Maxillofacial Prosthetics
Prosthodontic complications during implant-based oral rehabilitation of patients with head and neck cancer
Implant-retained prosthodontic rehabilitation of patients with head and neck cancer is complex. However, the extent of prosthodontic complications has been sparsely reported within the literature.Ultraviolet C as a method of disinfecting medical silicone used in facial prostheses: An in vitro study
Hygiene and disinfection are important factors for preserving facial prostheses and supporting tissue health. However, a method that does not accelerate degradation or color change is necessary.Quality of life in patients with soft palate resection: The relationship between reported functional prosthetic outcomes and the patient’s psychological adjustment
Tumors of the soft palate and the adjacent tissues often create considerable soft palate defects that are challenging for the maxillofacial prosthodontist. Soft palate obturator prostheses can usually address functional and esthetic concerns; however, the effectiveness of the prosthetic rehabilitation in improving the patient’s well-being and overall quality of life (QOL) has not been extensively researched.Two-piece oral facial prothesis retained with magnets for a complex maxillary facial defect: A clinical report
Total flap failure is a devastating complication in head and neck reconstruction. This clinical report describes the rehabilitation of an extensive maxillectomy defect communicating with the midface by using a 2-piece magnet-retained orofacial prosthesis fabricated in heat-processed acrylic resin. The innovative design and choice of material allowed early rehabilitation of a patient receiving palliative care at a resource-constrained tertiary care oncology center. Prosthetic treatment served to reduce the period of hospitalization and helped the patient to resocialize.Use of an occlusal ramp for rehabilitation after a mandibulectomy and its effects on mastication
Patients with a mandibular defect can develop mandibular deviation, resulting in a loss of or reduction in occlusal contact and ultimately loss of function. The occlusal ramp is a prosthesis used to help restore the masticatory function of such patients and is used particularly in the maxillofacial rehabilitation of patients with masticatory dysfunction resulting from mandibular deviation. The occlusal ramp is usually attached to a mandibular denture or worn as an independent device placed on the palate corresponding to the mandible that produces the offset.Digital fabrication of a maxillary obturator prosthesis by using a 3-dimensionally–printed polyetheretherketone framework
The digital fabrication of a maxillary obturator with a 3D-printed polyetheretherketone (PEEK) framework is described. Digital oral data were scanned for the computer-aided design (CAD) of the framework and the 3D printing of a preliminary resin cast. The framework was accurately printed from a PEEK filament material. A secondary impression was made to fabricate the definitive cast. The PEEK framework exhibited precise fit, excellent retention, and reduced weight compared with a typical metal framework.Disinfectant effects of Brazilian green propolis alcohol solutions on the Staphylococcus aureus biofilm of maxillofacial prosthesis polymers
Brazilian green propolis may be an alternative product that reduces the development of a microbial biofilm on the polymers used for maxillofacial prostheses. However, its effects as a disinfectant have not been fully established.Development of a psychosocial perception scale and comparison of psychosocial perception of patients with extra oral defects before and after facial prosthesis
Loss of facial organs and subsequent rehabilitation affects a patient’s psychological status. Understanding the perceived psychosocial aspects of quality of life among patients with missing organs and after prosthetic rehabilitation is essential, but studies that quantify this aspect are lacking.An implant-retained auricular prosthesis complicated by a modified temporal bone resection
A patient underwent a modified temporal bone resection and total auriculectomy to remove a sebaceous carcinoma arising from the tragus of the right auricle that extended into the external auditory meatus. Because the tumor extended into the temporal bone, the osseous sites originally selected for immediate placement of the craniofacial implants were resected and no longer available. Subsequently, after an appropriate period of healing, implants were placed into the residual temporal bone, considerably more superior and posterior to the external auditory meatus such that they emerged through hair-bearing skin.Are intraoral stents effective in reducing oral toxicities caused by radiotherapy? A systematic review and meta-analysis
Intraoral stents have been provided to minimize acute and chronic toxicities induced by radiotherapy, including oral mucositis, salivary changes, trismus, radiation-related caries, and osteoradionecrosis. However, a systematic review and meta-analysis is necessary to determine their effectiveness.Combined rehabilitation of a lower lip defect after resection of floor of mouth cancer: A clinical report
This clinical report describes the successful prosthetic rehabilitation of a deficient lower lip in an edentulous patient who had undergone surgery for removal of a squamous cell carcinoma of the anterior floor of the mouth and vestibule. The rehabilitation used a combined approach of an extraoral lip prosthesis joined by 3 magnets to an intraoral implant-retained mandibular resection prosthesis. The outcome demonstrated rehabilitation of the lower third of the face by eliminating loss of fluids and by improving the facial profile, lip contour and competence, esthetics, the patient’s eating ability, speech intelligibility, and reported quality of life.Screw-loaded compression device for auricular keloid
Pressure therapy is widely used in the management of keloid mass and for preventing postexcision recurrence of earlobe keloid. Although various types of compression devices are available, the pressure applied by these devices is uncontrolled and associated with the risk of pressure necrosis. This article presents a novel design for a compression device with threaded connectors to control the amount and direction of the pressure applied on the keloid mass.Bilabial-protruding, mouth-opening and tongue-depressing stent for proton radiation therapy
