Objective: To analyze the effects of a somatosensory education intervention targeting temporomandibular disorders (TMD) and awake bruxism on subjective tinnitus. Methods: This study had a pre-post-design in a primary care practice for orofacial physical therapy. Twenty-eight participants with the presence of TMD and suffering from moderate to severe subjective tinnitus, for at least 3 months, received the following treatments: (a) comprehensive information about tinnitus and the factors influencing it; (b) bruxism reversal training via a smartphone application; and (c) treatment for TMD. The primary outcome was the Tinnitus Functional Index (TFI). Secondary outcomes were awake bruxism frequency and the TMD pain screener. The study was approved by the Ethics Committee of the University of Groningen, the Netherlands. Results: The mean (95% CI) reduction in TFI scores and awake bruxism frequency were 18.4 (13.2–23.5) and 16.6% (2.0–31.2%), respectively. A clinically relevant reduction of 13 points on the TFI was observed in 63% of the participants. Regression analysis revealed that factors associated with TFI change included the TFI initial score at T0 (0.3, 95% CI 0.0–0.6), the presence of daytime clenching (21.0, 95% CI 8.7–33.4), and stiffness or pain around the TMJ (10.6, 95% CI −1.9–23.0) at baseline. Conclusions: The findings suggest that tinnitus education, TMD treatment, combined with decreasing awake bruxism, can reduce tinnitus in a primary care setting.

BACKGROUND:Adolescents undergoing orthodontic fixed appliance treatment face an increased risk of dental caries and developing white spot lesions (WSLs) due to challenges in maintaining effective oral hygiene. Preventive measures, including adherence to clinical guidelines, are important to reduce these risks. OBJECTIVE:To analyse adherence to clinical practice guidelines (CPGs) amongst patients undergoing orthodontic treatment with buccal fixed appliances in the northeast of the Netherlands. METHODS:A survey was presented to 539 adolescents aged 12-17 undergoing buccal fixed appliance treatment. Participants were recruited from ten orthodontic practices. The survey assessed adherence to the six recommendations of the Dutch CPGs. An adherence sum score (range 0 to 6) was calculated. Descriptive statistics and linear regression analyses (1000 bootstrap samples) were performed to analyse the relationships between participants' characteristics and adherence sum scores. RESULTS:In total, 485 adolescents started the survey, of whom 393 (72.9%) could be included (57% female; 48.9% aged 13 or 14). The median adherence sum score was 5 (IQR 4, 5), and 22.6% (n = 89) had an adherence sum score of 6. Males had a lower adherence sum score than females (-0.442, 95% CI: -0.979, -0.234). Older participants had a lower adherence sum score than younger participants (-0.066, 95%CI: -0.136, 0.002) per year of age. Higher educated participants had a lower adherence sum score than participants with lower education (-0.534, 95%CI: -0.953, -0.096). LIMITATIONS:Self-reported data may introduce information bias as participants may give socially desirable answers. CONCLUSIONS:Adherence to the CPGs amongst adolescents with buccal fixed orthodontic appliances is suboptimal, particularly in boys and older adolescents. Tailored educational interventions may address these gaps.

BACKGROUND:Autologous facial fat grafting is used to restore volume loss in the facial region. The volume retention after grafting is not stable over time. OBJECTIVES:The aim of this study was to assess long-term visible volume retention measured with 3-dimensional surface imaging and long-term patient-reported satisfaction 5 years after facial fat grafting. METHODS:Twelve patients were included for 3-dimensional analysis and satisfaction measurements with 5 years of follow-up. Volume was measured with a validated automatic algorithm using three-dimensional surface imaging and patient satisfaction was recorded with the FACE-Q questionnaire. RESULTS:After 5 years, the face volume increase was associated with the weight gain of the person and not with the injected volume. Weight gain beta (95% confidence interval) = 1.40 (0.37; 2.42), p = 0.013. Injected volume beta (95% confidence interval) = 0.30 (-0.28; 0.88), p = 0.268. Satisfaction returned to pre-operative levels (facial appearance score pre-operative) median 45.0 (IQR 25.5; 47.3); after 5 years median 39.0 (IQR 28.0; 57.0). CONCLUSION:After 5 years of facial fat grafting, volume retention was related to weight gain. Patient satisfaction returned to pre-operative levels. An increase in volume due to weight gain does not lead to increased patient satisfaction. Repeated fat grafting is necessary which will potentially increase satisfaction in the long term. Weight change as a confounder complicates long-term studies of volume retention.

