A Simple Method of Positioning the Iris Disk on a Custom-Made Ocular Prosthesis. A Clinical Report

We report two cases of ocular prosthesis fabrication that make use of a transparent graph grid for positioning the iris disk. The custom‐made ocular prostheses achieved intimate contact with the tissue bed enabling ideal fit. As asymmetry may result in a squint‐eyed appearance, proper positioning of the iris disk in the scleral wax pattern is vital to fabricating the custom‐made artificial eye. The position of the iris disk in the custom‐made ocular prosthesis was in symmetry with that of the natural eye, restoring esthetics of the patient.     

Alternative Technique of Iris Orientation in a Custom‐Made Ocular Prosthesis

Accurate positioning of the iris is critical for the success of an ocular prosthesis. Precise duplication of size and location of the iris is essential for the establishment of realism, symmetry, and a natural‐appearing gaze. This article explores an alternative procedure for positioning the iris in a custom‐made ocular prosthesis using a pupillary distance ruler (PD ruler). The orientation and mediolateral dimension of the iris of the natural eye was measured from the graduated scale on a PD ruler and transferred on to the sculpted scleral wax pattern. The iris button was positioned in the marked area, and the established orientation was evaluated for symmetry and a natural‐appearing gaze. Accurate, predictable, and easy positioning of the iris with the transfer of these dimensions to the definitive prosthesis provided a good result in terms of patient esthetics and satisfaction.     

Prosthetic Rehabilitation of Ocular Defect Using Digital Photography: A Case Report

The fundamental objective in restoring a congenital as well as acquired defect of eye with an ocular prosthesis is to enable the patient to cope better with the difficult process of rehabilitation after an enucleation or evisceration. A cosmetically acceptable prosthesis is that reproduces the color, form and orientation of iris and allows the patient to return to accustomed lifestyle. A sequence of steps for construction of custom-made ocular prostheses is outlined in this case report using the advantages of digital imaging technique.     

Surgical and prosthetic considerations to rehabilitate an ocular defect using extraoral implants: a clinical report

This clinical report shows the use of extraoral implants to rehabilitate an ocular defect, focusing the surgical and prosthetic procedures. Using local anesthesia and a surgical template obtained from the diagnostic wax ocular pattern, two cylinder dental implants were strategically placed in the lateral aspect of the right infraorbital region. Four months later, an acrylic framework including two spherical magnets was made using plastic UCLA abutments. After casting laboratory steps, a customized silicon prosthetic appliance was fabricated from the diagnostic wax ocular pattern and attached to the Co-Cr framework, observing its profile and seating aspects. The patient was satisfied with the treatment result, due to the retention, esthetics, and adhesive-free method to anchor his ocular prostheses.     

A flexible moulage for the fabrication of an orbital prosthesis

A technique is discussed by which a flexible three-piece moulage may be fabricated. This procedure is a useful aid in the modeling of an orbital prosthesis. It permits the continued transfer of a wax pattern from the moulage to the patient utilizing the tissue undercuts for the retention and stabilization of the pattern.The critical task of properly positioning the ocular prosthesis is simplified by the increased stability of the entire pattern. This is of the utmost importance since even a slight error in the alignment of the eye can entirely negate the effect of an otherwise accurate prosthesis. In addition, the retention of the wax pattern simplifies the carving procedure, and accurate detail is easily secured.The acrylic resin surface on which the final silicone prosthesis is cured has proven to be accurate. Well-adapted, thin margins of the facial prosthesis have been consistently obtained.     

Ocular Defect Rehabilitation Using Photography and Digital Imaging: A Clinical Report

Ocular disorders occasionally necessitate surgical intervention that may lead to eye defects. The primary objective in restoring and rehabilitating such defects with an ocular prosthesis is to enable patients to cope better with associated psychological stress and to return to their accustomed lifestyle. A series of detailed steps for custom‐made ocular prosthesis fabrication using the advantages of digital photography to replace the conventional oil paint and monopoly iris painting technique are presented in this article. In the present case, a digital photograph of the patient's iris was captured using a digital camera and manipulated on a computer using graphic software to produce a replica of the natural iris. The described technique reduces treatment time, increases simplicity, and permits the patient's natural iris to be replicated without the need for iris painting and special artistic skills.     

