Background: Severe trismus and post-oncologic maxillary defects often prevent conventional zygomatic implant placement. This study evaluates a novel implant specifically designed for reverse insertion (from the zygoma toward the oral cavity) and assesses its feasibility and accuracy in a cadaveric model. Materials and Methods: A Brown Class II maxillectomy was simulated in a fresh-frozen cadaver. Four custom reverse zygomatic implants were virtually planned and placed using CAD/CAM surgical guides. Superior and inferior orbital approaches were compared. Postoperative CT was superimposed onto the preoperative plan to measure linear and angular deviations, and a 3D-printed verification bar assessed prosthetic alignment. Results: All implants were successfully inserted with primary stability and without compromising critical structures. The superior orbital approach yielded lower deviations and better guide stability, which was reflected in the results: deviation at the zygomatic bone was 1.25 mm in the superior approach vs. 2.32 in the inferior approach, intraorally 4.7 mm vs. 7.3 mm, and angular deviation 1.85° vs. 5.63°. Despite minor distal deflection, intraoral emergence remained within clinically acceptable limits, allowing partial seating of the verification bar. Conclusions: Reverse-insertion zygomatic implants are technically feasible, anatomically safe, and compatible with fixed prosthetic rehabilitation in cases where conventional placement is impossible. Penetrating the orbit, injuring the skin or the infraorbital nerve could be possible but guided surgery seems to prevent them. A forthcoming clinical series of eight additional cases will further validate this protocol.

Background/Objectives: Total knee arthroplasty (TKA) is often associated with extensive bleeding and the need for intraoperative and postoperative blood transfusions. Due to concern about the risks associated with them, a push has been made in surgery toward the development of new intraoperative blood management devices and innovative postoperative care strategies. Tranexamic acid (TXA), fibrin sealant and standard electrocautery are widely used in orthopedic surgery, since several studies provided evidence about their efficacy and safety. A new device, the bipolar sealer system (BSS), provides hemostasis at lower temperature (<100°) than conventional electrocautery. It does not produce smoke, necrosis or burn tissue. Methods: In this study, we retrospectively analyzed data from 480 patients who underwent TKA between January 2017 and December 2024. The cohort was divided into two groups based on the hemostatic protocol adopted. The control group enrolled 240 patients who received the standard protocol with TXA and fibrin sealant, while the study group enrolled 240 patients who followed protocol with Aquamantys BSS and TXA. Hematological parameters, including hemoglobin (Hb), hematocrit (HCT) and red blood cells (RBCs) were analyzed preoperatively (T0) and postoperatively: immediately after surgery (T1), at day one (T2) and day three (T3). Results: Changes in hemoglobin from baseline to postoperative follow-up were significantly lower among patients who received TXA plus BSS and those receiving TXA plus fibrin sealant, with p-values of 0.0003 at T1 (immediately after surgery), 0.027 at T2 (one day post-op), and 0.0001 at T3 (three days post-op). Comparable results were observed for HCT and RBC values. Conclusions: These data demonstrate that Aquamantys is more effective than fibrin glue in controlling blood loss after knee replacement surgery, not only immediately after the procedure but also in the following days.

Background/Objectives: Interbody fusion cages provide both structural support and a biologically favorable environment for osseointegration. Through recent decades, cage design and biomaterial selection have evolved to more adapted implants in different concept philosophies. Based on this development, the objective of this work was to develop a systematic review of the state of the art regarding spine interbody cage concepts on the market and anticipate future directions in cage design. Methods: A systematic review following PRISMA 2020 guidelines was conducted in three databases of reference, Scopus, PubMed and Mendeley, in September 2025, considering results from between 2015 and the present using the following keywords: spine, interbody, cage and concept. A revision of the first results was performed, and duplicate entries were excluded, as well as papers without a firm relevance for cage design concepts. Results: This search resulted in 76 selected papers and different design concepts and clinical outputs, and after a duplicate analysis, just 40 papers were selected. The material properties may play an important role in the characteristics of the implant and critically influence load-sharing and bone ingrowth. Surface modifications, including texturing, porosity engineering, and osteoconductive coatings, have been introduced to enhance cellular adhesion and fusion rates. It was observed through the research performed that the main problems are related to micromobility, implant displacement and stress shielding effects in adjacent vertebras. Conclusions: Among the different evolutions observed in cages through the years, design changes played an important role in adapting each case. Knowing that the design could be strongly influenced by the surgical approach used (anterior, posterior, transforaminal or lateral) and bone quality, it is also possible to find, nowadays, different options for different needs that are only accessible due to the technological advances in additive manufacturing, which allowed the development of patient-specific implants.

