-
International Journal of Implant... Sep 2021Immediate loading of implant-supported full-arch rehabilitations has become routine practice when treating edentulous patients. The combination of static computer-aided...
BACKGROUND
Immediate loading of implant-supported full-arch rehabilitations has become routine practice when treating edentulous patients. The combination of static computer-aided implant surgery (s-CAIS) and digital prosthetic workflow could eliminate several treatment steps and facilitate prostheses delivery. The aim of this study is to evaluate the 1-year results of digitally prefabricated polymethyl methacrylate (PMMA) provisional prostheses without a cast for full-arch computer-assisted immediate loading.
MATERIALS AND METHODS
A digital pre-operative treatment planning was realized for all patients: dental implants and screw-retained abutments were selected in the planning software and two surgical templates were fabricated for each patient. The first template was mucosa or teeth-supported to drill the holes for fixating pins, while the second template was placed after raising a full-thickness flap and was supported by pins as well as soft or hard tissue distal support. Furthermore, based on the surgical planning, interim prostheses were digitally designed and milled of PMMA resin blocks with subsequent pink resin veneering. Osteotomies and implant placement were performed through the surgical guides and all implants were immediately loaded with prefabricated full-arch interim prostheses directly connected to titanium copings with a flowable resin.
RESULTS
A total of 55 dental implants were placed in ten patients. In all cases, interim prostheses allowed the insertion of titanium copings without the need of access hole enlargement or adaptation. All the prostheses had 1 year of functional loading to simulate the long provisional phase. No screw loosening occurred at the first removal of the prostheses after implant osseointegration. No fracture occurred during the whole period. After 1 year, the mean marginal bone loss level was 0.37 ± 0.06 mm, while the implant survival rate was 98.18% (n=54/55), with just one implant failing but not affecting final prosthesis delivery to the patient.
CONCLUSIONS
Within the limitations of the present study, the authors concluded that digitally prefabricated provisional prostheses for full-arch immediate loading with s-CAIS could be a valid alternative treatment modality. Milled PMMA restorations proved to be durable enough during the long provisional phase, without prosthetic complications.
Topics: Bone Screws; Computers; Dental Prosthesis, Implant-Supported; Humans; Immediate Dental Implant Loading; Pilot Projects; Prospective Studies
PubMed: 34486078
DOI: 10.1186/s40729-021-00369-0 -
Surgical Infections Apr 2023The use of medical implants continues to grow as the population ages. Biofilm-related implant infection is the leading cause of medical implant failure and remains... (Review)
Review
The use of medical implants continues to grow as the population ages. Biofilm-related implant infection is the leading cause of medical implant failure and remains difficult to diagnose and treat. Recent technologies have enhanced our understanding of the composition and complex functions of microbiota occupying various body site niches. In this review, we leverage data from molecular sequencing technologies to explore how silent changes in microbial communities from various sites can influence the development of biofilm-related infections. Specifically, we address biofilm formation and recent insights of the organisms involved in biofilm-related implant infections; how composition of microbiomes from skin, nasopharyngeal, and nearby tissue can impact biofilm-formation, and infection; the role of the gut microbiome in implant-related biofilm formation; and therapeutic strategies to mitigate implant colonization.
Topics: Humans; Staphylococcal Infections; Biofilms; Postoperative Complications; Microbiota; Prostheses and Implants
PubMed: 37010966
DOI: 10.1089/sur.2023.009 -
Radiologia 2023Progressive population aging and improved healthcare have led to a significant increase in patients with hip arthroplasty (HA). In this patient group, the proportion of...
Progressive population aging and improved healthcare have led to a significant increase in patients with hip arthroplasty (HA). In this patient group, the proportion of those who require a new arthroplasty (prosthetic replacement or secondary revision of the hip), has also increased. For this subgroup of patients in whom surgical prosthetic replacement should be considered but is contraindicated, a new technique has been developed since 2010: percutaneous injection of periprosthetic cement under fluoroscopic or CT control ("femoroplasty; FMP") as an alternative and less invasive treatment compared to surgery to stabilize the HA without replacing it, with excellent results on patients' quality of life. In this brief communication, we describe our positive experience regarding FMP, which we have performed for the first time in Spain on four patients (age range between 74-83 years, 2 female and 2 male patients, 3 right HA and 1 left HA), without post-complications. We highlight both the relative simplicity of this technique, which can be incorporated into radiological intervention even in regional hospitals, and the significant clinical improvement observed in all patients. In conclusion, we hope that our experience can contribute to the increased adoption of this innovative technique within the scientific community.
Topics: Humans; Male; Female; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip; Hip Prosthesis; Quality of Life; Cementoplasty; Prosthesis Failure
PubMed: 38049255
DOI: 10.1016/j.rxeng.2023.06.004 -
Cell Jul 2022Innovations in soft materials bridge electronic conduction in conventional electronics and ionic conduction in biology. In a recent issue of Science, Dobashi et al....