This systematic review and meta-analysis of individual patient data evaluates the outcomes of treatment for Dupuytren's disease using limited fasciectomy (LF), percutaneous needle fasciotomy (PNF) and collagenase clostridium histolyticum (CCH) injection. A total of 1423 studies were identified, of which 15 met the eligibility criteria for meta-analysis. The postoperative total extension deficit was smaller after LF than after PNF or CCH, but the difference was not clinically relevant. Minor complications were more frequent after CCH than after LF and PNF. The risk of major complications did not differ between the treatments. Recurrence occurred earlier after PNF and CCH than after LF during 36 months of follow-up. Patient-reported outcome measures showed substantial heterogeneity, which precluded meta-analysis. Overall, the clinically relevant contracture correction was comparable between LF, PNF and CCH, but CCH had a higher risk of minor complications and LF had the longest time to recurrence. Treatment decisions should consider the trade-off between complications and recurrence risk.

BACKGROUND:Patients with chronic limb threatening ischemia (CLTI) are at high risk for amputation and other cardiovascular adverse events. Nutrition-related symptoms and malnutrition are common in the CLTI population, and lead to worse clinical outcomes. Understanding of the factors influencing nutritional intake is required to determine whether optimization of nutritional intake in this population requires interventions. Therefore, this study aimed to describe perceptions and experiences on nutrition of patients with CLTI, and to identify perceived barriers and facilitators influencing their nutritional intake.METHODS:In this phenomenological qualitative study, individual semi-structured, face-to-face interviews were conducted with patients with CLTI who lived independently. Interviews were transcribed verbatim, and reflexive thematic analysis was performed.RESULTS:Twelve participants were interviewed. Five themes were generated: (1) lack of nutritional risk perception, (2) role of nutrition for health, functioning, and surviving, (3) multiple factors influencing nutritional intake, (4) limited nutritional advice, and (5) no intention to change current nutritional intake.CONCLUSIONS:Patients with CLTI perceive nutritional intake as a necessity to survive and function. Patients express limited risk perception regarding adequate nutritional intake and undernutrition. Nutritional intake is mainly based on non-health-related factors, as habits and taste, and multiple barriers hinder nutritional intake. Patients received no or only limited nutritional advice. Together this leads to an expressed lack of intention to change nutritional intake. Findings of this study stress the urgency for patient-centered nutritional support, to increase nutrition-related knowledge and motivation, to prevent or treat undernutrition, and may improve clinical outcomes in patients with CLTI.

Objective To analyse intraobserver and interobserver reliability of colour Doppler (CD) ultrasonography of the major salivary glands (SGUS) in patients clinically suspected of Sj & ouml;gren's disease (SjD). Methods One hundred consecutive outpatients visiting the University Medical Center Groningen for a diagnostic trajectory because of a suspicion of SjD were evaluated using CD ultrasonography of the submandibular and parotid salivary glands. All images were independently assessed by four observers (two experienced observers, one lesser experienced resident, one inexperienced trainee) in two sessions using the Outcome Measures in Rheumatology (OMERACT) CD scoring system (scale 0-3). A total score was calculated as the sum of the scores of the 4 glands (scale 0-12). Intra- and interobserver reliability, and reliability of live versus static scores were determined. Factors influencing variability in scores were analysed. Results Intraobserver weighted Cohen's kappa's of individual glands ranged from 0.23 (inexperienced observer) to 0.81 (experienced observer). Intraclass Correlation Coefficients (ICCs) for intraobserver reliability of the total CD score ranged from 0.53 (inexperienced observer) to 0.90 (experienced observer). The ICC for intraobserver reliability of live scoring compared to static images was 0.72. ICCs for interobserver reliability of the total CD score were 0.81 for session 1 and 0.71 for session 2. Patient variance was 74.1%, whereas residual variance contributed 15.5% to the total variance. Conclusion CD SGUS is a reliable imaging technique to visualise intraparenchymal vasculature in patients suspected of SjD, and therefore could be an asset in daily clinical practice. It requires, however, experience and prior training.

