Adaptation Of Prosthesis Research Articles

O RETORNO AO TRABALHO E AO SERVIÇO MILITAR DE ADULTOS AMPUTADOS: UMA REVISÃO DE ESCOPO

The rehabilitation of adult amputees involves, among other objectives, the return to work. In this sense, the present study seeks to investigate how the return to work and the return to military service occur for adults who have undergone amputation, identifying the factors of success and analyzing the impact of Occupational Therapy. This is a scoping review that follows the guide for scoping reviews from the Joanna Briggs Institute and includes 22 articles for final data analysis and collection. The following factors related to successful return to the labor market after amputation were identified: male gender; younger age; use of prosthesis; lower pain levels; unilateral amputations; availability of accessible infrastructure in the workplace; job function adaptations and assistive technologies; and administrative positions. Regarding the return to military service, the rank within the army was shown to be the main determinant in the individual's return to service. It is noteworthy that several demands pointed out by the studies regarding the rehabilitation process and return to work can be addressed by occupational therapists, such as the adaptation of prostheses for the specific tasks of the individual, analysis and adaptation of the work environment, pain management and reduction, work activity training, and spiritual support, since beliefs related to the sacred were indicated as the main factor of success for rehabilitation. However, only two articles mention Occupational Therapy, and in both, the service is characterized as inefficient.

TRUENESS AND PRECISION OF DIFFERENT DIGITAL SCAN SYSTEMS IN A TWO IMPLANT COMPLETE ARCH MODEL: AN IN-VITRO STUDY

Background: One of the major concerns in implant-retained prostheses is their accuracy which plays an essential role in implant success and prosthesis adaptation. Although many contemplates stated the indications and merits of different digital scanner systems, little is identified about their trueness and precision in scanning dental implants of implant-retained prostheses. Objectives: This contemplate aimed to evaluate and compare the trueness and precision of two unalike most recent digital scan systems in a mandibular two-implant complete arch model. Materials and Methods: A completely edentulous mandibular cast was utilized into which two conventional dental implant analogs were drilled in its inter-foramina area from which the distance between the analogs was measured by a caliper (Control). The same space was assessed via scanning the whole assembly 13 scans/each digital scanner system. The final distance of each scan attained from both systems was then compared with the control. The accuracy of each system was assessed in terms of trueness and precision. Results: Slight advancement of the Dof Freedom X5 premium digital scanner system than the Medit T300-T500 dental digital scanner regarding trueness although they were still insignificantly different, as P=0.66. The Medit digital scanner system was significantly better than the Dof Freedom one concerning precision, as P=0.001. Conclusion: The two dental laboratory digital scanner systems employed are reliable tools for scanning and reproducing digital dental records accurately for an implant-supported prosthesis. Furthermore, the Medit dental digital scanner system seemed to be more accurate in terms of precision than the Dof Freedom one.

Extrusion and Dislocation in Titanium Middle Ear Prostheses: A Literature Review.

Titanium middle ear (ME) prostheses are widely used in surgical practice due to their acoustic properties. However, they present a significant drawback shared by all synthetic materials currently in use for ME reconstruction: they can be rejected by the organism of the host. In this study, we aim to review the current literature on titanium partial ossicular replacement prostheses (PORPs) and total ossicular replacement prostheses (TORPs) extrusion and dislocation. Eighty articles were analysed after a full article review based on the inclusion and exclusion criteria. The most common indication for reconstruction was chronic otitis media with cholesteatoma. The average extrusion or dislocation rate was 5.2%, ranging from 0 to 35%. The average improvements in the air-bone gap were 12.1 dB (1.6 dB to 25.1 dB) and 13.8 (-0.5 dB to 22.7 dB) for the PORP and TORP groups, respectively. The data reported on this topic are highly variable, demonstrating that functional outcomes are difficult to predict in clinical practice. We believe that the current limitations could be overcome with technological developments, including bioengineering research focused on promoting prosthesis adaptation to the ME environment.

