. The TD test may thus offer a better understanding of the limitations of HA use in the context of cochlear implant candidacy assessment for HA users.

Dental implantology has evolved greatly as a result of the application of biomechanical engineering concepts, notably the utilization of additive manufacturing technologies that recreate the intricate architecture of real bone. This technique intends to improve functional compatibility with bone tissue while also addressing continuing problems of stress distribution inside dental implants. The research examines two types of dental implants: fully gyroid latticed and hybrid gyroid latticed with a solid neck, comprising three different cell sizes—FI-111, FI-222, FI-333, and their hybrid equivalents HI-111, HI-222, and HI-333. Traditional solid implants often cause stress shielding, which reduces long-term osseointegration and implant durability. Developed using nTopology for lattice configuration and meshing, this design undergoes a comprehensive stress analysis using finite element analysis (FEA). The study seeks to determine the most efficient implant design by maximizing stress distribution and mechanical stiffness. Analyses suggest that hybrid latticed implants, notably the HI-222 type, possess superior mechanical characteristics. These implants successfully balance stiffness and flexibility, reducing stress concentrations and improving stress distribution throughout the implant structure. This balance is critical for decreasing micromotions at the bone-implant interface, boosting osseointegration, and, ultimately, increasing implant longevity and success rates in clinical settings. The paper describes a substantial redesign of dental implants by combining biomechanical engineering and modern additive manufacturing. The novel proposed hybrid structure not only addresses typical challenges such as stress shielding, but it also establishes new standards in implantology, potentially leading to better clinical results and patient quality of life. This complete approach emphasizes the ability of personalized implant designs to fulfill individual clinical demands, indicating a significant improvement in dental treatment technology.

Hypoglossal nerve stimulator (HGNS) is a minimally invasive device used for treating obstructive sleep apnea (OSA). The conventional implantable HGNS is a device that consists of a stimuli generator, a breathing sensor, and electrodes connected to the hypoglossal nerve via leads. However, this implant is bulky and causes significant trauma. In this paper, we propose a minimally invasive HGNS based on an electrocardiogram (ECG) sensor and a wireless power transfer (WPT), consisting of a wearable breathing monitor and an implantable stimulator. The breathing external monitor utilizes an ECG sensor to identify abnormal breathing patterns associated with OSA with 88.68$\%$ accuracy, achieved through the utilization of a Convolutional Neural Network (CNN) algorithm. With a skin thickness of 5mm and a receiving coil diameter of 9mm, the power conversion efficiency was measured at 31.8$\%$. The implantable device, on the other hand, is composed of a front-end CMOS Power Management Module (PMM), a Binary Phase Shift Keying (BPSK)-based data demodulator, and a bipolar biphasic current stimuli generator. The PMM, with a silicon area of 0.06 $mm^2$ (excluding pads), demonstrates a power conversion efficiency of 77.5$\%$ when operating at a receiving frequency of 2 MHz. Furthermore, it offers three-voltage options (1.2V, 1.8V, and 3.1V). Within the data receiver component, a low-power BPSK demodulator has been ingeniously incorporated, consuming only 42 $\mu$W when supplied with a voltage of 0.7V. The performance is achieved through the implementation of the self-biased phase-locked loop (PLL) technique. The stimuli generator delivers biphasic constant currents, providing a 5-bit programmable range spanning from 0 to 2.4 mA. The functionality of proposed ECG and WPT-based HGNS was validated, representing a highly promising solution for the effective management of OSA, all while minimizing trauma and space requirements.

Irrigation and debridement using an irrigation solution is a fundamental step during the surgi-cal treatment of both acute and chronic periprosthetic joint infection (PJI). However, there is no consensus on the optimal solution, nor is there sufficient evidence on optimal irrigation time and combination of solutions. Therefore, it is necessary to determine which solution or combi-nation of solutions is most efficacious against biofilm, as well as the optimal irrigation time. We conducted an experimental in vitro model by inoculating stainless steel discs with ATCC strains of methicillin-susceptible Staphylococcus aureus, methicillin-resistant S. aureus, Pseudomonas aeru-ginosa, and a clinical strain of Staphylococcus epidermidis. The discs were all irrigated with com-monly used antiseptic solutions (10% and 3% povidone iodine, hydrogen peroxide, 3% acetic ac-id, and Bactisure™) for 1 min, 3 min, and 5 min and their combinations for 9 min (3 min each) vs. sterile saline as a positive control. We evaluated the reduction in biofilm based on colony form-ing unit (cfu) counts and, in combination assays, also based on cell viability and scanning elec-tron microscopy. All antiseptics alone reduced more than 90% of cfu counts after 1 min of irriga-tion; the worst results were for hydrogen peroxide and 3% acetic acid. When solutions were combined, the best results were observed for all those starting with acetic acid, in terms of both reduction of log cfu/ml counts and viable cells. We consider that a combination of antiseptic so-lutions, particularly that comprising the sequence acetic acid+povidone iodine+hydrogen per-oxide, would be the best option for chemical debridement during PJI surgery.