A Simplified Approach for Placing the Iris Disc on a Custom Made Ocular Prosthesis: Report of Four Cases

This case report describes a series of four cases of different age group, in which a simplified approach was applied for positioning the iris disc on a custom made ocular prosthesis. For each of the patient, a pre-fabricated eye was selected; whose iris and pupil closely matched that of the natural eye. This was duplicated for use as a tray in impression procedure. Iris portion of the stock eye was trimmed out and oriented on the cast according to previously transferred pupillary mark. This stock eye-wax pattern combination was tested in the eye socket, modified accordingly and finally cured in transparent heat cured acrylic resin. The technique to fabricate ocular prosthesis in present case reports modifies pre-fabricated eye prosthesis to a custom-made fit and aesthetics. This helped us to overcome the disadvantages of poor fit, inadequate movement and complex painting procedure and technique involved in making a custom-made ocular prosthesis. It can be concluded that close adaptation of the custom-made ocular prosthesis to the tissue bed provides maximum comfort and restores full physiologic function to the accessory organs of the eye.     

A modified technique and simplified laboratory procedure for ocular prosthesis fabrication

PurposeIn many cases dentist tries to satisfy the patient with stock prosthesis that comes in standard sizes, shapes and colors. However, most of the patients complain of discomfort even after appropriate adjustment because of insufficient adaptation to underlying soft tissues. The rehabilitation of a patient with loss of eye as a result of congenital defect, pathology or accidental trauma is a challenge in terms of re-establishment of the esthetics of the patient. The purpose of this technical procedure is to provide a well fitting prosthesis to the patient, reducing the number of laboratory steps and appointments for fabrication of ocular prosthesis.MethodA suitable stock eye shell was modified to fit the eye socket, followed by relining with low fusing compound and making a final impression with polyvinyl siloxane impression material. The impression was poured in die stone, flasking procedure was accomplished. After dewaxing, molten wax was flown in the lower half of the flask followed by repositioning of the upper half. The flask was reopened, the stock eye shell along with the hardened wax on tissue surface was tried in the patient's eye. Finally processing was done.ConclusionThis technique describes an impression procedure, followed by a wax pattern try-in in the same appointment and also the detailed laboratory procedure for fabrication of the ocular prosthesis, taking into consideration positioning of iris as a result enhancing the esthetic appearance of the patient.     

Fabrication of a craniofacial implant surgical and treatment planning guide

A procedure is described to fabricate a surgical guide to assist in the placement of craniofacial implants for prosthetic auricular rehabilitation. An impression is made of the defect, and a wax pattern of the missing ear is completed and evaluated on the patient. The definitive wax prosthesis is processed in acrylic resin. An occlusal maxillary splint is also fabricated. The occlusal splint and the acrylic resin ear are joined together using an extraoral acrylic resin bar. The resulting surgical guide provides proper orientation of the acrylic resin ear while remaining securely attached to the maxillary arch. This surgical guide can also be utilized for pretreatment radiographic examination.     

Rehabilitation of an Infected Eye with an Acrylic Ball Implant and a Custom made Scleral Ocular Prosthesis

This clinical report describes the prosthetic rehabilitation of a patient with corneal abscess with endophthalmitis of the left eye. Infection with a history of trauma resulted in loss of vision but with intact eye ball movements. Cornea excising evisceration was carried out following placement of poly(methyl methacrylate) ocular ball implant. Later custom made scleral prosthesis was fabricated to maintain functional integrity of the socket and to satisfy patient’s aesthetic needs.     

Periodic evaluation of the occlusal vertical dimension of maxillary dentures from the wax trial denture through 48 hours after polymerization

