Prosthetic Material Research Articles

The evolution of knowledge for treating Gram-negative bacterial infections.

Infections caused by nonprimarily pathogenic Gram-negative bacilli (GNB) have been increasingly reported from the second half of the 20th century to the present. This phenomenon has expanded during the antibiotic era and in the presence of immunodeficiency.Before the discovery of sulphonamides and penicillin G, infections caused by GNB were rare compared to Gram-positive infections. The advent of anticancer therapy, the expansion of surgical procedures, the use of corticosteroids, and the implantation of prosthetic materials, along with better control of Gram-positive infections, have promoted the current increase in GNB infections.GNB have similar antimicrobial targets to Gram-positive bacteria. However, only antibiotics that can penetrate the double membrane of GNB and remain in them for a sufficient duration have antibacterial activity against them. Sulphonamides and early penicillins had limited activity against GNB. Ampicillin and subsequent beta-lactams expanded their spectrum to treat GNB. Aminoglycosides may re-surge with less toxic drugs, as highly resistant to beta-lactams GNB rise. Polymyxins, tetracyclines, and fluoroquinolones are also used for GNB. Combinations with other agents may be needed in specific cases, such as in the central nervous system and prostate, where beta-lactams may have difficulty reaching the infection site.Alternatives to current treatments must be sought in the discovery of new drug families and therapies such as phage therapy combined with antibiotics. Narrower-spectrum immunosuppressive therapies and antibiotics, antimicrobials that minimally intervene with the human microbiota, and instant diagnostic methods are necessary to imagine a future where currently dominant bacteria in infectious pathology lose their preeminence.

Research progress of highly wear‐resistant and oxidation‐resistant polymer acetabular cup prosthesis

AbstractThe polymer‐based acetabular cup prosthesis, a vital component of hip replacement surgery, significantly contributes to the recovery of patients afflicted with osteoarthritic conditions. Nevertheless, the current clinical usage of polymer acetabular cup prostheses commonly encounters the challenge of balancing wear resistance and oxidation resistance, significantly impacting both their lifespan and patients′ quality of life. Consequently, researchers have persistently enhanced the attributes of polymer acetabular cup prosthetic materials. These enhancements, including irradiation and filler modifications, are intended to concurrently bolster both the wear and oxidation resistance of the prosthesis materials. This comprehensive approach aims to address wear‐associated clinical complications like osteolysis and oxidative brittleness, ultimately extending their in vivo service life. For this reason, this paper retrospectively discusses the progress of research on the modification of polymer acetabular cup prosthesis materials for high wear and oxidation resistance and explores potential design methods for optimising artificial acetabular cup materials, with a view to providing new ideas for extending the service life of artificial joint implants.

Breast Reconstruction: The Oncoplastic Approach.

Breast reconstruction surgery is continualladvancing, significantly enhancing patient well-being. Current surgical techniques prioritize minimizing donor site morbidity while achieving a more natural breast appearance. Increasing patient preferences for avoiding prosthetic materials in reconstruction, along with advancements in oncological safety and heightened aesthetic expectations, are driving the exploration and development of innovative approaches. Today's reconstructive options range from straightforward oncoplastic glandular remodeling to intricate microsurgical procedures. This narrative review, titled "Breast reconstruction: the oncoplastic approach," provides a comprehensive overview of contemporary trends in breast-conserving treatment. It evaluates the indications for these techniques and offers guidance to plastic surgeons in crafting personalized treatment plans. This approach presents a valuable single-stage alternative or adjunct to traditional prosthetic or microsurgical reconstruction methods.

Evidence on How Prosthetic Materials Can Influence the Stability of the Implant Rehabilitation Supporting Tissues

Evidence on How Prosthetic Materials Can Influence the Stability of the Implant Rehabilitation Supporting Tissues

Перспективы применения принтованных временных ортопедических конструкций при длительной эксплуатации

The non-removable temporary structures are used in orthopedic dentistry to provide high-quality treatment. The approaches in prosthetics are conditionally divided into conventional and digital. These approaches imply the use of both common materials for prosthetics and unique options. When the conventional approach is used, the quality of orthopedic dental treatment depends on the manual skill of the provider (dental technician). Unlike the conventional approach, the digital one uses a wide range of libraries with ready-made templates for various options for the dentoalveolar system aesthetic and functional characteristics. This fact allows the attending physician to do without any intermediary for the manufacture of dental prostheses, if the material and technical resources permit. The use of 3D printing in dentistry has only recently begun. From our point of view, the active use of photopolymer 3D resins can become a promising option in terms of economic and strength characteristics.