A low-cost easily implementable physiotherapy intervention clinically improves gait implying better adaptation to lower limb prosthesis: a randomized clinical trial

Lower limb amputation highly impacts the lives of individuals. The inability to walk due to difficulties in adapting to wearing prosthesis can potentially result in physical degeneration and comorbidity in this population. In this randomized clinical trial study, we investigated if a low-cost and easily implementable physiotherapy intervention was effective in improving gait performance and adaptation to lower limb prosthesis in individuals with an amputation. A total of 26 individuals participated in the study, 16 with lower limb amputation and 10 without amputation. Participants with amputation were further divided in intervention and control groups. The intervention group underwent a rehabilitation protocol aimed at strengthening muscles and improving prosthesis adaptation. Muscle strengthening targeted the hip segment, prioritizing the abdominal muscles, hip flexors, extensors, adductors and abductors, followed by cicatricial mobilization and weight-bearing on the stump for desensitization. Assessment and measures were performed across the kinetic and kinematic parameters of gait. In the comparison between pre-and post-intervention, a significant increase in gait speed (0.68—2.98, 95% CI, 1.83, effect size ES) and cadence (0.56—2.69, 95% CI, 1.63, ES) was found between groups and time points. Step (0.73—3.11, 95% CI, 1.92, ES) and stride length (0.62—2.84, 95% CI, 1.73) increased between pre- and post-intervention, while in the control group both variables remained smaller. The intervention group decreased stance phase as a percentage of gait cycle between pre- and post-intervention (− 1.33—0.62, 95% CI, − 36, ES), while it increased in the control group. Improvement in a combination of important gait parameters indicates that the intervention protocol promoted the adaptation to prosthesis and the functional independence of individuals with lower limb amputation. It is recommended that the participants continue receiving follow-up assessments and rehabilitation interventions.

Rehabilitation of Atrophic Posterior Mandible with Vertical Ridge Augmentation with Resorbable Membrane: Case Report with 3-Year Follow-up

Background: The placement of implants in the posterior mandible with the vertical bone defect can be associated with inadequate crown height space. Therefore, the vertical bone reconstruction of these defects is often necessary, although this procedure is technically challenging. Methods: A 49-year-old patient attended a private dental office for rehabilitation of an atrophic posterior mandible. The clinical and tomographic findings show absence of teeth #36, #37, #46, #47, and #48 with severe atrophy. Vertical bone augmentation was performed by using the guided bone regeneration technique with pericardium resorbable membrane followed by placement of short implants. The free gingival graft was performed, and after three months, screw-retained lithium disilicate single ceramic crowns were manufactured. Results: After a 3-years follow-up, bone loss around the implants or presence of gingival inflammation was not observed, and the prosthesis adaptation was found to have no alteration either. Therefore, aesthetics, as well as masticatory and speech functions, were preserved. Conclusion: There was no bone loss around the implants. The association between vertically guided bone regeneration using pericardium resorbable membrane is an alternative technique, and it avoids complications related to non-resorbable membrane exposure. It was shown to be viable after a 3-year follow-up.

Symmetry function - An effective tool for evaluating the gait symmetry of trans-femoral amputees.

Prostheses can help persons with trans-femoral amputation (TFA) regain normal function, but such individuals still exhibit gait deviations expressed in gait asymmetries. We apply a specialised tool, the Symmetry Function (SF), to evaluate the symmetry of walking in terms of kinematic and dynamic variables and to identify areas with large side deviations (exceeding defined ±5% threshold) in the movement cycle. Which movements and joints or GRF components revealed the most significant side deviations in the movement cycle? When exactly are they located in the gate cycle? In this retrospective observational study, an instrumented motion analysis system was used to register the gait of fourteen patients after unilateral TFA. Measurements involved evaluating the time series of gait variables characterising a range of motion and the ground reaction force components. Comparison of the prosthetic (involved) limb with the sound (uninvolved) limb in TFA patients was carried out on the basis of the Symmetry Function values. The Symmetry Function proved to be an effective tool to localise the regions of asymmetry and limb dominance in the full gait cycle. The difference between sides revealed by the Symmetry Function was the highest for the pelvis and the hip. In the sagittal plane, the pelvis was asymmetrically tilted, reaching the highest SF value of more than 25 % at 60 % cycle time. In the transverse plane, the pelvis was even more asymmetrically positioned throughout the entire gait cycle (50 % difference). The hip in the frontal plane reached a 60 % difference throughout the single support phase for the involved and then for the uninvolved limb. The Symmetry Function allows for the detection of gait asymmetries, temporal shifts in the gait phases and may assess the precise in time adaptation of prostheses and rehabilitation monitoring, especially in unilateral impairments.

