Pub Date : 2024-07-25DOI: 10.3390/prosthesis6040060
Mackenzie Smeeton, G. Isaac, Ruth Wilcox, James Anderson, T. Board, D. V. Van Citters, Sophie Williams
Despite their emerging use, the in vivo behaviour of dual-mobility (DM) total hip replacements (THRs) is not well understood. Therefore, the purpose of this study was to assess the articulating surfaces of 20 early-retrieved DM polyethylene liners (mean length of implantation 20.0 ± 18.8 months) for damage to improve the current understanding of their in vivo functional mechanisms. The internal and external surfaces of each liner were visually and geometrically assessed, and the material composition of embedded debris particles were further characterized. Scratching and pitting were the most common modes of damage identified on either surface, and a high incidence of burnishing (50%) and embedded debris (65%) were observed on the internal and external surfaces, respectively. Embedded debris particles were commonly titanium- or iron-based, although other materials such as cobalt-chrome and tantalum were also identified. The geometric assessment demonstrated highly variable damage patterns across the liners, with the internal surfaces commonly presenting with crescent-shaped, circumferential, or circular regions of penetration whilst the external surfaces commonly presented with regions of deep pitting or gouging. This study demonstrates that DM-THRs primarily articulate at the head/liner junction, and that polyethylene liners are capable of rotating about the femoral neck axis, although the extent of this may be limited in some cases. Additionally, this study suggests that intra-prosthetic dislocation and edge loading may remain pertinent failure mechanisms of DM implants despite the advent of highly crosslinked polyethylene and design features, thus highlighting the need for enhanced monitoring of these devices.
{"title":"Analysis of Early-Retrieved Dual-Mobility Polyethylene Liners for Total Hip Replacement","authors":"Mackenzie Smeeton, G. Isaac, Ruth Wilcox, James Anderson, T. Board, D. V. Van Citters, Sophie Williams","doi":"10.3390/prosthesis6040060","DOIUrl":"https://doi.org/10.3390/prosthesis6040060","url":null,"abstract":"Despite their emerging use, the in vivo behaviour of dual-mobility (DM) total hip replacements (THRs) is not well understood. Therefore, the purpose of this study was to assess the articulating surfaces of 20 early-retrieved DM polyethylene liners (mean length of implantation 20.0 ± 18.8 months) for damage to improve the current understanding of their in vivo functional mechanisms. The internal and external surfaces of each liner were visually and geometrically assessed, and the material composition of embedded debris particles were further characterized. Scratching and pitting were the most common modes of damage identified on either surface, and a high incidence of burnishing (50%) and embedded debris (65%) were observed on the internal and external surfaces, respectively. Embedded debris particles were commonly titanium- or iron-based, although other materials such as cobalt-chrome and tantalum were also identified. The geometric assessment demonstrated highly variable damage patterns across the liners, with the internal surfaces commonly presenting with crescent-shaped, circumferential, or circular regions of penetration whilst the external surfaces commonly presented with regions of deep pitting or gouging. This study demonstrates that DM-THRs primarily articulate at the head/liner junction, and that polyethylene liners are capable of rotating about the femoral neck axis, although the extent of this may be limited in some cases. Additionally, this study suggests that intra-prosthetic dislocation and edge loading may remain pertinent failure mechanisms of DM implants despite the advent of highly crosslinked polyethylene and design features, thus highlighting the need for enhanced monitoring of these devices.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":"29 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141806142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.3390/prosthesis6040061
D. Tigani, Enrico Ferranti Calderoni, M. Berti, S. Comitini, L. Amendola, G. Pipino, Giuseppe Melucci
Background: Total knee arthroplasty (TKA) for poliomyelitis patients is controversial due to its higher complication rate compared with that of TKA for osteoarthritis. In this study we evaluated the results, at a minimum of 10 years, of a consecutive series of third-generation rotating hinge total knee arthroplasties (RHKs) in patients affected by poliomyelitis. Methods: We conducted a retrospective analysis of 14 patients (15 TKA) performed between January 2000 and October 2021 that underwent a third-generation rotating hinge arthroplasty (Nex Gen RHK Zimmer). The clinical results using the American Knee Society Score (AKSS) were evaluated at an average follow-up of 154 months (min 120–max 216 months). Result: Of the 15 cases, 2 were lost at follow-up and 1 was excluded by the final evaluation due to infection. Of the remaining 12 cases at the final follow-up, the average AKKS clinical score improved from 30.08 points preoperatively, to 78.83 points postoperatively, while the average AKKS function score improved from 29.17 points to 56.25 points. We report only one intraoperative complication consisting of a femoral fracture at the tip of the stem, and a case of patellar fracture occurred 3 months after the index procedure. The presence of radiolucent lines was sporadic, while radiosclerotic lines were commonly visible around the stem extension, predominantly at the tip. Conclusions: The third generation of rotating hinge knee replacement has proved to be effective in polio patients, improving clinical and functional scores, and no cases of mechanical failure occurred.
