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The treatment of maxillofacial defects presents significant challenges due to the complexity of facial anatomy and the diversity of affected tissues. Traditional workflows are labor-intensive, costly, and limited in customization. Recent advancements in fully digital workflows and direct 3D printing technologies offer new possibilities for improving the fit, aesthetics, and efficiency of prosthetic manufacturing. This scoping review aims to evaluate the current state of direct 3D printing for maxillofacial soft prostheses, assess material properties and biocompatibility, and identify challenges and future directions in this field. Methods: A comprehensive search of PubMed and Scopus databases, along with a manual search of relevant journals, was conducted to identify studies published up to December 2024. Articles focusing on direct 3D printing of maxillofacial soft prostheses were included, while studies involving traditional or mold-based workflows, ocular prostheses, and literature reviews were excluded. Data on materials, manufacturing techniques, and clinical outcomes were extracted and analyzed. Results: Out of 898 articles screened, 11 were included, 5 of which were in vivo studies (case reports). The additive manufacturing methods used in these case reports were Drop-on-Demand (DoD) silicone printing and PolyJet technology. Conclusions: Fully digital workflows and direct 3D printing technologies show promise for advancing maxillofacial prosthesis manufacturing. However, the absence of dedicated software, biocompatible materials, and medium- to long-term clinical evaluations highlight significant research gaps. Future research should focus on material development, workflow optimization, and clinical validation to enable widespread clinical adoption.

As society ages, it is important to understand the prevalence of dementia and the difficulties of inserting prostheses in patients with maxillofacial defects in order to clarify issues in supportive care. We screened 183 patients for dementia using the revised Hasegawa’s dementia scale (HDS-R) at the Clinic for Maxillofacial prosthetics, Tokyo Medical and Dental University, and investigated age and sex differences in HDS-R score. We asked 47 of the 183 participants about the difficulty of inserting a maxillofacial obturator prosthesis and collected subjective comments, information about the prosthesis, and data from five assessments. Multiple regression analysis was used to reveal factors associated with insertion difficulty. Overall, 8.7% of the participants were judged to have possible dementia. Men were more likely than women to have possible dementia, and the risk increased with age. Of the 47 participants, 26 reported difficulty inserting their prosthesis, 12 of whom attributed it to their oral defect. Fourteen patients advised following doctor’s instructions to practice insertion in order to become accustomed to it. A lower HDS-R score had a significant impact on insertion difficulty. Cognitive function and difficulty inserting maxillary obturator prostheses should be considered in the provision of continuous supportive care to patients with maxillary defects.

Along with the development of nanotechnological strategies for biomaterials associated with the prevention of infections, a myriad of clinically unproven techniques have been described to date. In this work, the aim was to perform a critical analysis of the literature available concerning antibacterial biomaterials for oral implantology and to provide a practical derivation for such a purpose. As anti-adhesive strategies may affect osseointegration, they should no longer be recommended for inclusion in this class of biomaterials, despite promising results in biomedical engineering for other, non-bone load bearing organs. Targeted, antibacterial drug delivery is most likely desirable in the case of intraosseous implants. Interfering factors such as the oral cavity environment, saliva, the bacterial microbiome, as well as, the characteristics of the alveolar mucosa and peri-implant space must be taken into account when calculating the local pharmacokinetics for antibacterial coatings. Effective release is crucial for tailoring antibacterial implant longevity providing minimal inhibitory concentration (MIC) for the desired amount of time, which for oral implants, should be at least the cumulative time for the osseointegration period and functional loading period within the tissues. These parameters may differ between the implant type and its anatomical site. Also, the functional drug concentration in the peri-implant space should be calculated as the amount of the drug released from the implant surface including the concentration of the drug inactivated by biological fluids of the peri-implant space or saliva flow throughout the effective release time.

Exenteration surgery greatly affects a person in terms of function, esthetics, and psychological trauma. In such cases, restoration by silicone orbital prosthesis is a well-accepted treatment option. However, this is a difficult task, necessitating personalized design of method for each patient. This case report describes the technique for fabrication of a silicone orbital prosthesis for a male patient with left orbital defect due to exenteration of a Grade 3 squamous cell carcinoma of the left eye and surrounding tissues. The patient was delivered with a satisfactory silicone orbital prosthesis having good retention and finish. Multidisciplinary management and team approach are crucial in providing precise and effective rehabilitation for improving the patient's quality of life and help them return to their normal social life.

Background Artificial intelligence chatbots have the potential to inform and guide patients by providing human-like responses to questions about dental and maxillofacial prostheses. Information regarding the accuracy and qualifications of these responses is limited. This in-silico study aimed to evaluate the accuracy, quality, readability, understandability, and actionability of the responses from DeepSeek-R1, ChatGPT-o1, ChatGPT-4, and Dental GPT chatbots. Methods Four chatbots were queried about 35 of the most frequently asked patient questions about their prostheses. The accuracy, quality, understandability, and actionability of the responses were assessed by two prosthodontists using five-point Likert scale, Global Quality Score, and Patient Education Materials Assessment Tool for Printed Materials scales, respectively. Readability was scored using the Flesch-Kincaid Grade Level and Flesch Reading Ease. The agreement was assessed using the Cohen Kappa test. Differences between chatbots were analyzed using the Kruskal-Wallis test, one-way ANOVA, and post-hoc tests. Results Chatbots showed a significant difference in accuracy and readability ( p  <.05). Dental GPT recorded the highest accuracy score, whereas ChatGPT-4 had the lowest. DeepSeek-R1 performed best, while Dental GPT had the lowest performance in readability. Quality, understandability, actionability, and reader education scores did not show significant differences. Conclusions While accuracy may vary among chatbots, the domain-specific trained AI tool and ChatGPT-o1 demonstrated superior accuracy. Even if accuracy is high, misinformation in health care can have significant consequences. Enhancing the readability of the responses is essential, and chatbots should be chosen accordingly. The accuracy and readability of information from chatbots should be monitored for public health.