Custom intraoral radiation devices protect normal tissues, minimizing the adverse effects of radiation therapy. These devices also help immobilize the target by placing the patient’s head in a precise, repeatable position. This clinical report describes the fabrication and benefits of a modified mouth opening, tongue depressing radiation stent with bilabial protrusion of the lips that was used in proton radiation therapy for a malignancy of the upper lip.Successful prosthetic salvage of a suboptimal autogenous auricular reconstruction with digital technologies: A report of 3 challenging treatments
The surgical reconstruction of congenitally missing or malformed ears is challenging and involves complicated surgeries. Ear shape, position, and skin color will likely be compromised in patients with relative anatomic symmetry, and it is easier to reproduce these features with a prosthesis. This article describes the prosthetic reconstruction of 3 patients who had received failed or suboptimal surgical reconstruction of their missing or deformed ears. Challenging characteristics included limited soft-tissue availability, skeletal hypoplasia with prominent concavity defect, and bilaterally missing ears with abnormally low hairline.Custom nasal stent and columellar reconstruction after a rhinoplasty complication: A clinical report
Nostril stenosis is typically caused by retraction and contraction after trauma or infection, although loss of nasal tissue is not common during rhinoplasty. This clinical report describes the fabrication of a nasal stent to replace the lost columella and a columella prosthesis for a patient who had had reconstructive surgery for nasal valve collapse and a missing columella. The stent established a comfortable means of nasal air exchange that was also esthetically acceptable. The stent also provided the necessary support for the nasal tissue before further nasal reconstructive surgeries.Efficacy of incorporating silver nanoparticles into maxillofacial silicone against Staphylococcus aureus, Candida albicans, and polymicrobial biofilms
The presence of biofilms on maxillofacial silicone increases the risk of infections and reduces durability. Whether silver nanoparticles (AgNPs) with potent antimicrobial effects help reduce biofilm formation is unclear.Visual and instrumental color evaluation of computerized color matching system for color reproduction of maxillofacial prostheses
A commercially available computerized color matching system (e-Skin) has been introduced for maxillofacial prostheses. However, studies that have tested its ability to produce an acceptable color match for skin color are lacking.A virtual analysis of the precision and accuracy of 3-dimensional ear casts generated from smartphone camera images
The anatomic complexity of the ear challenges conventional maxillofacial prosthetic rehabilitation. The introduction of specialized scanning hardware integrated into computer-aided design and computer-aided manufacturing (CAD-CAM) workflows has mitigated these challenges. Currently, the scanning hardware required for digital data acquisition is expensive and not readily available for prosthodontists in developing regions.An evaluation of a technique to improve the mechanical properties of maxillofacial silicone elastomers with zinc oxide nanoparticles
Silicone elastomer is the most used material for fabricating maxillofacial prostheses, but the material has low tensile and tear strength and insufficient elasticity. Whether the addition of zinc oxide nanoparticles will improve these properties is unclear.Floor of mouth prosthesis with removable depressible tongue: A clinical report
The rehabilitation of a patient with a total glossectomy with a prosthetic device is challenging and depends on the individual patient. Ablation of a tongue tumor leaves defects that can be either surgically reconstructed or replaced by a prosthesis to help recreate normalcy and balance in the oral cavity. This clinical report describes a prosthetic design to rehabilitate a patient after a total glossectomy. This approach successfully recreated the glossal surface with a soft, hollow, depressible structure that emulates the tongue during speech and a solid structure to facilitate swallowing.Percentage of mesh reduction appropriate for designing digital obturator prostheses on personal computers
Computer-aided design (CAD) of maxillofacial prostheses is a hardware-intensive process. The greater the mesh detail is, the more processing power is required from the computer. A reduction in mesh quality has been shown to reduce workload on computers, yet no reference value of reduction is present for intraoral prostheses that can be applied during the design.Outcome measures in facial prosthesis research: A systematic review
Facial prosthesis research uses a wide variety of outcome measures, which results in challenges when comparing the effectiveness of interventions among studies. Consensus is lacking regarding the most appropriate and meaningful outcome measures to use in facial prosthesis research to capture important perspectives.An implant-supported prosthetic rehabilitation of a patient with a bilateral subtotal maxillectomy defect secondary to rhino-orbital-cerebral mucormycosis: A clinical report of a graftless approach
This clinical report presents the rehabilitation of extensive hard and soft tissue defects caused by rhino-orbital-cerebral mucormycosis as a result of untreated diabetes mellitus. The patient underwent subtotal maxillectomy and was rehabilitated with an implant-supported maxillofacial prosthesis with zygomatic and pterygoid implants by following an immediate loading protocol.Effect of tropical outdoor weathering on the surface roughness and mechanical properties of maxillofacial silicones
The climate of tropical Southeast Asia includes high humidity and ultraviolet radiation that reduce the lifespan of silicone prostheses by inducing changes in their mechanical properties and color stability. Studies on the surface roughness (SR) and mechanical properties of different silicone elastomers (SEs) subjected to the natural tropical weather of Southeast Asia are lacking.A combined digital technique to fabricate an implant-retained auricular prosthesis for rehabilitation of hemifacial microsomia
Implant-retained auricular prostheses provide an excellent treatment option with better retention and stability than a conventionally retained prosthesis. This article presents a technique for auricular reconstruction for a patient with misplaced implants. The scanning process combined the use of an intraoral scanner and a facial scanner to enhance accuracy in space management for different parts of the auricular prosthesis and to reduce sculpting time.