Background - Mandibular flexion (MF) is a complex biomechanical phenomenon, which involves a deformation of the mandible, due mainly to the contraction of the masticatory muscles, and can have numerous clinical effects. The main aim of the current systematic review is to highlight the different factors that can increase MF, to help clinicians, identify patients to whom they should pay more attention. As a secondary outcome, we wanted to analyze the preventive measures and suitable techniques to be adopted to minimize the negative effects of this phenomenon on oral fixed rehabilitations. Methods - The review, which was carried out in accordance with the “Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) flowchart, was recorded in the “International Prospective Register of Systematic Reviews” (PROSPERO). As research questions, “Patient/Population, Intervention, Comparison and Outcomes” (PICO) questions were employed. Using the ROBINS-I technique, the risk of bias in non-randomized clinical studies was evaluated. Results - The initial electronic search identified over 1300 potential articles, of which 54 studies were included in this systematic review. Information regarding the relationship between MF and individual factors, mandibular movements, impression-taking and fixed rehabilitations were obtained. Conclusions – The studies included in this systematic review showed that MF is greater during protrusive movements, in the posterior areas of the lower jaw, and in patients with brachial facial type, greater jaw length, small gonial angle and less density, length and bone surface of the symphysis. The biomechanical effects of mandibular flexion on fixed restorations are debated. Prospective clinical and radiological observational studies should be conducted to evaluate the potential short-, medium- and long-term consequences of MF.

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 &lt;0.01) and the different implant insertion torques (p &lt;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.

In recent years extensive studies have been continuously undertaken on the design of bioactive and biomimetic dental implant surfaces due to the need for improvement of the implant-bone interface properties. In this paper, the titanium dental implant surface was modified by a bioactive vitamin D3 coating prepared by self-assembly process. Surface characterization of the modified implant was performed by field emission scanning electron microscopy (FE-SEM), attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR), and contact angle measurements (CA). Implant’s electrochemical stability during exposure to an artificial saliva solution was monitored in situ by electrochemical impedance spectroscopy (EIS). Experimental results obtained were corroborated by means of quantum chemical calculations at the density functional theory level (DFT). The formation mechanism of the coating onto the titanium implant surface was proposed. During a prolonged immersion period, the bioactive vitamin D3 coating effectively prevented the underlying titanium from corrosive attack (polarization resistance in order of 10⁷ Ω cm²) with ~95% protection effectiveness.

Purpose: The aim of the present experimental 3D-finite element study was to evaluate the influence of an augmented sinus lift with an additional inserted bone graft block. The bone graft block stabilizes the implant in addition to conventional augmented bone. We placed the block in three different positions. The implants were loaded with axial force and forces secondary to laterotrusion and protrusion. Material and Methods: A simplified U-shaped 3D finite element model of the upper jaw and a more complex anatomical model of the left maxilla were created. The bone graft block was placed in three positions: in the lower third in contact with the sinus floor, the middle, and the upper third of the implant. Van Mises’ stress distribution was calculated and analyzed for the different models. We also compared the complex anatomical model with the simplified one. Results: The position of the bone graft block significantly influences the magnitude of stress distribution. A bone graft block positioned in the upper third or middle of the implant reduces the quantity of stress compared to the reference model without a bone graft block. The low bone graft block position is clearly associated with lower stress distribution in compact bone. We registered no significant differences in stress in compact bone with regard to laterotrusion or protrusion. Conclusions: Maximum values of von Mises stresses in compact bone can be reduced significantly by using a bone graft block. The reduction of stress is nearly the same for positions in the upper third and the middle of the implant. It is much more pronounced when the bone graft block is in the lower third of the implant near the sinus floor, which appeared to be the best position in the present study.

