Use of a stud attachment to retain a silicone orbital prosthesis: a clinical report

Orbital defects with total loss of eyelids and eyeball cannot be satisfactorily repaired by reconstructive surgery. Prosthetic replacement is the treatment of choice owing to its acceptable lifelike appearance. The use of semiprecision attachments in maxillofacial prostheses is limited to osseointegrated prostheses. Therefore, this article describes a conventional glasses frame technique, to retain the silicone orbital prosthesis using a Dalla Bona stud attachment.     

Combination Lower Lip Prosthesis Retained by an Intraoral Component

Patients who have had a partial or full surgical resection of the maxillary or mandibular lip experience difficulties with articulation of speech, swallowing, and salivary control. This is further complicated by significant alterations in facial esthetics and lowered self‐esteem. This clinical treatment will describe the fabrication of a two‐piece tooth‐retained maxillofacial prosthesis. An intraoral retentive portion and an extraoral section restoring lip anatomy were attached by retentive elements. This prosthesis restored the patient's esthetics, oral function, and self‐esteem.     

The Dentoalveolar Prosthesis: A Novel Approach in the Reconstruction of Hard and Soft Tissue Deficiencies

A clinical problem commonly encountered by the advanced restorative dentist is a requirement to replace missing teeth and the supporting alveolus in areas adjacent to healthy or manageable dentition. A potential solution could utilize a dentoalveolar prosthesis fabricated on two or more implants in the edentulous area. The implant substructure, or framework, may be cast, milled, or selectively laser melted from a variety of metals. A superstructure, or ceramic overlay incorporating a ceramic or composite resin gingival tissue component, is constructed to fit over the implant substructure and luted to the substructure with resin cement. This implant‐supported fixed dental prosthesis identifies a solution for the replacement of both teeth and supporting alveolar bone. It restores comfort, function, and esthetics to the patient.     

A Novel Method for Retention of an Orbital Prosthesis in a Case with Continuous Maxillary and Orbital Defect

Exenteration of the orbital contents as well as removal of a part of maxilla with an ablative surgery for the removal of a malignant tumor can severely affect a person in terms of function, esthetics and psychological trauma. A well-retained, user-friendly, removable maxillofacial prosthesis is the key to successful prosthetic rehabilitation in such cases. Various retentive techniques include using spectacle frame, conformers, adhesives, osseointegrated implants, magnets or buttons. This paper describes a novel technique for retention of silicone orbital prosthesis using acrylic resin base attached to maxillary obturator with the help of pin and socket of an electric plug wherein the latter is attached to the eye prosthesis with the help of a mechanical undercut. This helps in better retention of both the prostheses.     

Hybrid Maxillofacial Prosthesis: A Case Report

The role of a prosthodontist in the management of cleft lip & palate patients is pertinent involving restoration of mastication, facial harmony, dental harmony and phonation. This article presents the prosthodontic rehabilitation of a congenitally bilateral cleft lip and palate patient with a unique method which fulfilled the patient's needs, esthetics and psychological well being.     

Silicone Finger Prosthesis. A Clinical Report

The loss of all or part of a finger following traumatic amputation may have a negative impact on physical and psychological well being. An esthetic prosthesis can offer psychological, functional, and rehabilitative advantages. The success of a prosthetic restoration primarily depends on its retention. This clinical report describes an alternative method of retention by scoring the master cast of a partially amputated finger, thus enhancing the vacuum effect for the retention of the prosthesis. The methodology of treatment is also explained. Silicone material was used to provide function and esthetics.     

Influence of Pigments and Opacifiers on Color Stability of an Artificially Aged Facial Silicone

Purpose: The aim of this study was to evaluate the influence of two pigments (ceramic powder and oil paint) and one opacifier (barium sulfate) on the color stability of MDX4–4210 facial silicone submitted to accelerated aging. Materials and Methods: Sixty specimens of silicone were fabricated and divided into six groups‐–colorless (G1), colorless with opacifier (G2), ceramic (G3), ceramic with opacifier (G4), oil (G5), oil with opacifier (G6). All replicas were submitted to accelerated aging for 1008 hours. The evaluations of chromatic alteration through visual analysis and reflection spectrophotometry were carried out initially and after 252, 504, and 1008 hours of aging. The results were submitted to ANOVA and Tukey's test at 5% level of significance. Results: All groups exhibited chromatic alteration (ΔE > 0); however, this color alteration was not perceptible through visual analysis of the color. The pigmented groups with opacifier presented the lowest ΔE values, with a statistical difference from the other groups. For the groups without opacifier, the group pigmented with oil paint exhibited the lowest ΔE values in the different aging periods, with a statistical difference. Accelerated aging generated significant chromatic alterations in all groups after 252 hours, except for the colorless and oil groups, both with opacifier (G2 and G6). Conclusions: The opacifier protects facial silicones against color degradation, and oil paint is a stable pigment even without addition of opacifier.     

