Background/Objectives: Artificial intelligence (AI) may standardise radiographic measurement of component position, but its accuracy is uncertain. We assessed agreement between AI and reference-standard measurements after primary total hip (THA) and total knee arthroplasty (TKA). Methods: Four databases were searched from 2015 to 13 July 2026 (PROSPERO CRD420261455545). Study selection, data extraction, risk of bias (QUADAS-2), reporting (CLAIM 2024), and certainty of evidence (GRADE) were assessed in duplicate. Signed mean differences were pooled with random-effects models and modified Hartung–Knapp intervals, while proportions within 2° were pooled using binomial-normal mixed models. Results: Nineteen studies were included, and six contributed to meta-analysis. For THA, pooled directional mean differences were +0.05° (95% CI −0.27 to +0.37) for cup anteversion and −0.13° (95% CI −0.89 to +0.63) for inclination; reported study-level mean absolute errors reached 3.59° and 1.79°, respectively. For TKA, the study-level agreement within 2° ranged from 70.4% to 99.3%; pooled values ranged from 88.4% to 95.1%, with broad confidence and prediction intervals. Ten studies were at high risk of bias, and external testing was confirmed in only five. Certainty of evidence was very low for all five outcomes. Conclusions: Pooled directional mean differences for cup orientation were close to zero, but this does not establish accurate individual measurements. Knee estimates were heterogeneous and imprecise. Current evidence does not establish reliable autonomous clinical use; clinically important or borderline values require expert assessment.
Background: This case report documents selective explantation in advanced peri-implantitis, early clinical healing, and exploratory blood and retrieval observations. Methods: A 71-year-old woman with hypertension had radiographic peri-implant bone defects around six mandibular implants. Implants 35 and 42 had evidence of suppuration, probing depths up to 8 mm, clinical mobility, and bone loss exceeding 66% at one or more surfaces, including full-length mesial defects, and were removed. Treatment combined professional hygiene and mechanical debridement, explantation, curettage, adjunctive Er:YAG irradiation of the post-explantation defect walls, chlorhexidine, systemic amoxicillin, and supportive care. The first blood sample was collected on the day of surgery, 2 weeks after the initial hygiene consultation. A second sample was obtained at 6 weeks, while four implants with radiographic defects remained in situ. Results: Both explantation sites showed uncomplicated soft-tissue healing over 2 months; no osseous healing outcome was assessed. At 4 months, the retained implants showed no bleeding on probing, suppuration, or clinically detectable mobility, without establishing long-term disease control. The blood findings were descriptive observations from one patient and showed no consistent downward inflammatory pattern. Ex vivo scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM/EDS) was performed on implant 35. Conclusions: SEM/EDS analysis of the retrieved implant revealed surface alterations consistent with mechanical wear and localized variations in elemental composition, providing additional insight into the structural and chemical characteristics of an implant affected by advanced peri-implantitis. Blood-derived inflammatory markers may offer complementary information about the patient’s general systemic inflammatory status and contribute to a more comprehensive clinical assessment. However, their specific diagnostic and prognostic value in peri-implantitis remains to be established through larger prospective clinical studies.
