Digital Workflow of Auricular Rehabilitation: A Technical Report Using an Intraoral Scanner

Prosthodontic rehabilitation of a congenital or acquired defect of the ear is considered a challenging and skill‐dependent procedure. This technical report describes a novel approach for direct digital scanning of the unaffected contralateral ear using an intraoral scanner and external markers. The obtained digital data of the ear was exported, digitally mirrored, and successfully positioned to a virtual model of a human head with a missing ear. This technique demonstrates the potential application of CAD/CAM in the design and fabrication of an auricular prosthesis for patients with a unilateral ear defect.     

Fabrication of an auricular prosthesis: a case report

The fabrication of ear prosthesis is considered by many prosthetists to be one of the more difficult replacements in maxillofacial reconstruction. The severe undercuts and pronounced convolutions of the ear's surface present a challenge in simulating a natural proportioned prosthesis. The mould for the ear is generally made by creating a three surface die to reproduce the unique configuration adequately and to allow retrieval of the finished prosthesis without damage. This article presents an outlined procedure in the basic fabrication of a prosthetic ear by a conventional technique where the wax pattern is fabricated from the impression of an individual with a similarly proportioned ear. CLINICAL RELEVANCE: Fabricating an auricular prosthesis may be part of the work of a maxillofacial department.     

Auricular Retentive Prosthetic Conformer Post Brent's Stage III Surgery in Microtia Repair: A Clinical Report

Auricular reconstruction is an interdisciplinary approach where multiple specialties play a vital role in the treatment provided to the patient. This article provides a comprehensive interpretation of the process carried out for the fabrication of a custom‐made prosthetic conformer for the management of postoperative contraction of a skin graft after ear reconstruction surgery—Brent stage III. The prosthesis is used as a precautionary measure and is simple, effective, and economical.     

CAD/CAM ear model and virtual construction of the mold

This article describes a technique to make an implant-retained maxillofacial prosthesis using CAD/CAM technology and a rapid prototyping machine. The primary advantage of this technique is virtual 3-dimensional integration of the defective surface with the mirrored and digitalized normal ear. Making an impression of the defective side is not necessary, because only the position of the implants must be recorded to develop the bar for the retention of the prosthesis. This procedure allows positioning of the ear straight onto the computer screen, eliminating the diagnostic waxing, and the fabrication of the stone mold is not necessary because of the rapid prototyping process.     

The Hollow Maxillary Complete Denture: A Simple,Precise, Single‐Flask Technique Using a Caramel Spacer

The success of removable prostheses ultimately depends on a number of factors such as retention, stability, support, esthetics, and masticatory function. Increased intraoral inter‐arch distance leads to an increase in the weight of the prosthesis. This may compromise the retention and resistance, which are key for a successful removable prosthesis. Various methods, techniques, and materials have been reported to minimize the weight of a prosthesis. This article describes a simple, unique, precise single‐flask technique for the fabrication of a lightweight maxillary prosthesis using caramel as a 3D spacer, which was “indexed” to obtain a uniform thickness of acrylic around the hollow cavity.     

A modified technique to fabricate a complete hollow obturator for bilateral maxillectomy in a patient with mucormycosis—A technical case report

Maxillectomy performed in acquired lesions is often very extensive or bilateral, sparing very less hard and soft tissue in the oral cavity. These defects need both surgical and prosthetic rehabilitation. A definitive prosthesis is inserted after complete healing, when the patient is accustomed to the interim prosthesis. Definitive obturator warrants better retention and stability and needs a meticulous planning in design for long‐term use. Conventional design has a few disadvantages; it needs modification many times to improve retention and psychological comfort of the patient. The article explains an easy technique in fabrication of an obturator. The conventional obturator design has a hollow antral part but usually a solid oral part, which adds to the weight of the prosthesis pressurizing the soft tissues in a maxillectomy, which affects the function and esthetics. This article demonstrates the hollowing of oral part, which bears the artificial teeth, and modifying the antral bulb, which covers the defect. It was designed considering the potential difficulties shared by the patient in wearing the single piece conventional hollow bulb design. This technique when followed was beneficial in reducing the weight of the prosthesis and enhancing retention, and allowed the patient to perform normal functional movements.     