Innovations in soft materials bridge electronic conduction in conventional electronics and ionic conduction in biology. In a recent issue of Science, Dobashi et al. describe a hydrogel that generates large ionic currents in response to applied force. The technology could enable sensors and energy generators for wearable and implantable devices.
Topics: Hydrogels; Mechanical Phenomena; Prostheses and Implants; Wearable Electronic Devices
PubMed: 35868272
DOI: 10.1016/j.cell.2022.06.017 -
Asia-Pacific Journal of Ophthalmology... 2019Keratoprosthesis (KPro) is the last resort for corneal blindness. Boston KPro I and osteo-odonto-keratoprosthesis (OOKP) have the most favorable outcomes for their...
Keratoprosthesis (KPro) is the last resort for corneal blindness. Boston KPro I and osteo-odonto-keratoprosthesis (OOKP) have the most favorable outcomes for their respective indications. Recently, better outcomes have been achieved for these 2 devices mainly because of improvements in postoperative care and modifications in complication management through years of experience and research. Unfortunately, some patients cannot benefit from these KPros due to lack of access to devices, trained surgeons, or both. Boston KPro I is heading toward a more affordable variation particularly for patients in developing countries. In addition, more patients with severely compromised ocular surface will be candidates for Boston KPro II variants. Biosynthetic or synthetic OOKP analogues will make the operation less complex and suitable for patients without canine tooth.
Topics: Blindness; Corneal Diseases; Humans; Prostheses and Implants; Prosthesis Implantation
PubMed: 31789643
DOI: 10.1097/APO.0000000000000268 -
Beijing Da Xue Xue Bao. Yi Xue Ban =... Feb 2022According to the fourth national oral health epidemiological survey report (2018), billions of teeth are lost or missing in China, inducing chewing dysfunction, which is... (Review)
Review
According to the fourth national oral health epidemiological survey report (2018), billions of teeth are lost or missing in China, inducing chewing dysfunction, which is necessary to build physiological function using restorations. Digital technology improves the efficiency and accuracy of oral restoration, with the application of three-dimensional scans, computer-aided design (CAD), computer-aided manufacturing (CAM), bionic material design and so on. However, the basic research and product development of digital technology in China lack international competitiveness, with related products basically relying on imports, including denture 3D design software, 3D oral printers, and digitally processed materials. To overcome these difficulties, from 2001, Yuchun Sun's team, from Peking University School and Hospital of Stomatology, developed a series of studies in artificial intelligence design and precision bionics manufacturing of complex oral prostheses. The research included artificial intelligence design technology for complex oral prostheses, 3D printing systems for oral medicine, biomimetic laminated zirconia materials and innovative application of digital prosthetics in clinical practice. The research from 2001 to 2007 was completed under the guidance of Prof. Peijun Lv and Prof. Yong Wang. Under the support of the National Natural Science Foundation of China, the National Science and Technology Support Program, National High-Tech R & D Program (863 Program) and Beijing Training Project for the Leading Talents in S & T, Yuchun Sun's team published over 200 papers in the relevant field, authorized 49 national invention patents and 1 U.S. invention patent and issued 2 national standards. It also developed 8 kinds of core technology products in digital oral prostheses and 3 kinds of clinical diagnosis and treatment programs, which significantly improved the design efficiency of complex oral prostheses, the fabrication accuracy of metal prostheses and the bionic performance of ceramic materials. Compared with similar international technologies, the program doubled the efficiency of bionic design and manufacturing accuracy and reduced the difficulty of diagnosis and cost of treatment and application by 50%, with the key indicators of those products reaching the international leading level. This program not only helped to realize precision, intelligence and efficiency during prostheses but also provided functional and aesthetic matches for patients after prostheses. The program was rewarded with the First Technical Innovation Prize of the Beijing Science and Technology Awards (2020), Gold Medal of Medical Research Group in the First Medical Science and Technology Innovation Competition of National Health Commission of the People's Republic of China (2020) and Best Creative Award in the First Translational Medical Innovation Competition of Capital (2017). This paper is a review of the current situation of artificial intelligence design and precision bionics manufacturing of complex oral prosthesis.
Topics: Artificial Intelligence; Bionics; Computer-Aided Design; Dental Prosthesis Design; Humans; Printing, Three-Dimensional; Prostheses and Implants
PubMed: 35165461
DOI: 10.19723/j.issn.1671-167X.2022.01.002 -
BMJ Sexual & Reproductive Health Feb 2021
Topics: Adult; Contraceptive Agents, Female; Desogestrel; Female; Guidelines as Topic; Humans; Prostheses and Implants; Reproductive Health Services
PubMed: 33593815
DOI: 10.1136/bmjsrh-2021-CHC -
Scientific Reports Jul 2023Fixed prostheses are appropriate treatment solutions for edentulous patients. In fixed prostheses, following "All on four", titanium frameworks are commonly used to...