Epidemiological and microbial trends of infective endocarditis in western Norway: a 7-year prospective observational study

BackgroundIn this prospective, observational study, we aimed to investigate epidemiologic and microbial trends of infective endocarditis in western Norway.MethodsClinical and microbiological characteristics of 497 cases of infective endocarditis from 2016 through 2022 were investigated. Categorical data were analysed using Chi-squared tests. Survival data were analysed using multiple Cox regression and reported using hazard ratios.ResultsThe mean age was 67 years, and 74% were men. The annual incidence rates varied from 10.4 to 14.1 per 100,000 inhabitants per year. Infective endocarditis on native valves was observed in 257 (52%) of the cases, whereas infective endocarditis on prosthetic valves and/or cardiac implantable electronic devices was observed in 240 (48%) of the cases: infection on surgically implanted bioprostheses was observed in 124 (25%) of the patients, infection on transcatheter aortic valve implantation was observed in 47 (10%) patients, and infection on mechanical valves was observed in 34 (7%) cases. Infection related to cardiac implantable electronic devices was observed in a total of 50 (10%) cases.Staphylococcus aureus and viridans streptococci were the most common microbial causes, and isolated in 145 (29%) and 130 (26%) of the cases, respectively.Enterococcal endocarditis showed a rising trend during the study period and constituted 90 (18%) of our total cases of infective endocarditis, and 67%, 47%, and 26% of the cases associated with prosthetic material, transcatheter aortic valve implantation and cardiac implantable electronic devices, respectively.There was no significant difference in 90-day mortality rates between the native valve endocarditis group (12%) and the group with infective endocarditis on prosthetic valves or cardiac implants (14%), p = 0.522. In a model with gender, age, people who inject drugs, microbiology and type of valve affected, only advanced age was significantly associated with fatal outcome within 90 days.ConclusionsThe incidence of infective endocarditis, and particularly enterococcal endocarditis, increased during the study period. Enterococci appeared to have a particular affinity for prosthetic cardiac material. Advanced age was the only independent risk factor for death within 90 days.

Oral versus intravenous empirical antibiotics in children and adolescents with uncomplicated bone and joint infections: a nationwide, randomised, controlled, non-inferiority trial in Denmark

Bone and joint infections (BJIs) are treated with intravenous antibiotics, which are burdensome and costly. No randomised controlled studies have compared if initial oral antibiotics are as effective as intravenous therapy. We aimed to investigate the efficacy and safety of initial oral antibiotics compared with initial intravenous antibiotics followed by oral antibiotics in children and adolescents with uncomplicated BJIs. From Sept 15, 2020, to June 30, 2023, this nationwide, randomised, non-inferiority trial included patients aged 3 months to 17 years with BJIs who presented to one of the 18 paediatric hospital departments in Denmark. Exclusion criteria were severe infection (ie, septic shock, the need for acute surgery, or substantial soft tissue involvement), prosthetic material, comorbidity, previous BJIs, or antibiotic therapy for longer than 24 h before inclusion. Patients were randomly assigned (1:1), stratified by C-reactive protein concentration (<35 mg/L vs ≥35 mg/L), to initially receive either high-dose oral antibiotics or intravenous ceftriaxone (100 mg/kg per day in one dose). High-dose oral antibiotics were coformulated amoxicillin (100 mg/kg per day) and clavulanic acid (12·5 mg/kg per day) in three doses for patients younger than 5 years or dicloxacillin (200 mg/kg per day) in four doses for patients aged 5 years or older. After a minimum of 3 days, and upon clinical improvement and decrease in C-reactive protein, patients in both groups received oral antibiotics in standard doses. The primary outcome was sequelae after 6 months in patients with BJIs, defined as any atypical mobility or function of the affected bone or joint, assessed blindly, in all randomised patients who were not terminated early due to an alternative diagnosis (ie, not BJI) and who attended the primary outcome assessment. A risk difference in sequelae after 6 months of less than 5% implied non-inferiority of the oral treatment. Safety outcomes were serious complications, the need for surgery after initiation of antibiotics, and treatment-related adverse events in the as-randomised population. This trial was registered with ClinicalTrials.gov, NCT04563325. 248 children and adolescents with suspected BJIs were randomly assigned to initial oral antibiotics (n=123) or initial intravenous antibiotics (n=125). After exclusion of patients without BJIs (n=54) or consent withdrawal (n=2), 101 patients randomised to oral treatment and 91 patients randomised to intravenous treatment were included. Ten patients did not attend the primary outcome evaluation. Sequelae after 6 months occurred in none of 98 patients with BJIs in the oral group and none of 84 patients with BJIs in the intravenous group (risk difference 0, one-sided 97·5% CI 0·0 to 3·8, pnon-inferiority=0·012). Surgery after randomisation was done in 12 (9·8%) of 123 patients in the oral group compared with seven (5·6%) of 125 patients in the intravenous group (risk difference 4·2%, 95% CI -2·7 to 11·5). We observed no serious complications. Rates of adverse events were similar across both treatment groups. In children and adolescents with uncomplicated BJIs, initial oral antibiotic treatment was non-inferior to initial intravenous antibiotics followed by oral therapy. The results are promising for oral treatment of uncomplicated BJIs, precluding the need for intravenous catheters and aligning with the principles of antimicrobial stewardship. Innovation Fund Denmark and Rigshospitalets Forskningsfond.