{"title":"Long-Term Results of Third Generation of Rotating Hinge Arthroplasty in Patients with Poliomyelitis","authors":"D. Tigani, Enrico Ferranti Calderoni, M. Berti, S. Comitini, L. Amendola, G. Pipino, Giuseppe Melucci","doi":"10.3390/prosthesis6040061","DOIUrl":"https://doi.org/10.3390/prosthesis6040061","url":null,"abstract":"Background: Total knee arthroplasty (TKA) for poliomyelitis patients is controversial due to its higher complication rate compared with that of TKA for osteoarthritis. In this study we evaluated the results, at a minimum of 10 years, of a consecutive series of third-generation rotating hinge total knee arthroplasties (RHKs) in patients affected by poliomyelitis. Methods: We conducted a retrospective analysis of 14 patients (15 TKA) performed between January 2000 and October 2021 that underwent a third-generation rotating hinge arthroplasty (Nex Gen RHK Zimmer). The clinical results using the American Knee Society Score (AKSS) were evaluated at an average follow-up of 154 months (min 120–max 216 months). Result: Of the 15 cases, 2 were lost at follow-up and 1 was excluded by the final evaluation due to infection. Of the remaining 12 cases at the final follow-up, the average AKKS clinical score improved from 30.08 points preoperatively, to 78.83 points postoperatively, while the average AKKS function score improved from 29.17 points to 56.25 points. We report only one intraoperative complication consisting of a femoral fracture at the tip of the stem, and a case of patellar fracture occurred 3 months after the index procedure. The presence of radiolucent lines was sporadic, while radiosclerotic lines were commonly visible around the stem extension, predominantly at the tip. Conclusions: The third generation of rotating hinge knee replacement has proved to be effective in polio patients, improving clinical and functional scores, and no cases of mechanical failure occurred.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":"16 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141803553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-18DOI: 10.3390/prosthesis6040059
James Carlos Nery, Patrícia Manarte-Monteiro, Leonardo Aragão, Lígia Pereira da Silva, Gabriel Silveira Pinto Brandão, B. F. Lemos
Dental rehabilitation with implants is a clinical reality in clinical practice. The Interproximal Contact Loss (ICL) between implant-supported prostheses adjacent to natural teeth is a relatively common occurrence. This systematic review and meta-analysis aims to evaluate the possible clinical effects of the periodontium regarding the ICL between teeth and implanted-supported prostheses. We also identified the main ICL assessment tools described in the literature. This study was registered on the PROSPERO (CRD42023446235), was based on the PICO strategy, and followed the PRISMA guidelines. An electronic search was carried out in the PubMed, B-on, Google Scholar, and Web of Science databases without setting a time limit for publications. Only systematic reviews and comparative clinical trials were included and analyzed. Nineteen publications were eligible for meta-analysis, with thirteen retrospective and six prospective clinical trials. A total of 2047 patients and 7319 prostheses in function were evaluated, and ICL was found in 51% with a confidence interval of 0.40 to 0.61. As ICL assessment tools, dental floss was used in 65%, matrices were used in 30%, and X-ray images were used in 5% of cases. The clinical follow-up ranged from 1 to 21 years, with 50% between 1 and 3 years, 25% between 3 and 10 years, and 25% between 10 and 21 years. ICL was found to occur more frequently in the mandible. No statistically significant difference existed between the anterior (55%) and posterior (47%) oral regions. On the mesial surface, ICL ranged from 13% to 81.4%, possibly due to the different follow-up periods and the diversity of methods used in the assessment. No differences were found for ICL between single or multiple implanted-supported prostheses. Food impaction was the most common effect of ICL and was more prevalent on the implant-supported prosthesis’s mesial surface in the mandible’s posterior region. There was evidence of peri-implant mucositis but without progression to peri-implantitis, and the form of retention or the number of elements was not relevant.