Infections are a common post-operative ailment for patients who have received a dental implant or device and can be attributed to biofilm formation in tissue or on the implant. Many current solutions for oral hygiene have side effects and affect the natural oral microbiome. 2-heptylcyclopropane-1-carboxylic acid (2CP) is a medium-chain fatty acid and synthetic diffusible signaling factor that can prevent and disperse biofilm. The purpose of this work was to evaluate an immersion strategy for coating hydroxyapatite (HAp) with 2CP to prevent biofilm attachment on and around natural teeth and dental implants. The release profile of 2CP-loaded and 2CP+oral rinse-loaded HAp coupons (n=6) was assessed by a 3-day exposure to phosphate buffered saline (PBS). Antimicrobial properties against Porphyromonas gingivalis and cytocompatibility of 2CP-loaded HAp coupons (n=4) were also assessed alone and in combination with 0.12% chlorhexidine gluconate oral rinse. The majority of 2CP is released by 12 hours. 2CP, oral rinse, and 2CP+oral rinse significantly reduced P. gingivalis viability, though direct contact assay demonstrates a significant reduction in Saos-2 viability for oral rinse and 2CP+oral rinse coupons. Immersion or rinsing hydroxyapatite with 2CP could inhibit biofilm-associated dental infections and prevent further complications including caries, gingivitis, and peri-implantitis.

Some evidence supports the influence of the implant macro-design and primary stability. Additionally, tactile perception can be used to assess implant stability when placing the implant. This research aimed to quantify the primary and secondary stability of three implant systems with two different macro geometries (cylindrical and conical) determined through the insertion torque and the implant stability quotient (ISQ) at the moment of implant placement as a function of implant-related factors (length, width, dental arch, and implant location in the arch), intraoperative factors (bone density determined subjectively by the clinician's tactile perception), and patient-related factors (age, gender and bone density determined objectively in the cone beam computed tomography (CBCT). Methods: 102 implants of three implant systems with two different macro geometries (conical and cylindrical) were placed in 53 patients. The insertion torque, the ISQ at the implant placement (ISQ0), and bone quality according to the clinician's tactile sensation were recorded on the day of the surgery. After a three-month healing period, the ISQ was re-evaluated (ISQ3). Results: Cylindrical implants exhibited significantly higher insertion torque and ISQ at the moment of the surgery and after three months than conical implants. Cylindrical implants also showed significantly lower indices of tactile evaluation of bone quality during the implant placement surgery. However, no differences were demonstrated in the bone density measured objectively in the CBCT. (4) Conclusions: The cylindrical implants achieved the highest values for primary stability (Ncm and ISQ) and secondary stability (ISQ after three months). Insertion torque was the variable that most influenced ISQ on the day of the surgery. Implant location (incisors-canines, bicuspids-molars) and the implant macro geometry were the variables that most influenced the secondary stability (ISQ at three months).

This review article deals with the design of bioactive calcium phosphate coatings deposited on metallic substrates to produce bone implants. The bioceramic coating properties are used to create a strong bonding between the bone implants and the surrounding bone tissue. They provide a fast response after implantation and increase the lifespan of the implant in the body environment. The first part of the article describes the different compounds belonging to the calcium phosphate family and their main properties for applications in biomaterials science. The calcium to phosphorus atomic ratio (Ca/P)at. and the solubility (Ks) of these compounds define their behavior in a physiological environment. Hydroxyapatite is the gold standard among calcium phosphate materials, but other chemical compositions/stoichiometries have also been studied for their interesting properties. The second part reviews the most usual deposition processes to produce bioactive calcium phosphate coatings for bone implant applications. Plasma spraying is the main industrial process, but magnetron sputtering, pulsed laser deposition, electrospray deposition, electrophoretic deposition, and electrodeposition are also widely studied in academic and industrial research. The last part describes the main physicochemical properties of calcium phosphate coatings and their impact on the bioactivity of bone implants in a physiological environment.

Fatigue analysis plays a vital role in determining the structural integrity and life of a dental implant. With the use of such implants on the rise, there is a corresponding increase in the number of implant failures. As such, the aim of this research paper is to investigate the life of 3D-printed dental implants. The dental implants considered in this study were 3D printed according to the direct metal laser sintering (DMLS) method. Additionally, a finite element model was developed to study their performance, while fatigue life was predicted using Fe-Safe software®. The model was validated experimentally by performing fatigue tests. The life of the dental implants was analysed based on Normal strain and the Brown-Miller with Morrow mean correction factor algorithm. The model revealed that there was a strong correlation between the FEA and the experimental results. The clinical success of 3D-printed dental implant experimentally is 20.51 years and computationally under Normal strain is 19.89 years and Brown-Miller with Morrow mean correction factor is 26.82 years.