Design and Analysis of Finger Prosthetics Using Finite Element Methods

According to the Central Statistics Agency (BPS), the total number of physically disabled people in Indonesia until 2020 reached 22.5 million people. However, only around 18% use assistive devices. 3D printing technology in the world of health can be used to print prosthetic materials. However, many previous functional prosthetic designs were still fabricated conventionally and did not pay attention to prosthetic standards and quality. One computational testing method that can be used to test prosthetic strength is the finite element method. The aim of this research is to produce a functional finger prosthetic design that has tested its strength through computational simulations using the finite element method to minimize prosthetic production costs so that the resulting prosthetics are more affordable.The tools needed in this research are a ruler for finger measurements and a computer or laptop with Fusion 360 software.Based on the analysis results, it shows that this model is able to withstand loads of up to 100 N with deformation, stress and safety factor values produced respectively of 0.016 mm, 27,605 MPa and 7.49.

Tissue engineered decellularized bovine pericardium as prosthetic material in paediatric cardiac surgery

Tissue engineered decellularized bovine pericardium as prosthetic material in paediatric cardiac surgery

Temporal Trends, Health Care Resource Utilization and In-hospital Outcomes of Very Early Infective Endocarditis After Transcatheter Edge-to-Edge Repair

Current practice guidelines recommend antibiotic prophylaxis in patients with high-risk congenital heart conditions, including those with Prosthetic heart valves and prosthetic material, including annuloplasty rings or clips undergoing invasive dental procedures. However, there is limited clinical data on the burden of infective endocarditis (IE) following Mitral TEER. This study investigated temporal trends of very early IE immediately after TEER using National Inpatient Sample from 2016 - 2020. It showed that the rate of very early TEER-related IE was relatively low over the five years of analysis and that there was a downward trend of very early IE after TEER.

Evaluating the Impact of Prosthetic Material Choices on the Clinical Outcomes of Implant-Supported Restorations

ABSTRACT Background: By resolving the difficulties associated with missing teeth, implant-supported restorations have emerged as a key component of contemporary dentistry. The choice of prosthetic materials is crucial in establishing the durability and clinical efficacy of these restorations. Methods: A prospective design was used at a tertiary care hospital with 150 patients receiving implant-supported restorations. Depending on which of the three prosthetic materials were utilized for their prosthesis—ceramic, metal, or polymer—the patients were randomized into one of three groups. Clinical assessments were carried out at baseline and at regular intervals for a minimum follow-up period of [insert time]. These evaluations included implant stability, peri-implant health, restorative integrity, patient satisfaction, and maintenance needs. Results: When compared to metal and polymer alternatives, ceramic restorations showed superior implant stability (75.2 ± 3.6 N cm), peri-implant health (1.8 ± 0.4), and restoration integrity (92%). Ceramic restorations had the greatest patient satisfaction ratings (8.5 ± 1.2), but there was no statistically significant difference between the material groups. Restorations made of polymers showed the greatest maintenance requirements (2.0 ± 0.9). Conclusion: The choice of prosthetic material has a major impact on how well implant-supported restorations function clinically. Ceramic restorations performed better in terms of restoration quality, peri-implant health, and implant stability, demonstrating their appropriateness for producing positive long-term outcomes.