Fabrication of a Functional Finger Prosthesis With Simple Attachment

Finger prosthesis is more acceptable by the patient when it allows some of the movement in the prosthesis along with the restoration of a natural appearance to the lost structures of the patient. This article describes a custom-fabricated, custom-colored prostheses made from silicone elastomers with a simple attachment to make the prosthesis functional to imitate some of the movement.     

Rehabilitation of a missing ear with an implant retained auricular prosthesis

Burns can leave a patient with a severely debilitating disability even after treatment. The objectives of burn rehabilitation are to minimize the adverse effects caused by the injury while rehabilitating the patient''s physical and psychological well-being, maximizing social integration. Long-term success of maxillofacial prostheses mainly depends on the retention. Extra oral implant retained prostheses have proved to be a predictable treatment option for maxillofacial rehabilitation. Replacement of a severely deformed external ear with burned tissues may be satisfactorily accomplished by a cosmetic prosthesis anchored by implants integrated in the skull. The use of such implants is now a well-recognized method for creating a stable result in maxillofacial rehabilitation. This case report describes a safe, simple and economical method for the rehabilitation of a patient with missing right auricle using an implant supported silicone prosthesis. The implant was placed in the mastoid region of the temporal bone. Reconstruction of the ear was done with auricular silicone prosthesis, retained using magnets incorporated in an autopolymerizing resin shim to decrease the weight of the prosthesis on a single implant. This method eliminates the need of tedious laboratory procedures and exact casting and fitting requirements of a metal substructure while minimizing the overall weight and cost of the prosthesis while maintaining adequate support, esthetics and retention of the prosthesis.     

Prosthodontic management of maxillofacial cases: a case series

Maxillofacial prosthetics is an important and recognized sub‐discipline of prosthodontics that forms a key component of postgraduate training programmes. General dentists have a role to play in the management of maxillofacial defect patients even though treatment usually requires a multidisciplinary approach in an institutional environment. Maxillofacial prosthetic cases frequently present with complex histories but simple patient goals. The conservatively managed implant‐retained auricular prosthesis, speech aid prosthesis and orbital prosthesis cases described in this report were completed in a postgraduate clinical residency program and highlight the intrinsic complexities, challenges and ultimately satisfaction related to cases of this nature.     

Prosthetic rehabilitation of an orbital and facial defect: a clinical report

For patients undergoing radical head and neck surgery, the deformity or physical defect adds to the agony. Rehabilitation of patients with such deformities is a challenge for the maxillofacial prosthodontist to enhance the esthetics and give psychological strength to the patient. This clinical report describes the rehabilitation, using a silicone prosthesis, of a large facial and orbital defect due to mucoepidermoid carcinoma.     

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.     

Effect of Disinfection and Accelerated Aging on Color Stability of Colorless and Pigmented Facial Silicone

Purpose: The aim of this study was to evaluate the color stability of a facial silicone with different pigmentations submitted to disinfection and accelerated aging. Materials and Methods: Sixty replicas were fabricated with the silicone Silastic MDX 4‐4210 and divided into three groups: no pigmentation, pigmentation with makeup powder, and pigmentation with ceramic powder. Half the replicas of each group were submitted to disinfection with Efferdent and the other with neutral soap for 60 days (n = 10). After this period, all replicas were inserted in a chamber for accelerated aging of nonmetallic specimens. The color measurements were carried out initially, after disinfection, and after accelerated aging (252, 504, 1008 hours). Color stability was evaluated through spectrophotometry. The values were submitted to ANOVA and the means to Tukey's test (p < 0.01). Results: The specimens disinfected with neutral soap exhibited higher ΔE values regardless of the type of pigmentation. The colorless replicas and the specimens pigmented with ceramic exhibited a statistically significant difference between the methods of disinfection in all periods. The specimens pigmented with makeup powder did not demonstrate a statistically significant difference. Conclusions: The ceramic pigment presented greater color stability regardless of disinfection and period. On the other hand, the makeup pigment exhibited the highest values of chromatic alteration.     

