Prosthesis

Background/Objectives: Dental practice, particularly aesthetic dentistry, has been extensively promoted through social media. The widespread advertisement of dental procedures via social media may influence young patients’ perceptions of the dentist’s professional role and potentially alter the dynamics of the doctor–patient relationship. Our study aimed to examine young dentists’ perspectives on ethical considerations associated with aesthetic dental procedures marketed on social media, and to identify appropriate professional responses to such situations. Methods: A cross-sectional study was conducted at Iuliu Haţieganu University of Medicine and Pharmacy in Cluj-Napoca, Romania, between July and September 2022. Data was collected using four case-based scenarios designed to elicit ethical reasoning. Results: Around 60% of participants identified ethical concerns related to patient requests for aesthetic dental procedures and demonstrated an ability to determine appropriate professional conduct in these contexts. The shift in the dentist’s role—from health care provider to service provider—driven by patient demands for cosmetic treatments was the primary concern perceived by the participants. Conclusions: Most participating young dentists were able to recognize ethical issues surrounding aesthetic dental requests influenced by social media and to adopt a considered professional response. Our findings highlight the need for reinforced ethics education and guidance in navigating social media’s influence on dental practice. Full article

Approximately 185,000 people in the United states experience limb loss each year. There is a need for an intuitive neural interface that can offer high-fidelity control signals to optimize the advanced functionality of prosthetic devices. Regenerative peripheral nerve interface (RPNI) is a pioneering advancement in neuroengineering that combines surgical techniques with biocompatible materials to create an interface for individuals with limb loss. RPNIs are surgically constructed from autologous muscle grafts that are neurotized by the residual peripheral nerves of an individual with limb loss. RPNIs amplify neural signals and demonstrate long term stability. In this narrative review, the terms “Regenerative Peripheral Nerve Interface (RPNI)” and “RPNI surgery” are used interchangeably to refer to the same surgical and biological construct. This narrative review specifically focuses on RPNIs as a targeted approach to enhance prosthetic control through surgically created nerve–muscle interfaces. This area of research offers a promising solution to overcome the limitations of existing prosthetic control systems and could help improve the quality of life for people suffering from limb loss. It allows for multi-channel control and bidirectional communication, while enhancing the functionality of prosthetics through improved sensory feedback. RPNI surgery holds significant promise for improving the quality of life for individuals with limb loss by providing a more intuitive and responsive prosthetic experience. Full article

Background/Objectives: Maxillofacial silicone prostheses’ long-term color stability remains a challenge. This study aimed to evaluate and compare the color stability of conventional and digital maxillofacial silicone elastomers mixed with nano-sized antimicrobial additives (ZnO nanoparticles and chlorhexidine salt-CHX) at various concentrations over a 10-week period. Methods: A total of nine groups (n = 10) of maxillofacial silicone elastomers were prepared. These included a control group (no additives), conventionally pigmented silicone, digitally pigmented silicone (Spectromatch system), and silicone mixed with ZnO or CHX at 1%, 3%, and 5% by weight. Specimens were fabricated in steel molds and cured at 100 °C for 1 h. Color measurements were performed at baseline and after 1, 4, 6, and 10 weeks using a Minolta Chroma Meter (CIELAB system, ΔE₀₀ formula). Data were analyzed using two-way ANOVA and Tukey HSD post hoc tests (α = 0.05). Results: Color changes (ΔE₀₀) ranged from 0.74 to 2.83 across all groups. The conventional pigmented silicone group showed the highest color difference (ΔE₀₀ = 2.83), while the lowest was observed in the ZnO 1% group (ΔE₀₀ = 0.74). Digital silicone and all antimicrobial-modified groups exhibited acceptable color stability (ΔE₀₀ < 3.1). Time significantly affected color difference, with the largest change occurring during the first four weeks (p < 0.05), followed by stabilization. Regression analysis confirmed high color stability over time for all groups except the conventional pigmented group. Conclusions: This is one of the first studies to directly compare digital and conventional pigmentation methods combined with nano-antimicrobials in maxillofacial silicones. Maxillofacial silicone elastomers mixed with up to 5% ZnO or CHX maintained acceptable color stability over 10 weeks. Digital pigmentation is similar to conventional methods. The incorporation of nano-antimicrobials offers significant microbial resistance and improved color retention. Full article