{"title":"Clinical Effects of Interproximal Contact Loss between Teeth and Implant-Supported Prostheses: Systematic Review and Meta-Analysis","authors":"James Carlos Nery, Patrícia Manarte-Monteiro, Leonardo Aragão, Lígia Pereira da Silva, Gabriel Silveira Pinto Brandão, B. F. Lemos","doi":"10.3390/prosthesis6040059","DOIUrl":"https://doi.org/10.3390/prosthesis6040059","url":null,"abstract":"Dental rehabilitation with implants is a clinical reality in clinical practice. The Interproximal Contact Loss (ICL) between implant-supported prostheses adjacent to natural teeth is a relatively common occurrence. This systematic review and meta-analysis aims to evaluate the possible clinical effects of the periodontium regarding the ICL between teeth and implanted-supported prostheses. We also identified the main ICL assessment tools described in the literature. This study was registered on the PROSPERO (CRD42023446235), was based on the PICO strategy, and followed the PRISMA guidelines. An electronic search was carried out in the PubMed, B-on, Google Scholar, and Web of Science databases without setting a time limit for publications. Only systematic reviews and comparative clinical trials were included and analyzed. Nineteen publications were eligible for meta-analysis, with thirteen retrospective and six prospective clinical trials. A total of 2047 patients and 7319 prostheses in function were evaluated, and ICL was found in 51% with a confidence interval of 0.40 to 0.61. As ICL assessment tools, dental floss was used in 65%, matrices were used in 30%, and X-ray images were used in 5% of cases. The clinical follow-up ranged from 1 to 21 years, with 50% between 1 and 3 years, 25% between 3 and 10 years, and 25% between 10 and 21 years. ICL was found to occur more frequently in the mandible. No statistically significant difference existed between the anterior (55%) and posterior (47%) oral regions. On the mesial surface, ICL ranged from 13% to 81.4%, possibly due to the different follow-up periods and the diversity of methods used in the assessment. No differences were found for ICL between single or multiple implanted-supported prostheses. Food impaction was the most common effect of ICL and was more prevalent on the implant-supported prosthesis’s mesial surface in the mandible’s posterior region. There was evidence of peri-implant mucositis but without progression to peri-implantitis, and the form of retention or the number of elements was not relevant.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141824346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hip replacement surgery is increasingly being performed on older patients, raising the risk of periprosthetic proximal femur fractures (PPFFs). While the impact of surgery timing on mortality in proximal femoral fractures is established, its effect on PPFFs remains unclear. This study aims to examine the correlation between surgery timing and mortality in PPFF patients. In a historical cohort study, we analyzed data from 79 PPFF patients treated from 2012 to 2022. Patients were categorized by surgery timing (≤48 h, 32 patients vs. >48 h, 47 patients). Outcomes and mortality rates were compared. No significant difference in mortality was observed between patients undergoing early (<48 h) and delayed (>48 h) surgery at 30 days and 1 year. Factors such as age (p = 0.154), gender (p = 0.058), ASA score (p = 0.893), Vancouver classification (p = 0.577), and surgery type (implant revision p = 0.691, OR = 0.667) did not affect 30-day mortality. However, 1-year mortality was influenced by gender (male p = 0.045) and age (p = 0.004), but not by other variables (Vancouver classification p = 0.443, implant revision p = 0.196). These findings indicate no association between surgery timing and mortality in PPFF patients, suggesting that other factors may influence outcomes. Further research is needed to optimize PPFF management.