New Technique to Fabricate an Immediate Surgical Obturator Restoring the Defect in Original Anatomical Form

The presence of oral cancer can necessitate the surgical removal of all or part of the maxilla, leaving the patient with a defect compromising the oral cavity's integrity and function. The immediate postoperative restoration of esthetics, deglutition, and speech shortens recovery time in the hospital and expedites the patient's return to the community as a functioning member. This article describes a simple technique to fabricate an immediate surgical obturator by restoring the patient's original dentition and facial and palatal tissue form. An immediate obturator fabricated with this technique supports soft tissues after surgery and minimizes scar contracture and disfigurement and thus may have a positive effect on the patient's psychology.     

Surgical obturator duplicating original tissue-form restores esthetics and function in oral cancer

Oral cancer treatment primarily focused on the surgical removal of cancer tissues followed by surgical/prosthetic reconstruction. Restoration of the missing structures immediately after surgery shortens recovery time and allows patient to return to community as a functioning member. The most practiced surgical obturators are simple resin prosthetic bases without incorporation of the teeth. This article highlights a technique to fabricate a surgical obturator that duplicates patient’s original tissue form including teeth, alveolus and palatal tissues. The obturator is placed immediately after surgery and make patient feel unaware of surgical deformity. The obturator prosthesis fabricated with this technique supports soft tissues and minimizes the scar contracture. We have clinically tried this technique in 11 patients. Patients’ satisfaction level was recorded on visual analogue scale (VAS) and it ranges between 74% and 94% (with average of 87%). Four different prosthodontists have visually evaluated facial asymmetry of patients at 6 mo recall and their average perception on VAS varies between 71% and 93% (with average of 84%).     

SJ—1型插销式附着体义齿的制作和临床应用

目的 为临床推广应用ＳＪ－１型插销式附着体义齿提供制作和使用的方法。方法 采用ＳＪ－１型插销式附着本修复１０例牙列末端游离缺失的病例，并经近两年临床观察随访。结果 患者戴用义的适应期明显缩短，咀嚼能力增加。结论 该义齿固位，稳定作用良好，咀嚼效能明显改善且美观舒适。     

Early Prosthetic Management of Maxillectomy,Hemimandibulectomy Patient with a Lateral Mid Facial Defect: A Case Report

Maxillofacial prostheses for acquired defects have become more complex and sophisticated with advances in surgical, physical, and rehabilitative dentistry, but before planning, orofacial structures must be analyzed as to the specific cause and the consequent objectives of rehabilitation. Also retention of facial prostheses is very much challenging. Hence, we are presenting the fabrication of an interim prosthesis obturator and cheek prosthesis to restore the speech, help in deglutition and prevent drooling of saliva.     

An Alternative Design to Overcome the Problem of Unfavorable Implant Angulations for a Screw‐Retained,Implant‐Supported Fixed Prosthesis: Two Clinical Reports

Two clinical reports present an alternative design to address the problem of unfavorable implant angulations if a screw‐retained prosthesis is desired. The restorations were designed as screw‐retained prostheses, except in the area with the unfavorable implant screw emergence. The frameworks in these areas were customized to receive individual cement‐retained crowns. This design offers retrievability and helps to minimize complications associated with excess cement without compromising the functional or esthetic outcome.     

Hair band retained prosthetic reconstruction of bilaterally missing ears: A case of congenital atresia of external auditory canals and pinna

IntroductionAuricular defects present reconstructive challenges, especially if they are bilateral. Surgical reconstruction provides effective results for defects; however for some patients surgical intervention is contraindicated. This case report describes an easy clinical technique to rehabilitate a patient with auricular defects. The prime purpose of this treatment rendered was to restore the lost auricular structure to the patient's satisfaction in an elegant, comfortable and cost effective manner.PatientA thirteen year old female patient, who had bilaterally missing ears, was referred with a chief complaint of discomfort caused due to her existing hair band prosthesis and unsatisfactory esthetics. There was constant formation of ulcers at the site where the prosthesis came in contact with the skin. Considering the patient's age, ease of use and economic status, hair band retained ear prosthesis was selected. Silicone ear prostheses were fabricated on acrylic substructure to ensure fit, esthetics. Beneath the acrylic plates, a thin layer of soft silicone material was attached. The ear prostheses of both sides were connected with a metal hair band to retain.DiscussionThe newly fabricated prosthesis overcame the limitations of the existing one. The patient and her parents were satisfied with the results.ConclusionThe hair band retained silicone ear prosthesis is esthetic, economical and easy to use as a facial prosthesis. The addition of soft liner provided a cushion-like effect, thus reducing the formation of any ulcers due to pressure.