Objectives: Digitalization has revolutionized dentistry, introducing advanced technological tools that improve diagnostic accuracy and access to healthcare. This study aims to examine the effects of integrating digital technologies into the dental field, analyzing the associated benefits and risks, with particular paid attention to the therapeutic relationship and decision-making autonomy. Materials and Methods: A literature search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library, complemented by Google Scholar for non-indexed studies. The selection criteria included peer-reviewed studies published in English between 2014 and 2024, focusing on digital dentistry, artificial intelligence, and medical ethics. This is a narrative review. Elements of PRISMA guidelines were applied to enhance transparency in reporting. Results: The analysis highlighted that although digital technologies and AI offer significant benefits, such as more accurate diagnoses and personalized treatments, there are associated risks, including the loss of empathy in the dentist–patient relationship, the risk of overdiagnosis, and the possibility of bias in the data. Conclusions: The balance between technological innovation and the centrality of the dentist is crucial. A human and ethical approach to digital medicine is essential to ensure that technologies improve patient care without compromising the therapeutic relationship. To preserve the quality of dental care, it is necessary to integrate digital technologies in a way that supports, rather than replaces, the therapeutic relationship. Full article

Background/Objectives: This study aimed to assess the long-term clinical performance of full-arch fixed restorations made of fiber-reinforced composite (FRC) supported by four ultra-short implants (4.0 × 5.0 mm) in patients with edentulous, atrophic mandibles. Methods: Ten patients were treated at Sapienza University of Rome and monitored over a 10-year period. Each case involved the placement of four plateau-design implants with a pure conometric connection and a calcium phosphate-treated surface. The final prostheses were fabricated using CAD/CAM-milled Trinia^® fiber-reinforced composite frameworks. Clinical parameters included implant and prosthesis survival, marginal bone level (MBL), peri-implant probing depth (PPD), and patient-reported outcome measures (PROMs). Results: Implant and prosthesis survival reached 100% over the 10-year follow-up. MBL data showed a minor bone gain of approximately 0.11 mm per 5 years (p < 0.0001). PPD remained stable under 3 mm, with a minimal increase of 0.16 mm over the same period (p < 0.0001). PROMs reflected sustained high patient satisfaction. No technical complications, such as chipping or framework fracture, were observed. Conclusions: Rehabilitation of the edentulous mandible with ultra-short implants and metal-free FRC prostheses proved to be a minimally invasive and long-lasting treatment option. The 10-year follow-up confirmed excellent implant and prosthetic outcomes, favorable peri-implant tissue health, and strong patient satisfaction. Nonetheless, further studies with larger sample sizes are needed to confirm these encouraging results and strengthen the clinical evidence. Full article

Background/Objectives: Dental practitioners widely use dental implants to treat traumatic cases. Titanium implants are currently the most popular choice among dental practitioners and surgeons. The discovery of newer polymeric materials is also influencing the interest of dental professionals in alternative options. A comparative study between existing titanium implants and newer polymeric materials can enhance professionals’ ability to select the most suitable implant for a patient’s treatment. This study aimed to investigate material property advantages of high-performance thermoplastic biopolymers such as PEEK and PEKK, as compared to the time-tested titanium implants, and to find the most suitable and economically fit implant material. Methods: Three distinct implant material properties were assigned—PEEK, PEKK, and commercially pure titanium (CP Ti-55)—to dental implants measuring 5.5 mm by 9 mm, along with two distinct titanium (TI6AL4V) abutments. Twelve three-dimensional (3D) models of bone blocks, representing the mandibular right molar area with Osseo-integrated implants were created. The implant, abutment, and screw were assumed to be linear; elastic, isotropic, and orthotropic properties were attributed to the cancellous and cortical bone. Twelve model sets underwent a three-dimensional finite element analysis to evaluate von Mises stress and total deformation under 250 N vertical and oblique (30 degree) loads on the top surface of each abutment. Results: The study revealed that the time-tested titanium implant outperforms PEEK and PEKK in terms of marginal bone preservation, while PEEK outperforms PEKK. Conclusions: This study will assist dental practitioners in selecting implants from a variety of available materials and will aid researchers in their future research. Full article