Comparison of Maintenance in Different Materials for Implant Dental Prostheses

ABSTRACT Context: In contemporary prosthodontics, implant-supported dental prostheses are frequently utilized to restore function and esthetics for individuals who are edentulous. The prosthetic material selection has a big impact on long-term performance and maintenance needs. Methods: A retrospective review of patient files from the dental implant clinic of a tertiary care facility was done. Included were patients who had dental prosthesis supported by implants between January 2018 and December 2022. Data were gathered and examined on the prosthesis material, follow-up visits, and maintenance interventions (adjustments, repairs, and replacements). Results: Materials for 50 prostheses made of porcelain, 45 prostheses made of acrylic, 35 prostheses made of metal, and 40 prostheses made of composite were assessed. When it came to modifications and repairs, porcelain prosthesis needed less work than acrylic prostheses. Composite prostheses required the least amount of maintenance overall, whereas metal prostheses indicated a considerable demand for maintenance. Conclusion: Superior durability is provided by porcelain, frequent repairs are needed for acrylic, structural strength is provided by metal, and composite material gives promising esthetics with low maintenance requirements. These results highlight how crucial it is to take material properties into account when choosing a prosthesis to maximize long-term results and patient happiness.

Infective Endocarditis Due to Corynebacterium jeikeium: Four Case Reports and Narrative Review of the Literature.

Corynebacterium jeikeium, a pleomorphic Gram-positive bacillus, is a common component of the cutaneous microbiota, usually considered as a contaminant, with little pathogenic potential. However, its role in various types of infections, such as bacteremia, sepsis, endocarditis (IE) and infection of prosthetic material is gradually being proven. Few cases of IE due to Corynebacterium jeikeium have been described in the literature. The aim of this article was to describe four cases of IE due to Corynebacterium jeikeium diagnosed in our hospital between May 2021 and April 2022, as well as to conduct a narrative review of the literature on this entity. After analysis, we highlight that 65.6% were men, 81.3% were valve or intravascular device carriers, and IE cases presented early, before one year after surgery. The most affected valve was the aortic valve (68.8%), followed by the mitral valve (21.1%). Valve replacement was performed in 65.6% of cases, and the most commonly used antibiotic was vancomycin (68.8%) at a dose of 15 mg/kg/12 h. With respect to prognosis, the overall mortality rate was 21.9%. The comparative results between our series and the literature review were similar except for a higher mortality rate (50%) and the use of dalbavancin in the treatment. We go on to review previously reported cases, along with four cases described in our hospital, of C. jeikeium endocarditis and will discuss various aspects of C. jeikeium infection, focusing on microbiology, pathophysiology, and treatment.

Determination of the Color Change of Various Esthetic Monolithic Monochromatic Computer-Aided Design/Computer-Aided Manufacturing Materials.

Dental technology has developed materials for prosthetics that are very similar to natural teeth and offer a good balance between durability and esthetics; however, some of these materials are not very color-stable under the influence of external factors. Therefore, the aim of this study is to determine and compare the color change (∆E00) of different esthetic monolithic monochromatic CAD/CAM materials after they have been thermocycled and treated with staining solutions. The color parameters were determined using a spectrophotometer on a white and black background. Five CAD/CAM materials were used for this study-CAD/CAM nanoceramic (GC Cerasmart270), CAD/CAM lithium disilicate ceramic (IPS e.max CAD), CAD/CAM polymer (Telio CAD), CAD/CAM composite (Tetric CAD) and CAD/CAM polymer-infiltrated ceramic (Vita Enamic). The test specimens produced were divided into groups and were thermocycled in distilled water. They were then stored for four weeks at 37 °C in either distilled water as a control liquid, black tea, instant coffee or red wine. The aim is also to evaluate the color changes as a function of the exposure time of the staining solutions. The results obtained were analyzed statistically. All CAD/CAM materials tend to discolor to varying degrees. Among the factors contributing to discoloration, red wine proved to be the most significant influencing factor. The conclusion from the results is that the color change is influenced by the type of material, the staining solution, the sample thickness, the color background and the aging time.