越来越多的老年患者接受髋关节置换手术，从而增加了股骨近端假体周围骨折（PPFF）的风险。虽然手术时机对股骨近端骨折死亡率的影响已经确定，但其对 PPFF 的影响仍不明确。本研究旨在探讨手术时机与 PPFF 患者死亡率之间的相关性。在一项历史队列研究中，我们分析了从2012年到2022年接受治疗的79名PPFF患者的数据。患者按手术时间分类（≤48小时，32例；>48小时，47例）。对结果和死亡率进行了比较。早期（48小时）手术患者在30天和1年后的死亡率无明显差异。年龄（p = 0.154）、性别（p = 0.058）、ASA 评分（p = 0.893）、温哥华分级（p = 0.577）和手术类型（植入物翻修 p = 0.691，OR = 0.667）等因素对 30 天死亡率没有影响。然而，1 年死亡率受性别（男性 p = 0.045）和年龄（p = 0.004）的影响，但不受其他变量（温哥华分类 p = 0.443，植入物翻修 p = 0.196）的影响。这些研究结果表明，PPFF 患者的手术时机与死亡率之间没有关联，这表明其他因素可能会影响手术效果。要优化 PPFF 的管理，还需要进一步的研究。
{"title":"Mortality Rate in Periprosthetic Proximal Femoral Fractures: Impact of Time to Surgery","authors":"Jacopo Vittori, Norsaga Hoxha, F. Dettoni, Carolina Rivoira, Roberto Rossi, Umberto Cottino","doi":"10.3390/prosthesis6040058","DOIUrl":"https://doi.org/10.3390/prosthesis6040058","url":null,"abstract":"Hip replacement surgery is increasingly being performed on older patients, raising the risk of periprosthetic proximal femur fractures (PPFFs). While the impact of surgery timing on mortality in proximal femoral fractures is established, its effect on PPFFs remains unclear. This study aims to examine the correlation between surgery timing and mortality in PPFF patients. In a historical cohort study, we analyzed data from 79 PPFF patients treated from 2012 to 2022. Patients were categorized by surgery timing (≤48 h, 32 patients vs. >48 h, 47 patients). Outcomes and mortality rates were compared. No significant difference in mortality was observed between patients undergoing early (<48 h) and delayed (>48 h) surgery at 30 days and 1 year. Factors such as age (p = 0.154), gender (p = 0.058), ASA score (p = 0.893), Vancouver classification (p = 0.577), and surgery type (implant revision p = 0.691, OR = 0.667) did not affect 30-day mortality. However, 1-year mortality was influenced by gender (male p = 0.045) and age (p = 0.004), but not by other variables (Vancouver classification p = 0.443, implant revision p = 0.196). These findings indicate no association between surgery timing and mortality in PPFF patients, suggesting that other factors may influence outcomes. Further research is needed to optimize PPFF management.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-16DOI: 10.3390/prosthesis6040057
R. Sorrentino, M. I. Di Mauro, G. Ruggiero, R. Leone, E. Ferrari Cagidiaco, Marco Annunziata, Marco Ferrari, F. Zarone
The main objectives of the present prospective clinical study were to evaluate the survival and success rates of implant-supported zirconia single crowns fabricated with a full digital workflow for the rehabilitation of mono- and bilateral agenesis of maxillary lateral incisors after 2 years of clinical function; biological and technical parameters affecting the prosthetic restorations were recorded, as well as the patient-satisfaction score. Twenty-two patients showing mono- or bilateral agenesis of the maxillary lateral incisors were included in this study, and a total of 30 narrow-diameter implants were inserted. Thirty screw-retained monolithic cubic zirconia single crowns with internal connections were fabricated. Objective outcome evaluations were performed by means of the Functional Implant Prosthodontic Score, whereas the patient-satisfaction score was evaluated using Visual Analog Scales. Descriptive statistics were performed and the Kaplan–Meier analysis was run to analyze time-to-event data. After 2 years of clinical function, the overall FIPS found in the present study was 9.2, whereas the average patient-satisfaction score was 8.7. The Kaplan–Meier analysis at the 2-year follow-up reported a cumulative survival rate of 100% and a cumulative success rate of 93.3%. The implant-prosthetic rehabilitation with a full digital workflow proved to be an effective and reliable procedure for the functional and aesthetic treatment of the agenesis of maxillary lateral incisors in the short-term. Clinical investigations with wider sample populations and longer observational follow-ups could be useful to validate, in the long-term, the clinical outcomes of the present prospective clinical study.