PURPOSE: This study measured the effects of commercial resin type on maxillary complete dentures with monoplane teeth by periodically comparing the occlusal vertical dimension of the polymerized dentures with the baseline, wax trial denture fiducial measurements. MATERIALS AND METHODS: Commercially available compression-molded, injection-molded, and fluid poly(methyl methacrylate) resins, as well as one compression-molded methyl acrylate ester copolymer, were evaluated. Ten dentures were fabricated from each resin using monoplane teeth. The occlusal vertical dimension at the articulator pin was measured at the wax denture stage for each specimen, and changes in occlusal vertical dimension for each denture were evaluated at a simulated laboratory remount, and at 0, 3, 6, 24, and 48 hours after a simulated clinical remount. Repeated measures analysis of variance (alpha = 0.05) and post hoc one-way factorial analysis of variance and Scheffe's F-Tests for each resin group were performed using ranks of raw data. RESULTS: Changes in the maxillary denture mean occlusal vertical dimensions were recognized throughout the evaluation periods compared with the wax-denture baseline, and time was a significant influence on displacement (p = .0001). Only the compression-molded poly(methyl methacrylate) dentures exhibited a mean laboratory remount occlusal vertical dimension that was significantly greater than the mean wax denture measurement, and all resin systems exhibited occlusal error that was significantly less than the laboratory remount measurements at 48 hours. At 48 hours, all resin groups exhibited mean occlusal vertical dimension changes that were less than 1 mm compared with the wax denture. Only compression-molded poly(methyl methacrylate) dentures exhibited a mean 48-hour clinical remount measurement that was statistically similar to the mean wax denture occlusal vertical dimension. CONCLUSIONS: Individual maxillary dentures from all resin types and at all intervals exhibited dimensional change. At the last evaluation period, the compression-molded poly(methyl methacrylate) showed no change in mean occlusal vertical dimension from baseline, whereas remaining groups exhibited occlusal vertical dimensions significantly less than baseline.     

颜面赝复体阴模三维打印成形的初步研究

目的 探讨三维打印在颜面赝复体阴模自动化加工中的可行性.方法 选取鼻数据库中鼻数字化模型1个,利用Magics RP软件生成立体成型格式的鼻阴模.通过三维打印加工鼻石膏模型和鼻阴模石膏模型.将硅橡胶充填于鼻阴模石膏模型中,获得鼻硅橡胶模型.采用结构光三维测量系统扫描鼻石膏模型和硅橡胶模型,进行偏差分析.结果 鼻石膏模型和硅橡胶模型的最大正偏差为0. 98 m,位于鼻尖;最大负偏差为-0. 64 mm,位于鼻小柱;均值为0.17 mm.结论 颜面赝复体阴模直接快速成形具有可行性.     

Fabrication of custom clips for bar-and-clip attachments for implant-supported overdentures

Bar-and-clip attachments for dental implants are a common and versatile device for improving the retention and stability of a removable prosthesis. Manufactured clips may be unsubstantial and may not always fit or provide the desired amount of retention for the bar. The purpose of this article is to describe a technique for custom fabrication of clip attachments. The wax pattern of the clips is fabricated and then cast in dental gold alloy. The gold clips are then cut to an appropriate size that will allow for a variety of clinical applications.     

A Simplified Method to Fabricate a Pneumatic Ocular Prosthesis for Large Ocular Defects

When an enucleation or exenteration procedure removes the entire orbital contents but not the eyelids, an abnormally large orbital socket is created that would require an equally sized volume enhancing, flush fitting ocular prosthesis. The solid acrylic prosthesis would rest on or in the lower fornix and owing to its weight, causes distortion of the lower eyelid and/or asymmetrical alignment of the entire palpebral fissure. The aim of this article was to describe a method of fabricating a pneumatic light weight custom ocular prosthesis using lost wax technique to overcome the deteriorating effects of conventional solid ocular prosthesis.     

Prosthetic rehabilitation of extremely worn dentitions: case reports.

The stomatognathic system is a complicated structure, and patients usually adapt to their existing vertical dimension of occlusion. Therefore, prosthetic rehabilitation of decreased vertical dimension of occlusion should be considered only when dictated by esthetic or functional requirements. If the loss of vertical dimension is significant, provisional prostheses should be used before the final prosthesis to prevent tension or pain in the temporomandibular joints and the muscles as the patient adapts to the new dimensions. Acrylic resin provisional prostheses were used for three patients before the final prosthesis was fabricated with the restored vertical dimension of occlusion. The period of use varied, depending on the patient's individual adaptive ability. The important aspect is to find the most comfortable position for the patient.     