Dynamic hydrogels are attractive platforms for tissue engineering and regenerative medicine, but there are limited polymer platforms amenable to the formation of these dynamic materials. Most architectures reported are based either on telechelic synthetic polymers or side-chain modified natural polymers; synthetic versions of side-chain modified polymers are noticeably absent. Dynamic hydrogels are key tools for their ability to mimic key extracellular (ECM) mechanical properties like strain stiffening and stress relaxation, while enabling enhanced processing characteristics like injectability, 3D printing, and self-healing. Currently, the limited chemical design space is hindering progress. To facilitate access to new classes of dynamic hydrogels, we report the straightforward synthesis of a water-soluble copolymer with a tunable fraction of pendent aldehyde groups (12–64%) using controlled radical polymerization, and their formation into hydrogel biomaterials with dynamic crosslinks. We found the polymer synthesis to be well-controlled with the determined reactivity ratios consistent with blocky gradient microarchitecture. Subsequently, we observed fast gelation kinetics with imine-type crosslinking. We were able to vary hydrogel stiffness from ≈ 2–20 kPa and tune the onset of strain-stiffening towards a biologically relevant regime (critical stress ≈ 10 Pa). Moreover, we used fluorescence resonance energy transfer (FRET) to demonstrate ligand displacement along the copolymer backbone via competitive binding and highlighted the cytocompatibility of our system using human dermal fibroblasts. The combination of highly tunable composition, stiffness, and strain-stiffening, in conjunction with temporal control over ligand exchange/presentation, positions these cytocompatible copolymers as a powerful synthetic platform for the rational design of next generation synthetic biomaterials.

Melt extrusion-based additive manufacturing (ME-AM) is a promising technique to fabricate porous scaffolds for tissue engineering applications. However, most synthetic semicrystalline polymers do not possess the intrinsic biological activity required to control cell fate. Grafting of biomolecules on polymeric surfaces of AM scaffolds enhances the bioactivity of a construct; however, there are limited strategies available to control the surface density. Here, we report a strategy to tune the surface density of bioactive groups by blending a low molecular weight poly(ε-caprolactone)5k (PCL5k) containing orthogonally reactive azide groups with an unfunctionalized high molecular weight PCL75k at different ratios. Stable porous three-dimensional (3D) scaffolds were then fabricated using a high weight percentage (75 wt.

Objective(s) To explore learning effects when applying the clinician‐graded electronic facial function scale (eFACE) and the Sunnybrook Facial Grading System (Sunnybrook). Methods Surgeons, facial rehabilitation therapists, and medical students were randomly allocated to the eFACE ( n = 7) or Sunnybrook ( n = 6) and graded 60 videos (Massachusetts Eye and Ear Infirmary open‐source standard set); 10 persons with normal facial function and 50 patients with a wide variation of facial palsy severity. Participants received an introduction and individual feedback after each set of 10 videos. Scores were compared to the reference score provided with the set. Multilevel analysis was performed to analyze learning effect. Results A learning effect was only found for the eFACE, with significant difference scores in set 1 and 2 compared to set 6, and no significant difference scores in the following sets. The difference score was associated with the reference score (severity of facial palsy) for eFACE ( β = −0.19; SE = 0.04; p < 0.001) and Sunnybrook ( β = −0.15; SE = 0.04; p < 0.001). Age of participants was also associated with the difference score in the eFACE group ( β = 0.18; SE = 0.03; p < 0.001). No differences in scores were found between groups of participants. Conclusion The eFACE showed a learning effect of feedback while the Sunnybrook did not. Level of Evidence NA Laryngoscope , 134:3105–3111, 2024

Architectural, compositional, and mechanical gradients are present in many interfacial tissues in the body. Yet desired for regeneration, the recreation of these complex natural gradients in porous scaffolds remains a challenging task. Additive manufacturing (AM) has been highlighted as a technology to fabricate constructs to regenerate interfacial tissues. Integration of different types of gradients, which can be physical, mechanical, and/or biochemical, shows promise to control cell fate and the regeneration process in a spatial controlled manner. One of the most studied tissue interfaces is the osteochondral unit which connects cartilage to bone. This tissue is often damaged because of trauma or ageing, leading to osteoarthritis; a degenerative disease and a major cause of disability worldwide. Therefore, in view of osteochondral (OC) regeneration, a state-of-the-art overview of current approaches is presented to manufacture gradient scaffolds prepared by AM techniques. The focus is on thermoplastic, hydrogel, and hybrid scaffolds comprising gradients that induce biomimicry by their physical and biological properties. The effect of these different systems on OC tissue formation in-vitro and in-vivo is addressed. Finally, an outlook on current trends of dynamic materials is provided, including proposals on how these materials could improve the mimicry of scaffolds applied for OC regeneration.