{"title":"Implant-Prosthetic Rehabilitation of the Agenesis of Maxillary Lateral Incisors: A 2-Year Prospective Clinical Study with Full Digital Workflow","authors":"R. Sorrentino, M. I. Di Mauro, G. Ruggiero, R. Leone, E. Ferrari Cagidiaco, Marco Annunziata, Marco Ferrari, F. Zarone","doi":"10.3390/prosthesis6040057","DOIUrl":"https://doi.org/10.3390/prosthesis6040057","url":null,"abstract":"The main objectives of the present prospective clinical study were to evaluate the survival and success rates of implant-supported zirconia single crowns fabricated with a full digital workflow for the rehabilitation of mono- and bilateral agenesis of maxillary lateral incisors after 2 years of clinical function; biological and technical parameters affecting the prosthetic restorations were recorded, as well as the patient-satisfaction score. Twenty-two patients showing mono- or bilateral agenesis of the maxillary lateral incisors were included in this study, and a total of 30 narrow-diameter implants were inserted. Thirty screw-retained monolithic cubic zirconia single crowns with internal connections were fabricated. Objective outcome evaluations were performed by means of the Functional Implant Prosthodontic Score, whereas the patient-satisfaction score was evaluated using Visual Analog Scales. Descriptive statistics were performed and the Kaplan–Meier analysis was run to analyze time-to-event data. After 2 years of clinical function, the overall FIPS found in the present study was 9.2, whereas the average patient-satisfaction score was 8.7. The Kaplan–Meier analysis at the 2-year follow-up reported a cumulative survival rate of 100% and a cumulative success rate of 93.3%. The implant-prosthetic rehabilitation with a full digital workflow proved to be an effective and reliable procedure for the functional and aesthetic treatment of the agenesis of maxillary lateral incisors in the short-term. Clinical investigations with wider sample populations and longer observational follow-ups could be useful to validate, in the long-term, the clinical outcomes of the present prospective clinical study.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-21DOI: 10.3390/prosthesis6030039
E. Cumbo, Giuseppe Gallina, P. Messina, Luigi Caradonna, G. Scardina
In implantology, among the key choices, to obtain predictable results, it is essential to establish, using cone beam computed tomography (CBCT), the bone site and where to insert the implants; during the surgical phase, these sites must be identified on the oral mucosa. Surgical templates are a valid aid, especially in complex cases which require the insertion of more than three or four implants. In cases of a single implant, on the other hand, surgical guides are rarely used, and the implant is often inserted freehand; therefore, the identification of the implant site on the oral mucosa (after choosing the location on the CBCT) is more difficult. For this reason, the clinician uses the teeth in the arch as a reference. This study evaluates the ability of the human eye to identify, on the oral mucosa, where the implant collars will be positioned, the position of which has previously been chosen on the CBCT, in cases where the hands-free surgical technique (without surgical guides) is used. The verification of this precision is carried out using particular thermo-printed templates which contain radiopaque metal spheres. The results show that, in the freehand technique, it is difficult to precisely identify the implant sites (chosen via X-ray) on the mucosa, especially when they are far from natural teeth adjacent to the edentulous area. In case of monoedentulism, the freehand implant technique seems to be applicable by expert implantologists with a reduced risk of error; in fact, clinical experience helps to find the correct correspondence between the implant site chosen on the CBCT and its identification on the mucosa. The level of experience is fundamental in the clinician’s decision about 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.