Background/Objective: The most effective strategy for addressing users’ prosthetic needs is a comprehensive clinical assessment that provides a holistic understanding of the individual’s symptoms, health, function, and environmental barriers and facilitators. A standardized evaluation form would provide guidance for a structured approach to comprehensive clinical assessments of people with LLA. The objective of this study was to determine a list of relevant elements to be included in prosthetic evaluation for adults with lower limb amputation. Methods: Three independent focus group discussions were conducted with prosthetists (n = 15), prosthesis users (n = 11), and decision makers (n = 4) to identify all relevant elements that should be included in the clinical assessment of prosthetic services. The final content was then determined using the Delphi technique, with 35 panelists (18 prosthetists and decision makers, and 17 prosthesis users) voting in each round. Results: A total of 91 elements were identified through the focus group, of which 78 were included through the Delphi process. The identified elements are mostly related to the physical health of the prosthesis user (e.g., mobility, pain, and medical information), while others address personal or psychosocial aspects (e.g., activities of daily living, goals, and motivation) or technical aspects (prosthesis-related). Conclusions: Through a Delphi consensus, a list of relevant elements to be included in a prosthetic evaluation was generated. These results will inform the development of a standardized clinical prosthetic assessment form. This form has the potential to improve the quality of clinical evaluations, guide interventions, and enhance the well-being of prosthetic users. Full article

Background/Objectives: The present study aimed to evaluate the oral health and patient satisfaction of flexible and non-metal clasp dentures (NMCD) compared to removable partial dentures (RPD) using a systematic review. Methods: The PICOS framework of this review was as follows: Do rehabilitations involving flexible dentures or NMCD have a similar success rate to those using RPD? Thus, the PICOS approach involves the following topics: (P) Population/Problem: partial edentulous adult patients; (I) Intervention: patients rehabilitated with flexible dentures or NMCD; (C) Comparison: patients rehabilitated with standard RPD; (O) Outcome: clinical parameters such as oral health, masticatory function, and patient satisfaction; and (S) Study Type: clinical trials and observational studies (cohort, case–control, and cross-sectional). No language restrictions were applied to the studies. The search strategy consisted of the following keywords in different databases: ((flexible) OR (nonmetal) OR (non-metal) OR (thermoplastic)) AND (denture). Only clinical trials and observational studies (cohort, case–control, and cross-sectional studies) from the last 15 years were included, and no language restrictions were applied. Studies that did not describe the denture material were excluded. Results: Of the 2197 potentially relevant records, 14 studies were included in the present review. Two studies reported retrospective results, while twelve reported a prospective evaluation. Considering the thermoplastic materials, five studies evaluated polyester, five polyamides, three polyacetals, and only one study evaluated polyetheretherketone (PEEK). Flexible dentures and NMCD demonstrated similar periodontal status and bone levels on abutment teeth to RPD after up to 12 months. Flexible dentures exhibited a higher degree of redness of the mucosa after 12 months. One study showed a lower maximum bite force for flexible dentures compared to RPD. No study has performed a clinical evaluation of mastication and chewing ability. Conclusions: Despite increased short-term patient satisfaction for flexible dentures and NMCD, there is weak evidence to support a similar clinical performance of flexible dentures and NMCD to RPD. Full article