This case report describes the esthetic and functional rehabilitation of a 45-year-old male patient presenting with a missing maxillary right lateral incisor (#12). Due to persistent insufficiency of alveolar ridge width following multiple augmentation procedures, implant placement was contraindicated. A minimally invasive prosthetic approach was therefore selected, consisting of a single-retainer lithium disilicate resin-bonded fixed dental prosthesis (RBFDP) combined with laminate veneers to optimize anterior esthetics. The cantilever design and adhesive protocol were selected based on biomechanical principles aimed at minimizing interfacial stresses and preserving enamel structure. The prosthesis was fabricated using a fully digital workflow, and adhesive bonding was performed following established ceramic and enamel surface conditioning protocols. The restoration fulfilled the patient’s esthetic and functional expectations, and clinical follow-up at 18 months demonstrated stable bonding, healthy peri-abutment tissues, and absence of technical or biological complications. This case highlights the role of lithium disilicate cantilever RBFDPs as a minimally invasive and clinically viable treatment option for the replacement of maxillary lateral incisors when implant therapy is contraindicated, with outcomes limited to short- to medium-term observation.

Background: Targeted muscle reinnervation (TMR) is increasingly used to enhance prosthetic control and to reduce post-amputation pain. Its implementation across new centers raises questions about the reproducibility of outcomes and the impact of surgical experience. Methods: We compared the first three TMR patients treated in a newly established center in Nantes, France, with three patients treated in a high-volume center in Göttingen, Germany. Functional outcomes were measured using the Box and Block test (BBT), and operative time was recorded. Two French cases were performed with the assistance of a Göttingen-based surgeon. Conclusions: The functional outcomes showed a similar trend in both groups. The mean BBT scores were equivalent, suggesting reliable reinnervation and prosthetic integration even in early cases. Operative times were longer in Nantes, but did not impact outcomes. TMR appears not to have a pronounced learning curve, particularly regarding functional success in early cases under guided protocols. Factors such as assistance from experienced surgeons and favorable donor-to-recipient nerve ratios likely contribute to consistent outcomes. These findings support the reproducibility of TMR across institutions. Results: Within the first two years of rehabilitation we observed improvements in both functional performance and patient-reported quality of life. All six patients across both centers in-creased in BBT scores. All the patients reported an increase in social relationships and psychological health, and two of three patients reported an increase in physical health. Importantly, all six patients discontinued the use of pain medication at 2 years fol-lowing TMR. Furthermore, the French patients reported a decrease from 65–82 mm to 0–31 mm across the patients’ Visual Analog Scale (VAS) pain scores.

Upper limb deficiencies can limit the range of tasks children can perform. Current prosthetics provide overall good performance to increase the activities that users can complete, but challenges remain. Body- or electrically powered prostheses struggle to restore the full range of motion needed for specific tasks. Currently, these systems do not allow for controlled hand closure or opening across all possible postures. A breathing-powered prototype named Airbender, which extracts energy from a breathing input by means of a Tesla turbine, provides the possibility of operation in any position. This paper introduces a novel design for a multi-finger actuated breathing-powered upper limb prosthetic concept and analyses its performance through a series of lab-based experiments. Results show that such a design could provide a fully controllable system. The final assembled design is capable of achieving full actuation under a flow rate of 340 Ls/min. The results obtained demonstrate that a functional multi-finger actuated breathing-powered upper limb prosthesis could be feasible and opens a path for future research in the field, with the ultimate goal of reducing the minimum flow rate required and actuation time to further improve its functionality.

Background: Rehabilitation of head and neck cancer patients with acquired intraoral defects is challenging and requires multidisciplinary collaboration. This case report describes an integrated surgical and prosthetic approach in which palatal obturator rehabilitation is used to restore palatal integrity, speech, swallowing, aesthetics, and overall quality of life after maxillectomy. The objective is to show how careful surgical planning to optimize prosthetic prognosis, combined with a precisely designed obturator prosthesis, can achieve satisfactory functional rehabilitation. Methods: A man in his 50s with sinonasal carcinoma underwent partial left maxillectomy followed by radiotherapy and chemotherapy. The defect was classified as Aramany class I and Brown class 2b, and the surgical resection was planned to preserve structures favorable to prosthetic support. Prosthetic management included fabrication of a removable partial denture incorporating a hollow-bulb obturator. Results: During trial and delivery, the patient demonstrated improved speech and swallowing, enhanced denture stability, and favorable aesthetics. The patient reported satisfaction with functional and cosmetic outcomes and was provided with instructions for use and cleaning, with a plan for regular follow-up. Conclusions: Palatal obturator prostheses remain a gold standard for unilateral maxillectomy rehabilitation when adequate retention is achievable. Surgical-prosthetic collaboration permits restoring palatal contours, and dentition can normalize speech and swallowing, and substantially improve the quality of life.