在种植学的关键选择中，为了获得可预测的效果，必须使用锥形束计算机断层扫描（CBCT）确定骨部位和植入种植体的位置；在手术阶段，必须在口腔粘膜上确定这些部位。手术模板是一种有效的辅助工具，尤其是在需要植入三到四个以上种植体的复杂病例中。另一方面，在单颗种植体的病例中，很少使用手术导板，通常都是徒手植入种植体；因此，在口腔粘膜上识别种植体位置（在 CBCT 上选择位置后）更加困难。因此，临床医生使用牙弓中的牙齿作为参考。本研究评估了在使用免提手术技术（不使用手术导板）的情况下，人眼在口腔黏膜上识别种植体基台位置的能力。使用含有不透射线金属球的特殊热打印模板，可以验证这种精确性。结果表明，在徒手技术中，很难在粘膜上精确识别种植体位置（通过 X 射线选择），尤其是当种植体位置远离邻近缺牙区的天然牙齿时。事实上，临床经验有助于找到 CBCT 上选择的种植部位与粘膜上识别的正确对应关系。经验水平是临床医生决定是否使用手术导板的基础；事实上，经验不足的医生即使在最简单的病例中也应使用手术导板，以降低出错的风险。
{"title":"The Freehand Technique: The Ability of the Human Eye to Identify Implant Sites on the Patient","authors":"E. Cumbo, Giuseppe Gallina, P. Messina, Luigi Caradonna, G. Scardina","doi":"10.3390/prosthesis6030039","DOIUrl":"https://doi.org/10.3390/prosthesis6030039","url":null,"abstract":"In implantology, among the key choices, to obtain predictable results, it is essential to establish, using cone beam computed tomography (CBCT), the bone site and where to insert the implants; during the surgical phase, these sites must be identified on the oral mucosa. Surgical templates are a valid aid, especially in complex cases which require the insertion of more than three or four implants. In cases of a single implant, on the other hand, surgical guides are rarely used, and the implant is often inserted freehand; therefore, the identification of the implant site on the oral mucosa (after choosing the location on the CBCT) is more difficult. For this reason, the clinician uses the teeth in the arch as a reference. This study evaluates the ability of the human eye to identify, on the oral mucosa, where the implant collars will be positioned, the position of which has previously been chosen on the CBCT, in cases where the hands-free surgical technique (without surgical guides) is used. The verification of this precision is carried out using particular thermo-printed templates which contain radiopaque metal spheres. The results show that, in the freehand technique, it is difficult to precisely identify the implant sites (chosen via X-ray) on the mucosa, especially when they are far from natural teeth adjacent to the edentulous area. In case of monoedentulism, the freehand implant technique seems to be applicable by expert implantologists with a reduced risk of error; in fact, clinical experience helps to find the correct correspondence between the implant site chosen on the CBCT and its identification on the mucosa. The level of experience is fundamental in the clinician’s decision about 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.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":"30 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141117526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-20DOI: 10.3390/prosthesis6030038
M. Sapienza, Danilo Di Via, Marco Simone Vaccalluzzo, L. Costarella, V. Pavone, G. Testa
This retrospective cohort study assesses the effectiveness of straight-stem cementless versus cemented prostheses in hip replacement surgeries for elderly patients with femoral neck fractures. We analyzed 80 patients aged 70 and over who underwent surgery between 2018 and 2021. Clinical outcomes were evaluated using the Harris Hip Score, WOMAC Score, and Visual Analogue Scale, alongside radiological assessments through Brooker’s classification. Preoperative Dorr classification and five postoperative criteria (subsidence, cortical hypertrophy, pedestal sign, radiolucent lines, and stress shielding) were used to assess implant efficacy. The results demonstrated satisfactory mid-term outcomes for both groups, with slightly higher clinical scores observed in the cementless stem group. The Harris Hip Score (HHS) averaged 74.4 ± 6.7 in the cemented group and 79.2 ± 10.4 in the cementless group, with a statistically significant difference (p = 0.0146). The WOMAC Score showed an average of 30.1 ± 4.6 in the cemented group compared to 27.1 ± 6.9 in the cementless group, also indicating a statistically significant improvement (p = 0.0231). However, radiographic findings call for a re-evaluation of long-term stability. Our statistical analysis, which included power calculation and multivariate analysis to adjust for confounding variables, offers a comprehensive assessment of implant effectiveness. The findings contribute to the ongoing debate on the choice between cemented and cementless prostheses, indicating that both are viable options catering to different patient needs. Further research overcoming this study’s limitations is crucial for a deeper understanding of optimal treatment strategies in hip replacement surgery for the elderly.