Maxillofacial rehabilitation of patients with maxillary defects poses significant challenges due to the need for functional, esthetic, and psychological restoration. Hollow obturators offer a lightweight, effective solution for improving speech, mastication, and overall comfort. These two case reports highlight the fabrication of definitive hollow obturators using two innovative techniques, the glycerin soap and ice cube techniques, tailored for patients with maxillary defects. The glycerin soap technique involved creating a hollow spacer, which was removed after curing, ensuring optimal weight reduction and structural integrity. Conversely, the ice cube technique utilized ice as a spacer, which melted post- processing, leaving a hollow core. Both techniques used conventional fabrication methods to ensure clinical feasibility and cost-effectiveness. The outcomes demonstrated excellent patient satisfaction, enhanced retention, and improved functionality. This study emphasizes the practicality and adaptability of these methods in diverse clinical scenarios, contributing to advancements in maxillofacial prosthetic rehabilitation.

Surgical ablation of a large tumor creates a defect which is technically difficult to reconstruct. Radiated tissue bed poses a challenge to reconstruction and is complicated in presence of osteoradionecrosis. This report describes a case of a 62 year old gentleman with oral cancer who underwent surgery and radiotherapy twice. He developed an orocutaneous defect (OCD) following surgery and radiotherapy. Prosthetic rehabilitation of OCD was done. Full facial impression with irreversible hydrocolloid was made and wax sculpture made on the model obtained. Standard laboratory steps were followed for mould fabrication and maxillofacial silicone was used to fabricate the prosthesis. It was retained to the spectacle with silicone adhesives. The silicone facial prosthesis provided to the patient was easy to use, covered the defect and improved the quality of life of the patient.

The properties of maxillofacial silicone elastomers (MFSE) are far from ideal and still require reinforcement. The incorporation of nanofillers (NFs) at high levels still requires further investigation. This study evaluated the influence of different percentages (3 and 10% w/w) of titanium dioxide (TiO 2 ) and silica (SiO 2 ) NFs on the roughness and hardness of A-2000 silicone elastomer after two years of natural weathering. A total of 80 accepted specimens were divided into two groups: weathered and non-weathered. Each group was equally subdivided into 5 subgroups: non-filled, filled with 3% SiO2, 10% SiO2, 3% TiO 2 , and 10% TiO 2 . Surface roughness was quantitatively measured using a profilometer and qualitatively using a Scanning Electron Microscope (SEM). The hardness was measured using a digital Shore-A durometer. The chemical interaction between NFs and elastomers was examined using Fourier Transform Infrared (FTIR) spectroscopy. The data were exported to SPSS, and the analysis was done using 1-way ANOVA and an independent t-test. Adding 10% SiO 2 and TiO 2 NFs significantly decreased the surface roughness of A-2000 MFSE, with no significance among all concentrations after 2-year natural weathering ( P = 1). 10% SiO 2 was associated with the highest hardness of A-2000 MFSE (32.7 ± .34; P < .001). The hot, humid natural weather conditions demonstrate a significant decrease in surface roughness and an increase in the hardness of A-2000 MFSE ( P < .001). FTIR analysis confirmed that there were no changes in the chemical interactions between the silicone matrix with and without NFs.

The present study aims to evaluate and compare the tear strength of an indigenous platinum-based maxillofacial silicone material (Siloczest LSR [Liquid Silicone Rubber]) with and without the incorporation of 2%-2.5% zinc oxide nanoparticles, using an imported platinum-based silicone material (Technovent M511) as the benchmark control. Sixty-six unnicked 90° angle specimens (ASTM D624 [American Society for Material and Testing)) were fabricated and divided into three groups: Group A-Siloczest LSR without zinc oxide nanoparticles; Group B-Siloczest LSR with 2.5% zinc oxide nanoparticles; and Group C (control)-Technovent M511. Tear strength was evaluated using a Universal Testing Machine (UTM), and results were statistically analysed to compare the performance of the materials. Siloczest LSR showed significantly higher tear strength (22.64 N/mm) than Technovent (10.08 N/mm, < 0.001). The addition of 2.5% ZnO nanoparticles reduced tear strength to 20.54 N/mm ( < 0.05), indicating no reinforcement benefit. Siloczest LSR, an indigenous platinum-based maxillofacial silicone, exhibited higher tear strength than the imported Technovent material, supporting its potential use in clinical prosthetic applications as a cost-effective maxillofacial material. However, the addition of 2.5% zinc oxide nanoparticles did not improve tear strength and led to a slight reduction. These results highlight the need for further investigation into nanoparticle concentration and dispersion methods to optimize reinforcement without compromising the material's mechanical integrity and clinical validation.