Background/Objectives: Additive manufacturing (AM) technology has emerged as an innovative approach in dentistry. Recently, manufacturers have developed permanent resins engineered explicitly for the fabrication of definitive prostheses using AM techniques. This systematic review evaluated the mechanical and physical properties of 3D-printed permanent resins in comparison to milled resins and hybrid ceramics for the fabrication of indirect dental restorations. Methods: Three electronic databases—Scopus, Web of Science, and PubMed—were searched for English-language articles. Two independent researchers conducted study selection, data extraction, quality assessment, and the evaluation of the certainty of evidence. In vitro studies assessing the mechanical and physical properties of the permanent resins were included in this review. Results: A total of 1779 articles were identified through electronic databases. Following full-text screening and eligibility assessment, 13 studies published between 2023 and 2024 were included in this qualitative review. The investigated outcomes included physical properties (surface roughness, color changes, water sorption/solubility) and mechanical properties (flexural strength, elastic modulus, microhardness). Conclusions: Three-dimensionally printed permanent resins show promising potential for fabricating indirect dental restorations. However, the current evidence regarding their mechanical and physical properties remain limited and inconsistent, mainly due to variability in study methodologies. Full article

Background: The use of lower limb prosthesis can impact all aspects of daily life, activities and participation. Various studies have compared the microprocessor-controlled knee (MPK) to the non-microprocessor-controlled knee (NMPK) using a variety of different outcome measures, but results are inconsistent and raise the question of which type of knee is most effective. Therefore, we aimed to assess the effect of MPKs compared to NMPKs across all classified ICF domains in adult prosthesis users. Methods: Participants performed baseline measurements with the NMPK (T0). One week later, they started a four-to-six-week trial period with the MPK. Afterward, measurements were repeated with the MPK (T1). Functional tests (6MWT, TUG-test and activity monitor) and questionnaires (ABC, SQUASH, USER-P and PEQ) were used. For statistical analyses, paired t-tests, Wilcoxon signed-rank tests and Chi² test were applied. The Benjamini–Hochberg procedure was applied to correct for multiple testing. Results: Twenty-five participants were included. Using an MPK compared to an NMPK significantly resulted in improvements in balance and walking confidence, safety, walking distance and self-reported walking ability, as well as a decrease in number of stumbles and falls. Additionally, participants using an MPK were significantly more satisfied with their participation, experienced fewer restrictions, reported greater satisfaction with the appearance and utility of the MPK, experienced less social burden and reported better well-being, compared to using an NMPK. Conclusions: Using an MPK instead of an NMPK can lead to significant improvements in all classified ICF domains, such as improved walking ability, confidence and satisfaction and reduced fall risk. Full article

Background: Accuracy of optical impressions—defined by the intraoral scanner (IOS)’s trueness and precision per International Organization for Standardization (ISO) standards—is influenced by both operator- and patient-related factors. Thus, this in vitro study aimed to (1) evaluate how scanning distance affects the accuracy of three different intraoral scanners (IOSs), and (2) identify the optimal scanning distance for each scanner. Methods: A maxillary arch model was obtained using polyvinyl siloxane impression material and poured with Type IV stone (Octa-rock royal^®, Kulzer, Germany). Using three different types of IOSs—the trios 3 shape (TRIOS ^® cart, 3Shape, Copenhagen, Denmark); the Helios 500 (Eighteeth ^®, Changzhou, China); and the Heron (3Disc ^®, Herndon, VA 20170, USA)—ten scans were performed with each of the IOSs with five predetermined distances: 0 mm, 2.5 mm, 5 mm, 7.5 mm, and 10 mm. Spacers of varying heights were designed using Meshmixer version 3.5 (Autodesk, Inc., Mill Valley, CA, USA) and three-dimensional printed with the Form 2 printer (Formlabs, Somerville, MA, USA). The scanned data was processed using Geomagic Control X (Version 16.0.2.16496, 3D Systems, Wilsonville, OR, USA). Statistical analyses were performed using R Statistical Software (version 4.2.2), with significance set at α = 0.05. Results: Scanning distance significantly influenced scan accuracy for all three scanners. The 3Disc scanner (3Disc, Herndon, VA, USA) demonstrated the highest accuracy at a 7.5 mm distance, while both the Helios 500 (Eighteeth, Changzhou, China) and Trios 3 (3Shape, Copenhagen, Denmark) scanners achieved their best accuracy at a 5 mm distance, as indicated by the lowest root mean square (RMS) values (p < 0.05). Conclusions: To conclude, each IOS has an optimal scanning distance for best accuracy. Trios 3 (3Shape, Copenhagen, Denmark) outperformed the others in both trueness and precision. Future studies should examine these effects under full-arch and clinical conditions. Full article