{"title":"Comparative Analysis of Cemented and Cementless Straight-Stem Prostheses in Hip Replacement Surgery for Elderly Patients: A Mid-Term Follow-up Study","authors":"M. Sapienza, Danilo Di Via, Marco Simone Vaccalluzzo, L. Costarella, V. Pavone, G. Testa","doi":"10.3390/prosthesis6030038","DOIUrl":"https://doi.org/10.3390/prosthesis6030038","url":null,"abstract":"This retrospective cohort study assesses the effectiveness of straight-stem cementless versus cemented prostheses in hip replacement surgeries for elderly patients with femoral neck fractures. We analyzed 80 patients aged 70 and over who underwent surgery between 2018 and 2021. Clinical outcomes were evaluated using the Harris Hip Score, WOMAC Score, and Visual Analogue Scale, alongside radiological assessments through Brooker’s classification. Preoperative Dorr classification and five postoperative criteria (subsidence, cortical hypertrophy, pedestal sign, radiolucent lines, and stress shielding) were used to assess implant efficacy. The results demonstrated satisfactory mid-term outcomes for both groups, with slightly higher clinical scores observed in the cementless stem group. The Harris Hip Score (HHS) averaged 74.4 ± 6.7 in the cemented group and 79.2 ± 10.4 in the cementless group, with a statistically significant difference (p = 0.0146). The WOMAC Score showed an average of 30.1 ± 4.6 in the cemented group compared to 27.1 ± 6.9 in the cementless group, also indicating a statistically significant improvement (p = 0.0231). However, radiographic findings call for a re-evaluation of long-term stability. Our statistical analysis, which included power calculation and multivariate analysis to adjust for confounding variables, offers a comprehensive assessment of implant effectiveness. The findings contribute to the ongoing debate on the choice between cemented and cementless prostheses, indicating that both are viable options catering to different patient needs. Further research overcoming this study’s limitations is crucial for a deeper understanding of optimal treatment strategies in hip replacement surgery for the elderly.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141122246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-14DOI: 10.3390/prosthesis6030037
L. Fiorillo, C. D’amico, F. Gorassini, Marta Varrà, Emanuele Parbonetti, Salvatore Varrà, V. Ronsivalle, G. Cervino
This manuscript introduces a novel two-step technique for fabricating mobile dentures post-extraction to streamline prosthodontic rehabilitation. The study utilizes various materials, including dental polymers, metals, ceramics, and composite materials, each chosen for their unique properties that contribute to the final prosthesis’s functionality, durability, and esthetics. The detailed procedure involves an initial occlusal registration immediately following tooth extraction, capturing precise occlusal relationships and a comprehensive dental impression. This approach reduces clinical visits and leverages optimal alveolar ridge morphology. The expected results highlight the efficiency of the technique, reducing treatment time without compromising quality and potentially improving patient satisfaction and prosthodontic outcomes. This innovative method conclusively promises rapid, efficient, and patient-centered dental rehabilitation, emphasizing the need for future research to validate its effectiveness and explore long-term outcomes.