Effect of Compressive Modulus of Porous PVA Hydrogel Coating on the Preventing Adhesion of Polypropylene Mesh.

PP mesh is a widely used prosthetic material in hernia repair. However, visceral adhesion is one of the worst complications of this operation. Hence, an anti-adhesive PP mesh is developed by coating porous polyvinyl alcohol (PVA) hydrogel on PP surface via freezing-thawing process method. The compressive modulus of porous PVA hydrogel coating is first regulated by the addition of porogen sodium bicarbonate (NaHCO3) at various quality ratios with PVA. As expected, the porous hydrogel coating displayed modulus more closely resembling that of native abdominal wall tissue. In vitro tests demonstrate the modified PP mesh show superior coating stability, excellent hemocompatibility, and good cytocompatibility. In vivo experiments illustrate that PP mesh coated by the PVA4 hydrogel that mimicked the modulus of native abdominal wall could prevent adhesion effectively. Based on this, the rapamycin (RPM) is loaded into the porous PVA4 hydrogel coating to further improve anti-adhesive property of PP mesh. The Hematoxylin and eosin (H&E) and Masson trichrome (MT) staining results verified that the resulting mesh could alleviate the inflammation response and reduce the deposition of collagen around the implantation zone. The biomimetic mechanical property and anti-adhesive property of modified PP mesh make it a valuable candidate for application in hernioplasty.

Cutibacterium Species Valvular and Cardiac Device-Related Infective Endocarditis: Contemporary Data From the GAMES Prospective Cohort (2008-2023).

Information on infective endocarditis (IE) caused by Cutibacterium spp. is limited and new Duke-International Society for Cardiovascular Infectious Diseases (ISCVID) criteria have not yet been properly assessed. We examined clinical characteristics, outcomes, and performance of diagnostic tests for Cutibacterium valvular and cardiac implantable electronic device-related IE (CIED-IE). Data corresponding to all episodes of Cutibacterium IE recorded from 2008 to 2023 in a prospective national cohort including 46 Spanish hospitals were examined. Possible IE cases were reassessed using the new criteria. The sensitivity of blood cultures, valvular and CIED cultures, and polymerase chain reaction of the 16S rRNA gene and sequencing (16SPCR) was evaluated. Of 6692 episodes of IE, 67 (1%) were caused by Cutibacterium spp. with 85% affecting men. Of these, 50 were valve-related (45 prosthetic, 5 native) and 17 CIED-related. The new criteria identified 8 additional cases and reclassified 15 as definite IE. Intracardiac complications (abscess, pseudoaneurysm, perforation, or intracardiac fistula) occurred in 23 of 50 (46%) valvular IE episodes, leading to 18% mortality, and up to 40% mortality if surgery was indicated but could not be performed. All CIED-IE cases underwent device removal and no deaths were recorded. Positive diagnosis rates for blood cultures, valve/device cultures, and 16SPCR were 52%, 70%, and 82%, respectively. Cutibacterium IE is a rare yet potentially life-threatening condition that warrants a high index of suspicion in men with endovascular prosthetic material. The new Duke-ISCVID criteria and molecular techniques are useful for its diagnosis. Considering a significant complication rate, cardiac surgery and removal of CIEDs play a key role in reducing mortality.

Fifteen-year recall period on zirconia-based single crowns and fixed dental prostheses. A prospective observational study

AimThe aim of this study was to evaluate the long-term clinical outcomes of zirconia-based prostheses used for tooth-supported or implant-supported single crowns and fixed dental prostheses (FPD).MethodsThe authors conducted a prospective analysis of 562 zirconia core restorations supported by endodontically treated teeth or titanium implant in 276 patients in a general dental private practice, with a follow-up period of 15 years. The study was stopped after patients achieved 15 yrs of follow-up. The study analyzed the failure and complication rates of single and multiple crowns, based on Kaplan Meier analysis.ResultsDuring follow-up period, there were 26 complications and 156 failures. The crown level analysis revealed a cumulative failure rate of 28.33% and complication rate of 8.47% for zirconia crowns after 15 years. The complication rate was found to be higher for titanium implant-supported than for natural teeth-supported crowns. The different types of crown-based failure include: veener fracture 5.01% (N = 29), metal zirconia led to 14.85% (N = 86) loss of retention, and 1.73% (N = 10) loss of crown due to extraction.ConclusionBased on these findings, zirconia core restorations appear to be a reliable long-term solution for crowns and fixed dental prostheses.Clinical relevanceThe study suggests that zirconia restorations can be successfully used for long-term prostheses on natural teeth or implants supported. The study results provide clinicians valuable information when selecting prosthetic restorations material.