Cloud Computing is a promising and emerging technology that is rapidly being adopted by many IT companies due to a number of benefits that it provides, such as large storage space, low investment cost, virtualization, resource sharing, etc. Users are able to store a vast amount of data and information in the cloud and access it from anywhere, anytime on a pay-per-use basis. Since many users are able to share the data and the resources stored in the cloud, there arises a need to provide access to the data to only those users who are authorized to access it. This can be done through access control schemes which allow the authenticated and authorized users to access the data and deny access to unauthorized users. In this paper, a comprehensive review of all the existing access control schemes has been discussed along with analysis. Keywords: role-based access control, attribute-based access control, attribute-based encryption

Can the type of implant rehabilitation influence peri-implant bone loss in case of full-arch mandibular prosthesis? The purpose of the study was to assess, by orthopantomograms (OPG), bone loss around implants in different types of implant-supported prosthetic rehabilitations and evaluate potential risk factors associated with the number and location of implants that may have an association with bone defect. A radiographic study was conducted on 22317 OPGs in the time range from 2010 to 2024. All OPGs with implant-supported prosthetic mandibular rehabilitations were included in the study. A total of 155 OPGs were evaluated, with peri-implant bone loss identified in 64 (41.3%). Distal implants (furthest from the center) across various positioning patterns were most susceptible to bone loss, with positions 3.6 and 4.6 demonstrating the most frequent occurrences (25 and 26 cases, respectively). χ² test revealed significant associations between both implant positioning pattern (p &lt; 0.001) and number of implants (p &lt; 0.001) with peri-implant bone loss. Also by updating the sample of OPGs, increased susceptibility to bone resorption was found for implants placed distal to the mental foramen compared to mesial ones in full-arch implant-supported fixed prostheses. Prospective clinical studies will then be useful to investigate this finding further.

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.

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.

Electric stimulation via a Cochlear Implant (CI) enables people with severe to profound sensorineural hearing loss to regain speech understanding and music appreciation and thus allowing them to actively engage in social life. Three main manufacturers (Cochlear, MED-EL and Advanced Bionics “AB”) have been offering CI systems, thus challenging CI recipients and Otolaryngologists with a difficult decision, as currently no comprehensive overview or meta-analyses on performance outcome following CI implantation is available. The main goal of this scoping review is to provide evidence that data and standardized speech and music performance tests are available for performing such comparisons. To this end, a literature search was conducted to find studies that address speech and music outcomes in CI recipients. From a total of 1592 papers, 188 paper abstracts were analyzed and 147 articles were found suitable for examination of full text. From which, 42 studies were included for synthesis. A total of 16 studies used the consonant-nucleus-consonant (CNC) word recognition test in quiet at 60db SPL. We found that aside from technical comparisons, only very few publications compare speech outcomes across manufacturers of CI systems. Evidence suggests though, that these data are available in large CI centers in Germany and US. Future studies should therefore leverage large data cohorts to perform such comparisons that could provide critical evaluation criteria and assist both CI recipients and Otolaryngologists to make informed performance-based decisions.

Background: The objective of the present study was to evaluate the formation of biofilm in bone patellar tendon bone grafts (BPTB grafts) and to compare it to the formation of biofilm formation in quadrupled hamstring anterior cruciate ligament grafts (4xHt graft). Methods: A descriptive in vitro study was conducted. One 4xHt graft and one BPTB graft were prepared. They were then contaminated with a strain of S. epidermidis. Later, a quantitative analysis was carried out by means of microcalorimetry and sonication with plating. Additionally, a qualitative analysis was carried out by means of electron microscopy. Results: No significant differences were found between the bacterial growth profiles of 4xHt graft and BPTB graft in microcalorimetry and colony counting. In the samples analyzed with electron microscopy, no specific biofilm growth pattern was identified upon comparing BPTB graft to 4xHt graft. Conclusions: There were no significant differences at either the quantitative or qualitative level when comparing bacterial growth in BPTB graft to that in 4xHt graft. Therefore, the presence of sutures in 4xHt graft cannot be established as a predisposing factor for increased biofilm growth in this in vitro study.