Objective: Several studies have compared the accuracy of digital scans and conventional impressions for post space capture. However, only a few have specifically investigated the precision of intraoral scanners in measuring post spaces of varied lengths. This study aimed to evaluate the accuracy of various intraoral scanning techniques in capturing long and short post spaces. Material and Methods: This study grouped samples into eight categories based on four techniques and two post space depths (7 and 11 mm). After tooth preparation, root canal treatment, and post space preparation, laboratory scans were performed using Duralay. Intraoral scans were obtained directly and indirectly with the Trios fourth generation scanner using the Duralay and PVS techniques. The accuracies, in terms of trueness, and precisions were compared after ten repetitions for each group using the Kruskal–Wallis or Mann–Whitney U tests. Results: The Duralay Intraoral Scan groups demonstrated a high consistency, while the Direct Intraoral Scan groups showed moderate consistency. Variability was higher for the Duralay Lab Scan and PVS Intraoral Scan groups for short post spaces. Conclusions: The capture technique significantly affected the accuracies of the post space measurements. The techniques also demonstrated varying consistency and precision. These findings provide critical insights to guide their selections for clinical and research applications. Clinical Significance: This study is one of the few to compare the accuracy of intraoral scanners for the capture of both short and long post spaces. It addresses a key gap in current dental research and offers practical guidance for clinicians and researchers in selecting appropriate scanning techniques for various clinical scenarios. The findings have the potential to enhance the accuracy and reliability of post space measurements and improve patient outcomes. Full article

Objectives: Our goal was to assess the role of leaflet geometry on the structural deterioration of bioprosthetic aortic valves (BAVs) in a closed configuration. Methods: With a Fung-type orthotropic model, finite element modeling was used to create ten cases with parabolic, circular and spline leaflet curvatures and six leaflet angles. Results: A circular circumferential curvature led to lower von Mises and compressive stresses in both the coaptation and load-bearing areas, reduced tensile stresses in the coaptation regions, and increased tensile stresses in the load-bearing areas. A parabolic radial curvature reduced von Mises stresses in the coaptation, as well as the load-bearing regions, reduced compressive stresses in the coaptation, and reduced tensile stresses in the load-bearing regions, leading to a slight increase in the minimized tensile stress in the coaptation regions (1.794 vs. 1.765 MPa) and the minimized compressive stress in the load-bearing regions (0.772 vs. 0.768 MPa). Within a range of downward inclination of the leaflets, all stresses in the coaptation regions decreased. A parabolic circumferential curvature, a linear radial curvature, and, for most cases, upward leaflet inclinations were associated with larger contact pressures between the leaflets. Conclusions: A parabolic radial curvature and downward leaflet inclination likely lead to the longer durability of BAVs. Full article

Background. Digital dentistry continues to evolve, offering improved accuracy, efficiency, and patient experience across various prosthodontic procedures. Many previous reviews have focused on digital applications in prosthodontics. But the use of a fully digital workflow for full-arch implant-supported prostheses in edentulous patients remains an emerging and underexplored area in the literature. Objective. This article presents a comprehensive methodological review of the digital workflow in full-arch implant-supported rehabilitation. It follows a structured literature exploration and synthesizes relevant technological processes from patient assessment to prosthetic delivery. Methods. The relevant literature was retrieved from the PubMed database on 20 June 2024, to identify the most recent and relevant studies. A total of 22 articles met the eligibility criteria and were included in the review. The majority included case and technical reports. Results. The review illustrates the integration and application of digital tools in implant dentistry, including cone-beam computed tomography (CBCT) exposure, intraoral scanning, digital smile design, virtual patients, guided surgery, and digital scanning. The key findings demonstrate multiple advantages of a fully digital workflow, such as reduced treatment time and cost, increased patient satisfaction, and improved interdisciplinary communication. Conclusions. Despite these benefits, limitations persist due to the low level of evidence, technological challenges, and the lack of standardized protocols. Further randomized controlled trials and long-term clinical evaluations are essential to validate the effectiveness and feasibility of a fully digital workflow for full-arch implant-supported rehabilitation. Full article