PurposeTo describe perceptions and experiences of people who have undergone a major dysvascular lower limb amputation (LLA) regarding nutrition, and to identify perceived barriers and facilitators regarding nutritional intake.MethodsIn this phenomenological qualitative study, individual, semi-structured, face-to-face, interviews were conducted with people who had undergone a major dysvascular LLA and were living independently. Sample size was guided on information power. Interviews were transcribed verbatim, and reflexive thematic analysis was performed.ResultsThirteen participants were interviewed. Four themes were generated: (1) mainly non-health-related factors determine food choices, (2) limited perceived awareness of the nutritional value and the impact of nutrition on health and clinical outcomes, (3) support is mainly practical by personal network, while professional nutritional care is limited, and (4) low need to change eating habits.ConclusionsFindings of this study underscore the urgency to increase awareness of healthy and adequate nutritional intake. Patient-centered nutritional care should be provided with techniques of motivational interviewing, to potentially improve health and clinical outcomes in people who have undergone a major dysvascular LLA.

OBJECTIVES:Scleroderma is a heterogeneous chronic autoimmune disease affecting connective tissue, characterised by chronic inflammation and fibrosis, particularly affecting internal organs and skin. Orofacial involvement is common, leading to facial atrophy, mask-like appearance and difficulties in function that significantly impact patients' quality of life. This systematic review evaluates different autologous regenerative treatments of facial manifestations of scleroderma, aiming to provide comprehensive understanding of their effectiveness in reducing fibrosis, and thereby improving function and skin quality. METHODS:A search in PubMed, Embase, Web of Science Core Collection, Cochrane CENTRAL, and CINAHL was conducted. Studies assessing autologous regenerative treatments in cutaneous manifestations of the face in scleroderma patients were included. Outcomes of interest were treatment characteristics, characterisation of biomaterials, outcome measurements and patient satisfaction. Methodological quality was assessed with the Effective Public Health Practice Project tool. RESULTS:In total 18 studies were included. Methodological quality of studies was weak (n=15) and moderate (n=3). Treatments consisted of autologous fat grafting, platelet-rich plasma, stromal vascular fraction, and adipose-derived stem cells. In general, most studies showed improvements of symptoms, but no treatment was considered superior. CONCLUSIONS:Autologous regenerative treatments hold potential for alleviating cutaneous manifestations of the face in scleroderma. Further clinical trials should be well-designed to improve the quality of clinical evidence.

PURPOSE To determine prevalence of musculoskeletal complaints (MSCs) in adults with major congenital upper limb differences (CoULD) compared to able-bodied controls, and to examine associations of MSCs and disability with various biopsychosocial factors. MATERIALS AND METHODS Questionnaire-based cross-sectional study assessing MSCs, disability (using the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH)), general and mental health status, physical work demands, and upper extremity range of motion. RESULTS Seventy-one individuals with CoULD (participation rate: 41%) and 71 controls matched on age, gender, and education were included (49% female, mean age 28.9 years). Year prevalence of MSCs was significantly higher in the CoULD group (35%) than in the control group (18%). The CoULD group was less often employed and had lower scores on all measures of upper limb range of motion and hand grip. MSCs were associated with higher DASH scores and higher reported work demands. Disability was associated with female gender, more joints with limited range of motion, unemployment, and lower general and mental health. Factors associated with disability did not differ between groups. CONCLUSIONS MSCs are a frequent problem in young adults with major CoULD. To prevent or reduce MSC and disability, clinicians and researchers should be aware of the associated factors. Implications for rehabilitationThe year prevalence of musculoskeletal complaints (MSCs) in those with major congenital upper limb differences (CoULD) was approximately double to that of the control group, implying a potential relationship between CoULD and MSCs.Rehabilitation professionals should develop personalized strategies to manage work demands in those with CoULD, considering the association between MSCs and higher reported work demands.Recognizing the impact of a negatively perceived body image on mental health, clinicians should integrate psychological counseling into rehabilitation treatments to support mental well-being and improve overall quality of life in those with CoULD.Rehabilitation professionals should educate individuals with CoULD about the potential associations between upper limb work demands, MSCs, and disability.