The implant-supported milled-bar mandibular overdenture

Osseointegrated dental implants have been proven successful in the treatment of edentulism. The predictability of the implant‐supported prosthesis has also been established. Several techniques have been described for the successful restoration of the edentulous mandible: fixed‐detachable prostheses with either the original Brånemark hybrid prosthesis design or conventional implant‐supported fixed partial dentures, implant‐retained overdentures, and implant‐supported overdentures. However, in cases of advanced ridge resorption in which facial tissue support is needed from the flanges of the prosthesis or when a removable type of prosthesis is preferred by the patient, an implant‐supported prosthesis is indicated. Electric discharge machining is often used in the fabrication of the bar for an implant‐supported overdenture. This procedure is very costly and technique sensitive. An alternative procedure to fabricate a milled‐bar implant‐supported overdenture is described. This procedure is simple and uses inexpensive equipment and materials. The milled‐bar minimizes lateral and rotational displacement. The overdenture incorporates attachments that provide retention, minimizing possible movement along the path of insertion. This type of prosthesis is available to a broad patient population, especially those with advanced ridge resorption, providing an excellent result at a reduced cost.     

An Alternative Technique for the Fabrication of a Metal‐Reinforced Interim Implant‐Supported Fixed Prosthesis: A Clinical Report

Despite advancements in restorative materials and techniques, complications with implant‐supported fixed prostheses such as veneer fracture and material wear are very common and present with varying frequencies. Following these complications, repair of this type of prosthesis can be time‐consuming and costly even in the hand of experience clinicians. Several techniques have proposed using the existing framework to minimize the cost of the repair for the patient; however, while the repairs are being performed, the patient will have to either wear an interim complete denture or no prosthesis, which might cause some inconvenience to the patient. This article will present a technique for the fabrication of a metal‐reinforced interim implant‐supported fixed prosthesis for patients to wear while the existing prosthesis is being repaired.     

Implementation of 3D technologies in the workflow of auricular prosthetics: A method using optical scanning and stereolithography 3D printing

The fabrication of auricular prostheses is traditionally time consuming, and the definitive esthetic appearance is highly skill dependent. A method of creating the wax pattern for an auricular prosthesis by using optical scanning and 3D printing is described. A digital scan of the unaffected ear is used for computer-aided design and manufacturing of a mold for casting the wax pattern of the prosthesis. The process is efficient and increases the predictability of the esthetic outcome.     

Fabrication of a hollow obturator as a single unit for management of bilateral subtotal maxillectomy

Prosthetic rehabilitation with an obturator for a total or subtotal maxillectomy patient is a challenging task, as there are little or no residual maxillary structures to depend on for support, retention, and stability of the prosthesis. This clinical report describes the prosthodontic management of a patient operated on for a bilateral subtotal maxillectomy secondary to ameloblastoma of the palate with a closed hollow obturator. The processing technique described in this article to fabricate the hollow obturator is a variation of other well-known techniques. The variation comprises the use of a wax bolus to maintain a predictable internal dimension for a hollow obturator. This technique allows fabrication of a complete hollow obturator prosthesis as a single unit in heat-polymerized acrylic resin using a single-step flasking procedure.     

Fabrication of an Implant‐Supported Fixed Interim Prosthesis Using a Duplicate Denture: An Alternative Technique

The fabrication of an implant‐supported fixed complete denture prosthesis involves multiple clinical and laboratory steps. One of the main steps is to provide the patient with an interim fixed prosthesis to evaluate the patient's esthetic and functional needs as well as to enhance the patient's psychology before proceeding to the definitive prosthesis. Different techniques for fabricating interim prostheses have been described in the literature. This report describes an alternative technique that uses a duplicate denture made of self‐curing acrylic resin to fabricate an implant‐supported fixed interim prosthesis. The interim prosthesis was later used as a blueprint for the definitive implant‐supported hybrid prosthesis.     

Template for Surgical Crown Lengthening: Fabrication Technique

This article describes a technique for the easy fabrication of a template to facilitate surgical lengthening of the clinical crown to enhance esthetics and/or increase retention of a fixed prosthesis. The use of this surgical guide should result in more predictable clinical results.     

An Alternative Technique for Mandibular Advancement Prosthesis Fabrication

One of the conservative and successful modalities of treatment for obstructive sleep apnea is the mandibular advancement prosthesis. This prosthesis engages teeth on both dental arches for retention and stability. This article describes a technique that allows that fabrication of such a prosthesis in one piece and in a single laboratory step. This may be beneficial in reducing the laboratory time required for fabrication of such a prosthesis.     