Background/Objectives: Stability, retention, and support are removable partial denture (RPD) biomechanical principles. The literature shows contradictory opinions on indirect retention in RPDs, but no solid scientific evidence exists. This in vitro research aims to analyze indirect retainers’ (IRs) influence on forces transmitted to abutment teeth of a Kennedy Class I mandibular RPD. Methods: Bilateral distal-extension mandibular RPDs—differing only in the presence or absence of an IR on tooth 44 (IR model vs. nonIR model, respectively)—were installed on an acrylic master model. Tensile forces were applied perpendicularly to the occlusal plane on the longest free-end saddle’s distal aspect. Electronic speckle pattern interferometry (ESPI) measurements were obtained with and without an IR. The three-dimensional out-of-plane displacements of both models were acquired. Results: Abutment teeth 46 and 47 contralateral to the longest distal extension suffered more deformation under displacement forces when an IR was used. In turn, the IR’s influence on the deformation values of the abutment tooth 34 adjacent to the larger edentulous area depended on the intensity of the tensile force exerted: low-intensity forces resulted in reduced deformation, while higher-intensity forces resulted in higher deformation. Conclusions: This study’s findings indicate that indirect retention promotes better tensile force distribution in the existent teeth. However, they also question the IR’s role in protecting abutment teeth against excessive torque forces. This study’s preliminary results highlight the need for research on indirect retention principles using new methodologies, namely, in silico and ex vivo studies, and their experimental and clinical validation.

Long bone fractures are breaks or cracks in a long bone of the body typically caused by trauma like a fall, sport injury, accidents etc. This study investigates the effectiveness of experimental methods for fast and safe healing of long bone fractures in humans, highlighting both their advantages and disadvantages, respectively finding the most effective and safe methods for evaluating the types of fixators that can be used in the consolidation of fractured long bones. As for the preliminary data, numerical methods and applied mathematics were used to address this problem. After collecting of preliminary data there were performed a series of experimental analysis as follows: Electrical Strain Gauges (ESGs); the Moiré Fringes method; Photo-Elasticity, with the particular technique thereof, the so-called Photo-Stress method; Holographic Interferometry (HI); Speckle Pattern Interferometry (ESPI) and Shearography; and Video Image Correlation (VIC), which is also called Digital Image Correlation (DIC). By analyzing different methods, the following two methods resulted to be widely applicable, namely, ESG and DIC/VIC. The findings highlight the net advantages regarding the objective choice of these types of fixators, thereby contributing to a possible extension of these approaches for the benefit of medical surgical practice

Background/Objectives: Finite element analysis (FEA) can predict biomechanical performance of dental implants in compromised bone. In the posterior maxilla, low bone density, thin cortex, and variable regenerated bone stiffness may lead to pathological peri-implant strains. This study examined the effects of implant diameter, cortical thickness, cancellous bone type, and regenerated bone elasticity on strain distribution in short plateau (Bicon SHORT®) implants. Methods: Three-dimensional FEA models of type III and IV maxillae with cortical layers of 1.0, 0.75, and 0.5 mm were developed. Implants of 4.5, 5.0, and 6.0 mm diameter were tested, with regenerated bone elasticity set to 25–100% of cortical values. An oblique load of 120.9 N at 75° was applied under full osseointegration, and first principal strains were compared with Frost’s 3000 με threshold. Results: Cortical strains remained at physiological levels, but cancellous bone in type IV often exceeded 3000 με, especially with smaller diameters and low regenerated stiffness. Enlarging implant diameter to 6.0 mm lowered cancellous maximal first principal strain by up to 56% in type III and 36% in type IV bone. Reduced regenerated bone elasticity markedly increased risk, particularly with cortical thickness < 0.75 mm. Conclusions: Biomechanical risk depends on implant diameter and regenerated bone quality. Wide short implants (6.0 mm) most effectively limited pathological strain under low cortical support and poor regenerated stiffness. Patient-specific FEA may guide implant choice and improve outcomes in atrophic maxilla rehabilitation.