{"title":"Innovating Prosthodontic Rehabilitation: A Streamlined Two-Step Technique for Mobile Denture Fabrication","authors":"L. Fiorillo, C. D’amico, F. Gorassini, Marta Varrà, Emanuele Parbonetti, Salvatore Varrà, V. Ronsivalle, G. Cervino","doi":"10.3390/prosthesis6030037","DOIUrl":"https://doi.org/10.3390/prosthesis6030037","url":null,"abstract":"This manuscript introduces a novel two-step technique for fabricating mobile dentures post-extraction to streamline prosthodontic rehabilitation. The study utilizes various materials, including dental polymers, metals, ceramics, and composite materials, each chosen for their unique properties that contribute to the final prosthesis’s functionality, durability, and esthetics. The detailed procedure involves an initial occlusal registration immediately following tooth extraction, capturing precise occlusal relationships and a comprehensive dental impression. This approach reduces clinical visits and leverages optimal alveolar ridge morphology. The expected results highlight the efficiency of the technique, reducing treatment time without compromising quality and potentially improving patient satisfaction and prosthodontic outcomes. This innovative method conclusively promises rapid, efficient, and patient-centered dental rehabilitation, emphasizing the need for future research to validate its effectiveness and explore long-term outcomes.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140978412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-13DOI: 10.3390/prosthesis6030036
Hasan Mhd Nazha, Muhsen Adrah, Thaer Osman, Mohammad Issa, Ahmed Imran, Yicha Zhang, Daniel Juhre
This study delves into an in-depth examination of the biomechanical characteristics of various materials commonly utilized in the fabrication of artificial ankle joints. Specifically, this research focuses on the design of an ankle joint resembling the salto-talaris type, aiming to comprehensively understand its performance under different loading conditions. Employing advanced finite element analysis techniques, this investigation rigorously evaluates the stresses and displacements experienced by the designed ankle joint when subjected to varying loads. Furthermore, this study endeavors to identify the vibrating frequencies associated with these displacements, offering valuable insights into the dynamic behavior of the ankle joint. Notably, the analysis extends to studying random frequencies across three axes of motion, enabling a comprehensive assessment of directional deformities that may arise during joint function. To validate the effectiveness of the proposed design, a comparative analysis is conducted against the star ankle design, a widely recognized benchmark in ankle joint prosthetics. This comparative approach serves dual purposes: confirming the accuracy of the findings derived from the salto-talaris design and elucidating the relative efficacy of the proposed design in practical application scenarios.
{"title":"Investigating Material Performance in Artificial Ankle Joints: A Biomechanical Study","authors":"Hasan Mhd Nazha, Muhsen Adrah, Thaer Osman, Mohammad Issa, Ahmed Imran, Yicha Zhang, Daniel Juhre","doi":"10.3390/prosthesis6030036","DOIUrl":"https://doi.org/10.3390/prosthesis6030036","url":null,"abstract":"This study delves into an in-depth examination of the biomechanical characteristics of various materials commonly utilized in the fabrication of artificial ankle joints. Specifically, this research focuses on the design of an ankle joint resembling the salto-talaris type, aiming to comprehensively understand its performance under different loading conditions. Employing advanced finite element analysis techniques, this investigation rigorously evaluates the stresses and displacements experienced by the designed ankle joint when subjected to varying loads. Furthermore, this study endeavors to identify the vibrating frequencies associated with these displacements, offering valuable insights into the dynamic behavior of the ankle joint. Notably, the analysis extends to studying random frequencies across three axes of motion, enabling a comprehensive assessment of directional deformities that may arise during joint function. To validate the effectiveness of the proposed design, a comparative analysis is conducted against the star ankle design, a widely recognized benchmark in ankle joint prosthetics. This comparative approach serves dual purposes: confirming the accuracy of the findings derived from the salto-talaris design and elucidating the relative efficacy of the proposed design in practical application scenarios.","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":"114 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140985707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Johann Wolfgang von Goethe, Götz von Berlichingen, and the „Iron Hands“","authors":"A. Otte","doi":"10.3390/prosthesis6030035","DOIUrl":"https://doi.org/10.3390/prosthesis6030035","url":null,"abstract":"Knight Götz von Berlichingen (1480–1562) was born into a time of upheaval during the transition from the late Middle Ages to modern times [...]","PeriodicalId":506748,"journal":{"name":"Prosthesis","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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