Clinical Walking Tests and Gait Pattern Characterization During 6-Minute Walk Test Using Inertial Sensors: Follow-Up in Individuals With Lower Limb Amputation.

Inertial measurement units and normative values enable clinicians to quantify clinical walking tests and set rehabilitation goals. Objectives of this study were (1)to compare time- and distance-based walking tests in individuals with lower limb amputation (iLLA) and normative values following rehabilitation discharge (T1) and 6 weeks after discharge (T2) and (2)to investigate spatiotemporal and foot kinematic parameters over a 6-minute walk test using inertial measurement units. Twelve iLLA participated in this study. Distance, cadence, stance ratio, loading rate ratio, push-up ratio, path length, and minimum toe clearance were analyzed during 6-minute walk test. Nonparametric repeated-measures analysis of variance tests, Bonferroni corrections, were performed. Time of distance-based walking tests diminished at T2 (P < .02). Compared with normative values, walking performance in iLLA was reduced. Cadence at T2 increased significantly (P = .026). Stance ratio increased in both legs at T2 (P < .05). Push-up ratio tended to decrease at T2 in the amputated leg (P = .0003). Variability of path length and minimum toe clearance at T2 were less than at T1 in the nonamputated leg (P < .05). Spatiotemporal improvement at T2 could be due to prosthesis adaptation in iLLA. The lower performance of the functional walk test compared with normative values could be due to amputation and pain-related fatigue.

Joint speed feedback improves myoelectric prosthesis adaptation after perturbed reaches in non amputees

Accurate control of human limbs involves both feedforward and feedback signals. For prosthetic arms, feedforward control is commonly accomplished by recording myoelectric signals from the residual limb to predict the user’s intent, but augmented feedback signals are not explicitly provided in commercial devices. Previous studies have demonstrated inconsistent results when artificial feedback was provided in the presence of vision; some studies showed benefits, while others did not. We hypothesized that negligible benefits in past studies may have been due to artificial feedback with low precision compared to vision, which results in heavy reliance on vision during reaching tasks. Furthermore, we anticipated more reliable benefits from artificial feedback when providing information that vision estimates with high uncertainty (e.g. joint speed). In this study, we test an artificial sensory feedback system providing joint speed information and how it impacts performance and adaptation during a hybrid positional-and-myoelectric ballistic reaching task. We found that overall reaching errors were reduced after perturbed control, but did not significantly improve steady-state reaches. Furthermore, we found that feedback about the joint speed of the myoelectric prosthesis control improved the adaptation rate of biological limb movements, which may have resulted from high prosthesis control noise and strategic overreaching with the positional control and underreaching with the myoelectric control. These results provide insights into the relevant factors influencing the improvements conferred by artificial sensory feedback.

Navigational guidelines and positional relationships of the human auditory ossicles from three-dimensional topography for ensuring safe and effective malleostapedotomy : Stereotactic topography of the auditory ossicles and its clinical implication.

The aims of the present study were to identify detailed positional relationship between the auditory ossicles and to provide theoretic navigational guidelines for optimal prosthesis adaptation and effective malleostapedotomy. Fifty sides of the temporal bone from donated cadavers were scanned by MicroCT and the malleus, incus, stapes and tympanic membrane were materialized three dimensionally using computer software. Dimensions between the auditory ossicles closely related to malleostapedotomy were measured twice. The grip site of malleus handle was mean 1.8mm superior and mean 1.3mm anterior, and linear distance between the grip site of malleus handle and the footplate of the stapes was mean 6.5mm. The stapes was not parallel to the tympanic membrane and rotated mean 10.7° posteriorly relative to the tympanic membrane. Surgeons should start with at least 8.75mm prosthesis to cover the upper limits of potential anatomy and then trim down to the individualization to the case. The ideal loop morphology has to be oval shape more than 1.4mm in the long diameter and 1.0mm in the short diameter. The wire of the prosthesis has to be bended at the two points: about 10° anteriorly at the most proximal point of the wire and about 50° superiorly at the stapes head point.