PURPOSE To systematically review literature on nutritional intake, nutritional status and nutritional interventions, and to study their association with short- and long-term clinical outcomes in people with a major dysvascular lower limb amputation. METHODS PubMed, Ovid, CINAHL, and The Cochrane Library were searched. Studies were included if nutritional intake, nutritional status, or nutritional interventions in people with a major dysvascular lower limb amputation were analyzed. RESULTS Of the 3038 unique papers identified, 30 studies were included. Methodological quality was moderate (1 study) or weak (29 studies). Limited information was available on nutritional intake (2 studies) and nutritional interventions (1 study). Nutritional intake and nutritional status were assessed by diverse methods. The percentage of people with a poor nutritional status ranged from 1% to 100%. In some studies, measures of poor nutritional status were associated with adverse short- and long-term clinical outcomes. CONCLUSIONS The percentage of people with a poor nutritional status is inconclusive in the major dysvascular lower limb amputation population, because of the heterogeneity of the assessment methods used. Some included studies reported a negative association between poor nutritional status and clinical outcomes. However, these results should be interpreted with caution, because of the limited quality of the studies available. Studies high in methodological quality and high in hierarchy of evidence are needed.IMPLICATIONS FOR REHABILITATIONThe proportion of people with a poor nutritional status in the major dysvascular lower limb amputation population is inconclusive.Poor nutritional status seems to affect clinical outcomes negatively.More uniformity in assessment of malnutrition in the major dysvascular lower limb amputation population is needed.

Increasingly, patients suffering from subjective tinnitus seek help from physical therapists. Numerous randomised controlled trials (RCTs) have investigated the effect of physical interventions commonly used in physical therapy practice on subjective tinnitus. This systematic review and meta-analysis aimed to analyse the effects of physical interventions on tinnitus loudness, tinnitus annoyance, and scores on the Tinnitus Handicap Index (THI). Four databases were searched from inception up to March 2022. A total of 39 RCTs were included in the systematic review, and 23 studies were appropriate for meta-analyses. Risk of bias assessments were also performed. Interventions analysed in at least five studies were summarised, including transcutaneous electrical nerve stimulation (TENS), laser therapy, and acupuncture. Random-effects meta-analysis models were used, and effect sizes were expressed as Hedge's standardised mean differences (SMD) with 95%CI's. The quality of three-quarters of the studies was limited due to insufficient allocation concealment, lack of adequate blinding, and small sample sizes. Large, pooled effects sizes were found for acupuncture (SMD: 1.34; 95%CI: 0.79, 1.88) and TENS (SMD: 1.17; 95%CI: 0.48, 1.87) on THI as well as for acupuncture on tinnitus loudness (VAS Loudness (SMD: 0.84; 95%CI: 0.33, 1.36) and tinnitus annoyance (SMD: 1.18; 95%CI: 0.00, 2.35). There is some evidence that physical interventions (TENS and acupuncture, but not laser therapy) may be effective for tinnitus. However, the lack of high-quality studies and the risk of bias in many studies prohibits stronger conclusions.

Objective: Complex Regional Pain Syndrome type I (CRPS-I) is an often intractable regional pain syndrome, usually affecting limbs in which amputation may be a final resort. Not all patients are suited for amputation. This retrospective case series with explorative interviews aims to gain insight in the quality of life in those who have been denied an amputation and their functioning with CRPS-I.Patients and methods: Between 2011 and 2017, 37 patients were denied an amputation. Participants were interviewed regarding quality of life, treatments received since their outpatient clinic visit and their experiences at our outpatient clinic. Results: A total of 13 patients participated. Most patients reported improvements in pain, mobility and overall situation. All patients received treatments after being denied an amputation, with some reporting good results. Many felt they had no part in decision making. Of the 13 participants 9 still had an amputation wish. Our participants scored worse in numerous aspects of their lives compared with patients with an amputation from a previous CRPS-I study of us.Conclusion: This study shows that amputation should only be considered after all treatments have been tried and failed, since most participants reported improvements in aspects of their functioning over time. LAY ABSTRACTPeople with complex regional pain syndrome suffer from severe pains, usually in a limb, which can lead to serious and longstanding disability. Sometimes when all other treatments have been tried, amputation is the only option left. Not all patients are suitable for amputation. This study tries to gain insight into those patients who have been denied an amputation. Our findings show that over time most patients reported improvements in pain, mobility and overall situation. All patients received further treatments after being denied amputation. Our study showed that amputation should only be considered after all other treatments have been tried and have failed, since over time, most of our participants still reported improvements in various aspects of their functioning.