Background/Objectives: Dental cavity preparation is a critical procedure in restorative dentistry that involves the removal of decayed tissue while preserving a healthy tooth structure. Excessive stress during tooth preparation leads to enamel cracking, dentin damage, and long term compressive pulp health. This study employed finite element analysis (FEA) to investigate the stress distribution in dental structures during cavity preparation using round diamond burs of varying diameters and depths of cut (DOC). Methods: A three-dimensional human maxillary first molar was generated from computed tomography (CT) scan data using 3D Slicer, Fusion 360, and ANSYS Space Claim 2024 R-2. Finite element analysis (FEA) was conducted using ANSYS Workbench 2024. Round diamond burs with diameters of 1, 2, and 3 mm were modeled. Cutting simulations were performed for DOC of 1 mm and 2 mm. The burs were treated as rigid bodies, whereas the dental structures were modeled as deformable bodies using the Cowper–Symonds model. Results: The simulations revealed that larger bur diameters and deeper cuts led to higher stress magnitudes, particularly in the enamel and dentin. The maximum von Mises stress was reached at 136.98 MPa, and dentin 140.33 MPa. Smaller burs (≤2 mm) and lower depths of cut (≤1 mm) produced lower stress values and were optimal for minimizing dental structural damage. Pulpal stress remained low but showed an increasing trend with increased DOC and bur size. Conclusions: This study provides clinically relevant guidance for reducing mechanical damage during cavity preparation by recommending the use of smaller burs and controlled cutting depths. The originality of this study lies in its integration of CT-based anatomy with dynamic FEA modeling, enabling a realistic simulation of tool–tissue interaction in dentistry. These insights can inform bur selection, cutting protocols, and future experimental validations. Full article

Background/Objectives: the precise application of torque during prosthetic screw tightening is essential to the long-term success and mechanical stability of implant-supported restorations. This study aimed to evaluate the influence of practitioner experience, glove material, screwdriver length, and hand moisture on the maximum torque value (MTV) generated during manual tightening. Methods: thirty participants, comprising 10 experienced professors and 20 senior dental students, performed tightening tasks under six hand conditions (nitrile gloves, latex gloves, and bare hands, each in dry and wet environments) using two screwdriver lengths (21 mm and 27 mm). The torque values were measured using a calibrated digital torque meter, and the results were analyzed using a linear mixed model. Results: professors applied significantly higher torque than students (16.92 Ncm vs. 15.03 Ncm; p = 0.008). Nitrile gloves yielded the highest torque (17.11 Ncm), surpassing bare hands significantly (p = 0.003). No statistically significant differences were found for screwdriver length (p = 0.12) or hand moisture (p = 0.11). Conclusions: these findings underscore the importance of clinical proficiency and glove material in torque delivery, providing evidence-based insights to enhance procedural reliability and training standards in implant prosthodontics. Full article