Will they fit? Determinants of the adaptability of stock TMJ prostheses where custom TMJ prostheses were utilized

Currently only two alloplastic temporomandibular joint (TMJ) total joint replacement (TJR) systems are available in the United States. The aim of this study was to define variables that determine whether a Biomet stock prosthesis could have been used to reconstruct a TMJ previously reconstructed with a TMJ Concepts patient-fitted prosthesis. All of the TMJ Concepts prostheses placed between 2010 and 2018 at the University of Texas – Health at San Antonio were analyzed retrospectively. There were 128 cases (241 joints) with intact stereolithographic models analyzed for successful adaptation of the Biomet stock TMJ prosthesis. Anatomical, demographic, etiological, and perioperative data were gathered for each joint to investigate possible causes of failure of stock adaptation. The majority of joints, 74% (178/241), could have had a stock prosthesis adapt. All joints with ≥40mm gap arthroplasty failed stock prosthesis adaptation. Only 50% (32/64) of the joints with at least one previous open TMJ surgery and 60% (58/96) of the joints with concomitant orthognathic surgery could have had a stock TMJ prosthesis. The stock prosthesis could not be adapted for any of the patients requiring TMJ replacement for congenital disorders or those requiring TMJ salvage. Overall, the majority of cases treated with a patient-specific TMJ TJR could have been treated with a stock prosthesis.

Sociodemographic Determinants for the Health-Related Quality of Life of Patients with Vascular Amputations as Determined with the Prosthesis Evaluation Questionnaire.

Background: To identify the sociodemographic variables independently related to the different dimensions of the Prosthesis Evaluation Questionnaire (PEQ). Methods: An observational, cross-sectional study was conducted, with a sample of 61 Spanish vascular amputees (Valencia, Spain). Included in this study are the results of the PEQ and explanatory-sociodemographic variables, as well as a descriptive and analytic analysis. Results: Gender differences were observed in “appearance” and “perception of appearance” (significantly higher levels for men). Older patients tended to have worse scores in “utility”, “frustration”, “social burden” and “deambulation”. More favorable scores were obtained for those residing in rural areas in “social burden” and “deambulation”. Educational level had a positive correlation with scores. Conclusion: Gender, age, place of residence, and educational level could be considered determinants of the quality of health related to prosthesis adaptation in vascular amputees. Clinical relevance: Knowing the influential variables in the process of prosthetization will allow better adaptation and an improvement in the quality of life.

LIQUID SUPPORTED MAXILLARY COMPLETE DENTURE: A CASE REPORT

Patients with problematic situations like flabby tissues, diabetes, xerostomia, atrophied ridges, parafunctional habits, etc. pose significant problems in attaining basic objectives of getting a stable and retentive dental prosthesis. In the literature, several techniques have been mentioned, each having their own advantages and disadvantages, to achieve continued adaptation of dental prosthesis to the mucosa both at resting and functional state in such situations. This article presents a case report describing a technique of fabricating a liquid supported maxillary complete denture in which the characteristics of pliability and rigidity can be combined to achieve the objectives of proper retention, stability, support and comfort to the patient.

Evaluation of clinical adaptation of dental prostheses printed by 3-dimensional printing technology

Evaluation of clinical adaptation of dental prostheses printed by 3-dimensional printing technology

Prosthetic Limb Design and Function: Latest Innovations and Functional Results

We review the latest innovations and functional results in prosthetic limb design and function. Bionic prostheses, computer-aided design software applications, 3D scanners, automated carving machines, are recent innovations in limb designs. Recent advances in the development of bionic prostheses, computer-aided design software applications, 3D scanners, automated carving machines, as well as the development of measuring and alignment devices that allow us the placement, orientation, adjustment, and adaptation of prosthesis to the particular conditions of the user, in a biomechanically correct manner, have meant a definitive leap towards an improvement in the quality of life. The application of new technologies such as 3D printing is proposed as an alternative to reduce costs. We discuss here both the current advances in bioelectric prostheses, their benefits and advantages, and the applications of 3DP in clinical practice.

Evaluation of sealing between abutment and inner connection of cone morse dental implant

Introduction: The adaptation of prostheses fixed over implants involves biomechanical aspects that are directly associated with treatment success. Objective: The aim of this in vitro study was to evaluate the presence of microgaps in the abutment/inner connection interface of cone morse dental implants. Materials and methods: Two groups of implants were analyzed. The first group (n = 16) employed single-manufacturer dental implants and abutments, whereas the second group (n = 16) combined multi-manufacturer materials. The sets were analyzed through scanning electron mi­croscopy, wherein microgaps between the implant connection and the abutment were observed. Results: Group 1 had an average microgap of 5.69 μm (SD ± 8.46 μm). Group 2 had an average microgap of 1.24 μm (SD ± 0.44 μm). A significant difference was found between the two groups (p = 0.002). Conclusion: Within the limitations of this study, results suggest that the group formed by multi-manufacturer implants and abutments (group 2) had smaller microgap values, and, therefore, a higher in vitro adaptation of components.&#x0D; DESCRIPTORS | Dental Implants; Dental Abutments; Scanning Electron Microscopy.