Background: Zirconia has become a widely used material in dentistry, and it is easy to see why. It offers excellent mechanical strength, great biocompatibility, and from an aesthetic point of view, it closely resembles natural teeth. Add to that the growing adoption of digital workflows and the fact that dentists are becoming more and more comfortable with CAD/CAM technology, and it is no surprise that multilayer zirconia is gaining so much traction. Objective: To evaluate the structural stability, interlayer cohesion, and flexural behavior of a multilayer zirconia developed for dental applications. Materials and Methods: A total of 10 samples of multilayer fully sintered zirconia specimens supplied by Biodynamic were subjected to accelerated aging according to conditions simulating ISO 13356 requirements. Crystalline phases were investigated by X-ray diffraction (XRD) before and after aging. Interlayer cohesion was assessed by environmental scanning electron microscopy (ESEM) and elemental analysis (EDAX). Flexural properties were evaluated through bending tests on ten specimens. Results: XRD analysis demonstrated no significant increase in monoclinic phase after aging (1%), indicating a tetragonal phase content exceeding 99%. ESEM observations showed a continuous microstructure without evidence of interfacial separation between layers. EDAX analysis confirmed the expected zirconia-based composition stabilized with yttria. Flexural testing revealed a mean maximum load of 980.54 ± 28.5 MPa and a mean fracture load of 1177.6 ± 34.2 MPa. Although some variability was observed among specimens, all samples exhibited high mechanical resistance. Conclusions: The choice of prosthetic material significantly affects the long-term clinical success of tooth- or implant-supported dental restorations. Since prolonged exposure to the oral environment and hydrothermal aging processes can alter the structural and mechanical properties of zirconia, this study was designed to evaluate the aging resistance, phase stability, interlayer cohesion, and flexural behavior of a multilayer dental zirconia produced using a graded-strength technology. The investigated multilayer zirconia demonstrated excellent phase stability, strong interlayer cohesion, and high flexural performance. These findings support its potential use in demanding dental prosthetic applications.
Background: The prosthetic socket is the primary component responsible for comfort, stability, and load transfer in lower limb prostheses. Traditional transtibial socket fabrication relies on plaster casting and manual rectification performed by prosthetists, producing workflows that depend heavily on clinical experience and are difficult to standardize and reproduce. Digital technologies such as three-dimensional scanning, computer-aided design, and finite element analysis (FEA) have expanded the possibilities for socket design, yet many existing approaches address geometry acquisition or biomechanical simulation without translating Patellar Tendon Bearing (PTB) clinical modification criteria into a structured digital process. This gap is especially relevant in real clinical applications where CT, MRI, and instrumented measurement systems are often unavailable, so the information that guides rectification must come from landmarks the prosthetist identifies directly on the residual limb. Methods: This study proposes a computational and digital strategy for PTB transtibial socket design that uses those prosthetist’s landmarks and PTB rectification criteria in structured geometric operations, combining structured light scanning, digital modification in Blender and MeshMixer, and anatomical reconstruction without dependence on CT or MRI. Results: We evaluated the resulting sockets through finite element analysis and compared them, on a patient-matched basis, with manually rectified sockets across three transtibial cases under static standing load. Across the three cases, the digital rectification reproduced the PTB load transfer logic of the results of the manual approach, directing load toward the patellar tendon while relieving the pressure-sensitive regions, although the two approaches did not produce the same stress magnitudes. Conclusions: The results show that a structured digital process can capture PTB modification logic while remaining usable in settings without advanced imaging. This study is a computational evaluation of how the two rectification approaches transfer load under static standing conditions. Interface contact pressure and clinical fitting were not measured, so experimental validation was not included.
Tricuspid regurgitation (TR) is common, undertreated, and associated with substantial morbidity and mortality. Transcatheter tricuspid valve intervention (TTVI), comprising transcatheter edge-to-edge repair (TEER) and transcatheter tricuspid valve replacement (TTVR), has emerged as an alternative to surgery. In this narrative review, we summarize device design and implantation techniques (TriClip, PASCAL, Cardioband, EVOQUE), evidence from pivotal and early feasibility trials (TRILUMINATE, CLASP TR, TRI-REPAIR, TRISCEND II), and the anatomic and clinical factors that guide patient selection. TEER and annuloplasty reduce TR and improve symptoms and quality of life, with lower rates of bleeding and conduction disturbance than TTVR. TTVR with EVOQUE achieved more complete TR reduction (99.1% with moderate or less TR) but carried higher rates of bleeding and new pacemaker implantation. Differences in trial design and study populations preclude direct comparison. Coaptation gap, jet location, leaflet tethering, annular size, device leads, and right ventricular function determine device suitability. TTVI is an effective treatment for TR, but long-term durability and conduction-system safety remain uncertain. We propose a heart team algorithm to guide selection between TEER and TTVR.