Damping factor for monitoring the bone interface at dental implants

OBJECTIVES: The aim of this study is to investigate whether the damping of osseointegrated implants, as measured quantitatively with the Osstell equipment, is related to the fractal dimension of peri-implant bone. MATERIAL AND METHODS: Fifty-five maxillary implants in function for 3 years before the present study were investigated. Two Osstell measurements were obtained for each implant with the transducer oriented first palatally and then distally. Using the half-power bandwidth method, the damping was calculated from the frequency/amplitude plot obtained from the Osstell. Damping data were then related to the fractal dimension of peri-implant bone. Fractal dimensions were calculated using a box-counting algorithm on digitally processed intra-oral radiographs of the implants. A Spearman's test was used to verify the correlation between damping and fractal dimension values. RESULTS: All the implants were clinically stable and free from symptoms. The mean ISQ was 63 for the palatal orientation and 71 for the distal orientation. The mean fractal dimension was 1.47; the mean damping value for palatal orientation was 12.3%, while that for the distal orientation was 8.2%. No significant correlation was found. CONCLUSIONS: Damping values, measured at peri-implant bone, were found not to be related to a radiographic parameter of trabecular bone pattern like the fractal dimension. The clinical implication would be that Osstell graphs displaying distinct or more rounded peaks might both indicate a stable implant as long as the associated implant stability quotients are in the range of satisfactory values proposed in the literature.     

A method for fabricating an implant-retained orbital prosthesis using the existing prosthesis

This article describes a time-saving technique for fabricating a new implant-retained orbital prosthesis using the patient's existing prosthesis. The location of the ocular component is transferred; the position and openings of the palpebral anatomic structures and the precise anatomic details of the existing orbital prosthesis are duplicated. Making the impression, fabricating the definitive cast, alignment of the ocular component, and completing the wax sculpture of the prosthesis are accomplished in one appointment.     

Custom ocular prosthesis: Comparison of two different techniques

BackgroundLoss of tissue, whether congenital or traumatic or resulting from malignancy or radical surgery, is accompanied by esthetic and psychological effects. Fabrication of an ocular prosthesis is a challenging and time-consuming procedure.Patients and techniquesThis article describes two different techniques of iris customization on two different patients. First technique describes the iris customization with the use of conventional paint on technique while second describes the photographic method of fabricating the eye prosthesis.DiscussionA sequence of steps of construction of ocular prostheses is outlined, and the critical areas of fabrication and artistic techniques employed in the successful prosthetic treatment are described in this article. Conventional iris paint on technique and digital photographic technique to customize the iris are explained along with their advantages, disadvantages and indications.ConclusionIn addition to decrease treatment time and increased simplicity, digital photography technique is particularly advantageous in cases requiring thin acrylic shell type of prosthesis.     

熔模材料对铸造嵌体精度的影响研究

目的研究不同熔模材料对铸造嵌体精度的影响。方法采用5种熔模材料：Pattem resin、嵌体蜡、普通蜡、自凝塑料、Pr（Pattern resin）＋嵌体蜡制作后牙MOD嵌体熔模,然后将熔模包埋、焙烧、铸造,分别用数字万能工具测定显微镜测量铸造前、后熔模底边与模具间距离。结果铸造前、后Pattem resin的底边与模具间距离最小,和其余各组间有显著性差异（P〈0．05）;自凝树脂与普通蜡的底边间距最大,和其余各组间有显著性差异（P〈0．05）;每种熔模材料铸造后底边间距明显大于铸造前（P〈0．05）。结论在研究的五种熔模材料中,Pattem resin的变形最小,尺寸最稳定;应用Pattem resin制作的嵌体精度最高。     

Fabrication of a removable partial denture combining conventional and digital techniques

This article describes a combined conventional and digital workflow for fabricating removable partial dentures (RPDs). After scanning the dental cast and RPD framework assembly, artificial teeth and denture base regions were designed using computer-aided design software. The artificial teeth and denture base assembly was milled as a single structure by using a wax disk and then placed on the RPD framework. The artificial teeth were additionally milled from a polymethyl methacrylate disk. Conventional procedures were followed for denture investment until the wax elimination procedure, after which the assembly was replaced with the artificial teeth in the cope of the flasks, and the denture resin material was injected to process the RPD. This technique enabled the RPD to be fabricated in the same form as the design state.