Nonsurgical periodontal treatment and prosthetic rehabilitation of a renal transplant patient with gingival enlargement: a case report with 2-year follow-up

BackgroundDrug-induced gingival enlargement is a common condition which can be observed in patients taking immunosuppressive medications following organ transplant surgery. The disfiguring excessive tissue often hinders proper oral hygiene practices, therefore accompanied by periodontitis, tooth mobility, and even pathological tooth migration in extreme cases. This case report presents a conservative treatment protocol for a patient with the aforementioned conditions involving neither surgical nor orthodontic intervention. Few related studies have reported such a noninvasive protocol for managing these kinds of conditions.Case presentationA 51-year-old woman presented with bleeding gingiva, mobile teeth and complained of chewing difficulties. She had undergone renal transplant surgery 16 years prior to this dental visit and had been taking immunosuppressive drugs including cyclosporine ever since. After clinical and radiographic examinations, the patient was diagnosed with drug-induced gingival enlargement, pathological tooth migration, severe periodontitis, and missing teeth. Through careful and meticulous nonsurgical debridement, oral hygiene instruction, tooth extraction, and occlusal adjustment, the patient’s periodontium was restored to a healthy state without surgical intervention. Moreover, the patient’s chewing function was restored by means of removable partial dentures. Good adaptation of prostheses and satisfaction with overall treatment outcomes were reported.ConclusionsThrough proper diagnosis, treatment, and with good patient cooperation, complex systemic and dental problems can be managed conservatively without invasive surgeries to attain a stable periodontium and eventually, occlusal function could be restored.

Evoked haptic sensations in the hand via non-invasive proximal nerve stimulation

Objective. Haptic perception of a prosthetic limb or hand is a crucial, but often unmet, need which impacts the utility of the prostheses. In this study, we seek to evaluate the feasibility of a non-invasive transcutaneous nerve stimulation method in generating haptic feedback in a transradial amputee subject as well as intact able-bodied subjects. Approach. An electrode grid was placed on the skin along the medial side of the upper arm beneath the short head of the biceps brachii, in proximity to the median and ulnar nerves. Varying stimulation patterns were delivered to different electrode pairs, in order to emulate different types of sensations (Single Tap, Press-and-Hold, Double Tap) at different regions of the hand. Subjects then reported the magnitude of sensation by pressing on a force transducer to transform the qualitative haptic perception into a quantitative measurement. Main results. Altering current stimulations through electrode pairs on the grid resulted in repeatable alterations in the percept regions of the hand. Most subjects reported spatial coverage of individual fingers or phalanges, which can resemble the whole hand through different pairs of stimulation electrodes. The different stimulation patterns were also differentiable by all subjects. The amputee subject also reported haptic sensations similar to the able-bodied subjects. Significance. Our findings demonstrated the capabilities of our transcutaneous stimulation method. Subjects were able to perceive spatially distinct sensations with graded magnitudes that emulated tapping and holding sensation in their hands. The elicitation of haptic sensations in the phantom hand of an amputee is a significant step in the development of our stimulation method, and provides insight into the future adaptation and implementation of prostheses with non-invasive sensory feedback to the users.

Current overview of the state of disabled population, regarding the use of transtibial prosthesis