Bilateral implant-retained auricular prosthesis for a patient with congenitally missing ears. A clinical report

Microtia is a major congenital anomaly of the external ear. It includes a spectrum of deformities from a grossly normal but small ear to the absence of the entire external ear. These deformities account for three in every 10,000 births, with bilaterally missing ears seen in fewer than 10% of all cases. Congenital abnormalities of the ear are unlikely to result in the complete absence of the ears, but the patient presented in this article had bilateral congenitally missing ears. There was loss of anatomic landmarks and alteration of normal bony architecture. Minimal tissue was available for retention; therefore, conventional techniques could not be used for achieving retention. A two-implant-supported auricular prosthesis was planned, but the patient was found to have deficient bone in the implant site. Hence the implants were placed posterior to these sites, and the superstructure was modified to accommodate for this change in position of the implant to ensure the esthetic positioning of the prosthesis.     

Prosthodontic Rehabilitation with a Telescopic Prosthesis of a Nonsyndromic Oligodontia Patient

Oligodontia is the congenital absence of six or more permanent teeth, excluding the third molars. Oligodontia of permanent dentition is a rare occurrence. Preservation of the remaining deciduous dentition in such situations is important for both functional and esthetic rehabilitation of the patient. This clinical report describes the rehabilitation of a 16‐year‐old male with oligodontia of permanent teeth treated by an interdisciplinary team of prosthodontist, pedodontist, and orthodontist. The remaining deciduous dentition was endodontically treated. Occlusal vertical dimension (OVD) of the deciduous dentition was assessed. A full‐mouth single piece porcelain‐fused‐to‐metal telescopic prosthesis for the maxillary and mandibular arches was planned with a minimal increase in OVD. The telescopic prosthesis provided excellent retention, stability, esthetics, and stress equalization on the remaining deciduous dentition. Maintenance of oral hygiene procedures was simplified for the adolescent with the telescopic prosthesis. Preservation of remaining deciduous dentition and fabrication of a telescopic prosthesis in this patient provided an effective esthetic and functional rehabilitation.     

Full‐Arch Implant‐Supported Fixed Dental Prosthesis Retained by a Combination of Galvano‐Telescopic Copings and Screws: A Clinical Report

Full‐arch screw‐retained implant‐supported fixed dental prostheses have a high long‐term success rate and are considered the gold standard by many clinicians. However, accurate fabrication of a passive fit long‐span prosthesis can be challenging. A novel intraoral adhesion method using galvano‐telescopic copings was proposed as a way of improving prosthetic fit for edentulous patients. This report describes the treatment of a 74‐year‐old female with a full‐arch implant‐supported dental prosthesis, supported by a combination of galvano‐telescopic copings and screws to prevent retention loss. Four years have passed since this superstructure was placed, during this time she exhibited a good clinical course with no inflammation noted in surrounding tissues. Treatment with an implant‐supported fixed dental prosthesis, retained by a combination of galvano‐telescopic copings and screws, can be a useful alternative treatment for edentulous patients.     

Complete denture with a removable palatal lift prosthesis: a case report and clinical evaluation.

The palatal lift prosthesis is used to alleviate rhinopharyngeal closure dysfunction. It is generally problematical to use in edentulous patients, because the palatal lift prosthesis requires secure retention of the denture base and is difficult for the patient to retain while eating. This article describes the fabrication of a complete denture with a removable palatal lift prosthesis and a clinical evaluation of the denture's stability. A sprue pin and tube were used as a connecting attachment between the removable palatal lift prosthesis and the denture base. The force required for lifting the soft palate and the denture's stability were measured in the clinical evaluation. The prosthesis required an average retentive force of 0.26 N for each 1 mm of soft palate lift. The force required to dislodge the denture was measured with and without the palatal lift prosthesis in place. The force required to dislodge the conventional complete dentures of five healthy individuals was also measured as a reference. The denture was 24.4% less stable when the palatal lift prosthesis was in place and was generally easier to dislodge than were conventional dentures. This denture with a removable palatal lift prosthesis is useful for patients with dysfunction of the soft palate involving hypernasal speech who have difficulty in retaining the prosthesis while eating.     

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.     

种植体与杆卡式附着体用于义耳修复

将３只骨融合式螺旋种植体植入耳缺损区，采用杆卡式附着体作为种植上的部结构和义耳的固体装置，解决义耳固位，这种固位方式具有固位可靠，取戴方便，便于自洁，利于局部组织健康等优点，特别是在对抗侧向力方面具明显的优越性，是目前义耳修复最佳的固位方式。     

A two-section metal mold for an ear prosthesis

Several of the techniques employed in making metal molds for the fabrication of ear prostheses are mentioned. An alternative method for preparing metal molds for making an ear prosthesis of flexible material is presented. This method results in a two-section mold that is easy to construct and use.