Forensic study of the mechanical properties of prosthetic materials: Submersion in mangrove environment – A pilot study

IntroductionIt is crucial for dental surgeons to use the mechanical properties of dental prosthetic materials to correlate the submersion time in a mangrove environment. ObjectiveThis study aimed to submerge dental prosthetic materials, such as acrylic resin and zirconia, contained within acrylic resin disks in a mangrove environment, and analyze the alterations in mechanical parameters, such as surface roughness and microhardness, to estimate submergence time in similar forensic situations. Materials and methodsA total of 6 specimens was embedded in acrylic resin disks numbered from 1 to 6. The materials were polished for initial parameter readings a day before submersion, and new readings were obtained 1after submersion. All specimens were subjected to surface roughness analysis, in addition to Knoop microhardness analysis for acrylic resin and Vickers microhardness analysis for zirconia. After the experiment, the data were computed for statistical comparation of the materials properties different parameters. ResultsThere was a significant increase in surface roughness and Knoop microhardness was reduced in the Acrylic Resin samples (p< 0.05); however, no statistically significant differences were observed in the roughness or Vickers microhardness values of the zirconia samples. ConclusionZirconia prosthetics were more resistant to degradation when submerged in a mangrove environment compared to acrylic resin ones; however, owing to the obstacles inherent in this study, we suggest further research on the properties of prosthetic materials submerged in mangroves or other environments, which could bolster the work of dental professionals in forensic medical institutes.

The Use of Long-term Antibiotics for Suppression of Bacterial Infections.

Suppressive antibiotic therapy is prescribed when a patient has an infection that is presumed to be incurable by a defined course of therapy or source control. The cohort receiving suppressive antibiotic therapy is typically highly comorbid and the infections often involve retained prosthetic material. In part due to a lack of clear guidelines regarding the use of suppressive antibiotics, and in part due to the complex nature of the infections in question, patients are often prescribed suppressive antibiotics for extremely long, if not indefinite, courses. The risks of prolonged antibiotic exposure in this context are not fully characterized, but they include adverse drug effects ranging from mild to severe, the development of antibiotic-resistant organisms, and perturbations of the gastrointestinal microbiome. In this narrative review we present the available evidence for the use of suppressive antibiotic therapy in 4 common indications, examine the gaps in the current literature, and explore the known and potential risks of this therapy. We also make suggestions for improving the quality of evidence in future studies, particularly by highlighting the need for a standardized term to describe the use of long courses of antibiotics to suppress hard-to-treat infections.

USE OF MESH REPAIR IN HIATAL HERNIAS: OUR EXPERIENCE

Abstract Aim The use of meshes, their composition and fixation as reinforcement in hiatal hernia (HH) is currently controversial. The aim of this study is to evaluate the safety of the use of mesh in hiatoplasty, as well as to compare the medium-term results between absorbable and non-absorbable prosthesis. Methods Prospective study of a series of cases of patients with hiatal hernia operated on in our center between July 2010 and December 2023. In all cases, reinforcement hiatoplasty with prosthesis. Intra-surgical and post-operative complications were recorded. Clinical and radiological recurrence was evaluated. Results A total of 84 patients were operated on, in 12 cases (14.3%) a APTC mesh was placed, in 38 (45.2%) a cPTFE mesh and 34 (40.5%) a P4HB mesh. The percentage of overall clinical recurrence that we found occurred in 6 patients (7.1%). Radiological recurrence occurred in 9 patients (10.7%), of which 4 (10.5%) were treated with cPTFE mesh and another 4 (11.8%) with P4HB mesh, and 1 (8.3%) with APTC mesh. No statistically significant differences. 2 (16.7%) in the APTC group had some complication, 11 (28.9%) in the cPTFE group and 7 (20.6%) in the P4HB group. Conclusions No cases of serious intra- or posto-perative complications have been reported. The main medium-term complication was dysphagia with no differences between groups. There are no statistically significant differences in clinical or radiological recurrence between patients treated with different prosthetic materials.