En el Centro de Diseño y Metrología del SENA– CDM se ha detectado que la población en condición de discapacidad de miembros inferiores representa un desafío técnico y tecnológico en la recuperación de las condiciones normales de la marcha, puesto que se requieren intervenciones costosas o elementos que ayuden al desplazamiento de estas personas, como bastones, sillas de ruedas, muletas u otros implementos que sirvan de soporte y faciliten la rehabilitación del paciente. Es importante tener en cuenta que hay dudas acerca de si las prótesis existentes en el mercado suplen las necesidades económicas y de funcionalidad de cada paciente. Con esta investigación se pretende implementar una prótesis transtibial, a fin de mejorar algunas condiciones de la marcha del paciente. Colombia no cuenta con muchas entidades que diseñen y fabriquen los elementos que componen una prótesis. Por tal razón y porque en el SENA, específicamente en el Centro de Diseño y Metrología- CDM, hace aproximadamente cinco años se viene trabajando en el diseño y adaptación de ortesis y prótesis, pero con componentes importados, se quiere diseñar e implementar una articulación de tobillo para amputación transtibial, haciendo uso del recurso humano y tecnológico disponible en el país, y así, poder desarrollar un sistema con manufactura propia y 100 % SENA, que cumpla con las características de funcionalidad y ergonomía para los pacientes con dicha discapacidad. Este artículo científico original recopila la Información más relevante sobre un tema que afecta nuestra sociedad. Aquí se analizan diferentes fuentes bibliográficas descritas en la literatura existente. Con ellas creamos las etapas necesarias para la redacción del artículo definiendo los objetivos de la revisión, haciendo la búsqueda más relevante de la bibliografía y organizando la información de acuerdo con mapas mentales para redactar el artículo.

Daily living activities quantification for a transfemoral amputee subject using embedded sensors

Microprocessor prostheses all have embedded sensors. The data recorded by these sensors could be used in classification algorithms for real life activity recognition. Activity recognition can be used for the adaptation and the evaluation of the rehabilitation by assessing the performance progression of the patient. It can also serve for a better prosthesis adaptation to the terrain. Recently, a knee ankle prosthesis system has been described which adapts to slopes and stairs situations. These prosthesis sensors were used to setup an activity recognition algorithm. A single subject, equipped with the knee ankle system, walked continuously in four situations (stair descent, slope ascent and descent, and level walking) for four to five minutes. Sensors data were recorded and synchronized with a video. This protocol was repeated on three different days. Sensors signals were segmented according to the gait cycles and labelled according to the video as one of the four situations. One hundred and forty-nine features were extracted from extrema, thresholds and ranges of the signal sensors and used to feed a machine-learning algorithm. A decision tree algorithm was chosen for its simplicity and understandability. Data from the two first days were used to train the algorithm and set the tree complexity. The last day was used to evaluate the tree error with a confusion matrix, the specificity and the sensitivity of each situation versus all the others. The optimal tree complexity led to four final branches, which means that only three different features had been used for the activity recognition. A 98% mean specificity and sensitivity across all situations was found. The decision tree has the advantage to give an intelligible final model that can be explained to a patient. But decision tree are known to be prone to overfitting. This overfitting can be avoided by a precise methodology followed in this study. The results of this study are encouraging with a very low error rate. The next step of this work is to train a generic decision tree on several patients and to implement it on the knee ankle prosthesis to give an activity report to the user or the practitioner.

Alternative Method to Evaluate the Adaptation of Implant-Supported Multi-Unit Prosthetic Frameworks.

Various methods to evaluate the adaptation of dental prostheses are available; however, only a few of these methods assess the adaptation of the framework as a whole. This study aimed to propose an alternative method to evaluate the adaptation of implant-supported multi-unit Co-Cr alloy frameworks. A four-unit framework supported by two implants was designed using a computer. Six dots with a diameter of 0.2 mm were designed randomly using 3Shape software on the abutment surface of the framework for measurement. Then, Co-Cr frameworks were fabricated via the milled and selective laser melting (SLM) techniques (n = 10 for each technique). They were subsequently scanned and exported as files in stereolithography format. The distances between two dots roughly along 3D directions were measured in both the designed framework and fabricated frameworks. The differences in distances were calculated. The adaptation of the frameworks was also evaluated using the impression replica method. The data were compared and statistically analyzed via t-test. The average difference of the distances between the designed and milled frameworks was 0.046 ± 0.057 mm when evaluated using the new method. This result was significantly different from that between the designed and SLM frameworks (0.073 ± 0.048 mm, p < 0.05). The average marginal gap width of the milled frameworks was 44.44 ± 8.61 μm when evaluated using the impression replica method. This result was also significantly different from that of the SLM frameworks (57.31 ± 7.97 μm, p < 0.05). The new method can evaluate the adaptation of implant-supported multi-unit frameworks, thereby making assessments more effective and comprehensive when it is combined with the traditional impression replica technique.