Background/Objectives: The projected rise in limb amputations highlights the need for advancements in prosthetic technology. Current transtibial prosthetic designs primarily focus on sagittal plane kinematics but often neglect both the ankle kinematics and kinetics in the coronal plane, and the metatarsophalangeal joint, which play critical roles in gait stability and efficiency. This study aims to evaluate the combined effects of compliance in the coronal plane and a flexible toe joint on prosthetic gait using non-amputated participants as a model. Methods: We conducted gait trials on ten non-amputated individuals in the presence and absence of compliance in the coronal plane and toe compliance, using a previously developed three-degree-of-freedom (DOF) prosthetic foot with a prosthetic simulator. We recorded and analyzed sagittal and coronal kinematic data, ground reaction forces, and electromyographic signals from muscles involved in the control of gait. Results: The addition of compliance in the coronal plane and toe compliance had significant kinematic and muscular effects. Notably, this compliance combination reduced peak pelvis obliquity by 27%, preserved the swing stance/ratio, and decreased gluteus medius’ activation by 34% on the non-prosthetic side, compared to the laterally rigid version of the prosthesis without toe compliance. Conclusions: The results underscore the importance of integrating compliance in the coronal plane and toe compliance in prosthetic feet designs as they show potential in improving gait metrics related to mediolateral movements and balance, while also decreasing muscle activation. Still, these findings remain to be validated in people with transtibial amputations. Full article

Background/Objectives: The aim of this systematic review was to identify the role of orthodontics in patients undergoing tumor-ablative surgery, in collaboration with maxillofacial prosthodontic rehabilitation in a multidisciplinary fashion. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42024582050). The focused question was constructed using the PICO (participant, intervention, comparison, and outcome) approach. A three-stage search was performed in PubMed, Scopus, and Web of Science using Medical Subject Heading (MeSH) terms. To assess the risk of bias, the National Institute of Health (NIH) “Quality Assessment Tool for case series/reports” was used. All data was synthesized qualitatively, according to the Synthesis Without Meta-analysis (SWiM) reporting guideline. Results: The initial search yielded 624 articles, of which 22 met the inclusion criteria after screening and eligibility assessment, with most being single-patient case reports and one case series involving 12 patients. The included studies primarily involved tumors in the mandible (64.5%) and maxilla (32.3%). Orthodontic treatment was initiated at various time points, ranging from one month pre-surgery to 19 years post-surgery, primarily utilizing fixed appliances (77.8%). In some studies, orthodontic appliances were used to enhance the stability of maxillofacial prostheses. The results of this study indicate that orthodontic treatment may facilitate prosthetic rehabilitation by improving conditions prior to prosthetic intervention and increasing the retention of the obturator prosthesis. Conclusions: Orthodontic treatment can enhance maxillofacial prosthetic rehabilitation after tumor-ablative surgery by optimizing jaw growth, improving occlusion, and facilitating prosthetic retention or space creation. Further research is needed to establish treatment guidelines. Orthodontic miniscrews may improve temporary prosthesis retention before final implant placement, when indicated. Full article

Background/Objectives: Partial maxillectomy frequently results in severe impairments of oral functions, such as difficulties in chewing, speech, swallowing, and facial appearance. Immediate prosthetic rehabilitation is challenging because soft tissue healing is typically required before impression taking. This study aimed to (1) develop a comprehensive digital workflow for fabricating immediate obturator prostheses using preoperative data and (2) assess their early clinical effectiveness in restoring oral functions after surgery. Methods: In this prospective clinical study, 20 patients undergoing partial maxillectomy from January 2023 to January 2025 were enrolled. A digital workflow combining cone-beam computed tomography (CBCT), intraoral scanning, CAD/CAM design, and 3D metal printing was implemented. Obturator prostheses were digitally designed preoperatively and inserted immediately post-resection. Functional outcomes were postoperatively evaluated after one month using the Obturator Functioning Scale (OFS), which measures functional, speech, esthetic, and psychosocial aspects. Results: The digitally fabricated immediate obturator prostheses were successfully placed intraoperatively in all patients. Most participants reported mild to moderate difficulties, with speech-related issues being the most common, while esthetic concerns were minimal. Masticatory function was satisfactorily restored in 75% of cases, and 60% of patients experienced minimal fluid leakage during swallowing. No significant differences were found between genders. Patients with larger defects tended to report greater functional challenges. Conclusions: The digitally planned immediate obturator prosthesis provides a practical and effective solution for early rehabilitation following partial maxillectomy. This digital workflow reduces patient discomfort, restores key oral functions, and facilitates psychosocial recovery. Full article