Fixed prostheses are appropriate treatment solutions for edentulous patients. In fixed prostheses, following "All on four", titanium frameworks are commonly used to support the implants. However, the limitations of titanium have prompted researchers to search for alternative materials (e.g. polymers). This study applied finite element investigation to evaluate the stress distribution in the parts of fixed prosthesis and the surrounding bone tissue, using polymeric frameworks in place of titanium, and different densities of spongy bone. As, the success of fixed prosthesis was predicted to be influenced also by bone quality, particularly spongy bone density. Fixed prosthesis was constructed on edentulous mandible, then different frameworks (CFR-PEEK 60%, CFR-PEEK 30%, PEKK, and PEEK) were stimulated instead of titanium, under 300N unilateral and bilateral forces. Three densities of spongy bone were stimulated which are normal, low and high. The choice of framework material depended on the density of spongy bone. Moreover, PEEK framework showed the lowest stress values on bone tissues and the highest stress values on mucosa. All frameworks could be used in the fixed prosthesis, in the cases of normal and high densities of spongy bone. In low-density case, soft frameworks (PEKK and PEEK) were recommended to reduce the stresses generated on bone tissues.
Topics: Humans; Titanium; Polymers; Artificial Limbs; Mandible; Dental Implants; Finite Element Analysis
PubMed: 37460592
DOI: 10.1038/s41598-023-38288-2 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Sep 2022To complete the working principle design and prototype construction of the Chinese multichannel vestibular prosthesis (CMVP) with independent intellectual property...
To complete the working principle design and prototype construction of the Chinese multichannel vestibular prosthesis (CMVP) with independent intellectual property rights, and verify its working performance, so as to lay the foundation for the clinical promotion and application of CMVP. On the basis of previous research, the working principle of CMVP was constructed based on the information encoding principle of vestibular nervous system, and the circuit was designed according to the principle. Then, appropriate electronic components and software systems were selected to construct a CMVP prototype according to the design. Finally, the input and output characteristics of the CMVP prototype were verified through the performance test. In the present study, a block diagram of the working principle of the CMVP was successfully designed and drawn, and the working principle was explained in detail according to the block diagram. Further, the circuit diagram of the CMVP was designed and drawn based on the working principle, then the selected electronic components and software systems were combined one by one to complete the construction of a prototype. Finally, the performance test for the prototype was completed, which showed that all stimulus electrodes of the prototype could output biphasic pulse current, and the frequency of biphasic pulse current was modulated by the spatial rotation data input sensed by a motion sensor. The working principle and circuit design of the CMVP are reasonable; the CMVP prototype in China has been successfully constructed; the spatial rotation motion sensing input and the modulated pulse current output are stable and reliable.
Topics: China; Humans; Prostheses and Implants; Rotation; Software; Vestibule, Labyrinth
PubMed: 36036070
DOI: 10.13201/j.issn.2096-7993.2022.09.008 -
Scientific Reports May 2021Myoelectric hand prostheses offer a way for upper-limb amputees to recover gesture and prehensile abilities to ease rehabilitation and daily life activities. However,...
Myoelectric hand prostheses offer a way for upper-limb amputees to recover gesture and prehensile abilities to ease rehabilitation and daily life activities. However, studies with prosthesis users found that a lack of intuitiveness and ease-of-use in the human-machine control interface are among the main driving factors in the low user acceptance of these devices. This paper proposes a highly intuitive, responsive and reliable real-time myoelectric hand prosthesis control strategy with an emphasis on the demonstration and report of real-time evaluation metrics. The presented solution leverages surface high-density electromyography (HD-EMG) and a convolutional neural network (CNN) to adapt itself to each unique user and his/her specific voluntary muscle contraction patterns. Furthermore, a transfer learning approach is presented to drastically reduce the training time and allow for easy installation and calibration processes. The CNN-based gesture recognition system was evaluated in real-time with a group of 12 able-bodied users. A real-time test for 6 classes/grip modes resulted in mean and median positive predictive values (PPV) of 93.43% and 100%, respectively. Each gesture state is instantly accessible from any other state, with no mode switching required for increased responsiveness and natural seamless control. The system is able to output a correct prediction within less than 116 ms latency. 100% PPV has been attained in many trials and is realistically achievable consistently with user practice and/or employing a thresholded majority vote inference. Using transfer learning, these results are achievable after a sensor installation, data recording and network training/fine-tuning routine taking less than 10 min to complete, a reduction of 89.4% in the setup time of the traditional, non-transfer learning approach.
Topics: Algorithms; Amputees; Artificial Limbs; Electromyography; Gestures; Hand; Hand Strength; Humans; Machine Learning; Muscle Contraction; Neural Networks, Computer; Prostheses and Implants; Prosthesis Design
PubMed: 34050220
DOI: 10.1038/s41598-021-90688-4