Digital light processing (DLP) is one of the most accurate and fastest additive manufacturingtechnologies to produce a variety of products, from patient-customized biomedical implants toconsumer goods; however, DLP’s use in tissue engineering is limited largely due to a lack ofbiodegradable resins. Herein, a library of biodegradable urethane acrylate-capped poly(esters)(with variations in molecular weight) is investigated as the basis for a DLP printable ink fortissue engineering. The synthesized oligomers show good printability in a DLP resin, capableof creating complex structures with mechanical properties matching those of medium-softtissues (1–3 MPa). While fabricated films from different molecular weight resins showed fewdifferences in surface topology, wettability, and protein adsorption, the adhesion and metabolicactivity of L929 and human dermal fibroblasts (HDFs) were significantly different: resins fromhigher molecular weight oligomers provided greater cell adhesion and metabolic activity. Theseprintable and biodegradable resins show the importance of oligomer molecular weight onscaffold properties, and facilitate the printing of elastomeric customizable scaffolds for a varietyof tissue engineering applications.

Poly(lactide) (PLA) and poly(ethylene glycol) (PEG)-based hydrogels were prepared by mixing phosphate buffer saline (PBS, pH 7.4) solutions of four-arm (PEG-PLA)2-R-(PLA-PEG)2 enantiomerically pure copolymers having the opposite chirality of the poly(lactide) blocks. Dynamic Light Scattering, rheology measurements, and fluorescence spectroscopy suggested that, depending on the nature of the linker R, the gelation process followed rather different mechanisms. In all cases, mixing of equimolar amounts of the enantiomeric copolymers led to micellar aggregates with a stereocomplexed PLA core and a hydrophilic PEG corona. Yet, when R was an aliphatic heptamethylene unit, temperature-dependent reversible gelation was mainly induced by entanglements of PEG chains at concentrations higher than 5 wt.%. When R was a linker containing cationic amine groups, thermo-irreversible hydrogels were promptly generated at concentrations higher than 20 wt.%. In the latter case, stereocomplexation of the PLA blocks randomly distributed in micellar aggregates is proposed as the major determinant of the gelation process.

Jaw motion tracking functionalities of cone beam computed tomography (CBCT)-scanners can visualize, record, and analyze movements of the mandible. In this explorative study, the validity of the 4D-Jaw Motion module (4D-JM) of the ProMax 3D Mid CBCT scanner (Planmeca, Helsinki, Finland) was tested in vitro. The validity of the 4D-JM was accepted if values differed less than 0.6 mm (three voxels sizes) from the gold standard. Three dry human skulls were used. CBCT scans, the gold standard, were taken in eight jaw positions and exported as three-dimensional (3D) models. Individualized 3D-printed dental wafers ensured the correct positioning of the mandible. Jaw positions were recorded with the 4D-JM tracking device and exported as 3D models. The coordinates of six reference points for both superimposed 3D models were obtained. The differences in the x, y and z-axis and the corresponding vector differences between gold standard 3D models and 4D-JM models were calculated. For the mandible 10% and for the maxilla 90% of the vector differences fell within 0.6 mm of the gold standard. With an increasing vertical jaw opening, larger differences between the gold standard and the 4D-JM 3D models were found. The smallest differences of the mandible were observed on the x axis. In this study, the 4D-JM validity was not acceptable by the authors' predefined standards.

Several new systems for three-dimensional (3D) surface imaging of the face have become available to assess changes following orthognathic or facial surgery. Before they can be implemented in practice, their reliability and validity must be established. Our aim, therefore, was to study the intra- and inter-system reliability and validity of 3dMD (stereophotogrammetry), Artec Eva and Artec Space Spider (both structured light scanners). Intra- and inter-system reliability, expressed in root mean square distance, was determined by scanning a mannequin’s head and the faces of healthy volunteers multiple times. Validity was determined by comparing the linear measurements of the scans with the known distances of a 3D printed model. Post-processing errors were also calculated. Intra-system reliability after scanning the mannequin’s head was best with the Artec Space Spider (0.04 mm Spider; 0.07 mm 3dMD; 0.08 mm Eva). The least difference in inter-system reliability after scanning the mannequin’s head was between the Artec Space Spider and Artec Eva. The best intra-system reliability after scanning human subjects was with the Artec Space Spider (0.15 mm Spider; 0.20 mm Eva; 0.23 mm 3dMD). The least difference in inter-system reliability after scanning human subjects was between the Artec Eva and Artec Space Spider. The most accurate linear measurement validity occurred with the Artec Space Spider. The post-processing error was 0.01 mm for all the systems. The Artec Space Spider is the most reliable and valid scanning system.