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Ruse MK, Calhoun M, Davis BK. Prosthetic Nasal Reconstruction. Facial Plast Surg Clin North Am 2024; 32:327-337. [PMID: 38575290 DOI: 10.1016/j.fsc.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Prosthetic nasal reconstruction provides a restorative option for patients with nasal defects, and these can be retained with a variety of methods including adhesives and implants. These prostheses can significantly improve appearance, self-esteem, and quality of life for patients and they restore many functions of the external nose. Traditional fabrication methods are often used by the skilled professionals who make these custom prostheses, but digital technology is improving the workflow for design and fabrication of silicone nasal prostheses. Nasal prosthetic reconstruction requires multidisciplinary coordination between surgeons, maxillofacial prosthodontists, anaplastologists, and other members of the healthcare team. Prosthetic treatment can be considered as an alternative to, or an addition to treatment with surgical reconstruction.
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Affiliation(s)
- Michelle K Ruse
- HCA Healthcare and Sarah Cannon Cancer Institute, 9228 Medical Plaza Drive, Charleston, SC 29406, USA
| | - Michaela Calhoun
- Medical Art Resources, Inc and Prosthetics at Graphica Medica, 1880 Livingston Avenue, West Saint Paul, MN 55118, USA
| | - Betsy K Davis
- HCA Healthcare and Sarah Cannon Cancer Institute, 9228 Medical Plaza Drive, Charleston, SC 29406, USA.
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Noel OF, Dumbrava MG, Daoud D, Kammien AJ, Kauke-Navarro M, Pomahac B, Colen D. Vascularized Composite Allograft Versus Prosthetic for Reconstruction After Facial and Hand Trauma: Comparing Cost, Complications, and Long-term Outcome. Ann Plast Surg 2024; 92:100-105. [PMID: 37962243 DOI: 10.1097/sap.0000000000003731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
ABSTRACT In the past decade, vascularized composite allotransplantation (VCA) has become clinical reality for reconstruction after face and hand trauma. It offers patients the unique opportunity to regain form and function in a way that had only been achieved with traditional reconstruction or with the use of prostheses. On the other hand, prostheses for facial and hand reconstruction have continued to evolve over the years and, in many cases, represent the primary option for patients after hand and face trauma. We compared the cost, associated complications, and long-term outcomes of VCA with prostheses for reconstruction of the face and hand/upper extremity. Ultimately, VCA and prostheses represent 2 different reconstructive options with distinct benefit profiles and associated limitations and should ideally not be perceived as competing choices. Our work adds a valuable component to the general framework guiding the decision to offer VCA or prostheses for reconstruction after face and upper extremity trauma.
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Affiliation(s)
- Olivier F Noel
- From the Division of Plastic and Reconstructive Surgery, Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT
| | | | - Deborah Daoud
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ
| | - Alexander J Kammien
- From the Division of Plastic and Reconstructive Surgery, Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT
| | - Martin Kauke-Navarro
- From the Division of Plastic and Reconstructive Surgery, Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT
| | - Bohdan Pomahac
- From the Division of Plastic and Reconstructive Surgery, Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT
| | - David Colen
- From the Division of Plastic and Reconstructive Surgery, Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT
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Soliman IS, El-Attar MS, Fata M, Mohamed Kheneifar K, Ashry A. A novel design for prosthetic ear guiding device: A technical note. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101638. [PMID: 37729966 DOI: 10.1016/j.jormas.2023.101638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/17/2023] [Indexed: 09/22/2023]
Abstract
This article describes a newly designed Prosthetic Auricular Guide (PAG) that allows for accurate planning and positioning of both the auricular implants and the prosthetic auricle. The design aims to provide a cost-effective guiding device for more esthetic ear prostheses which is the patient's main concern. Along with determining the best clinically accepted position of the ear, the device can be used while taking CBCT which allows for the integration of the clinically approved position with the remaining bone for accurate planning of implant positions. Furthermore, the device can be fixed during surgery for accurate transmission of the planned position. The device is also adjustable making it suitable for all patterns of auricular defects, different ages, and even for patients with asymmetric faces.
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Affiliation(s)
- Ingy S Soliman
- Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | | | - Mohamed Fata
- Department of Maxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | - Amal Ashry
- Department of Prosthodontics, Faculty of Dentistry, Damanhur University, Damanhur, Egypt
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Gupta D, Thakkur R, Shah B. A case report on implant retained auricular prosthesis: Bringing back hope and smile. Natl J Maxillofac Surg 2023; 14:152-156. [PMID: 37273440 PMCID: PMC10235729 DOI: 10.4103/njms.njms_441_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 01/03/2022] [Accepted: 06/03/2022] [Indexed: 06/06/2023] Open
Abstract
Long-term success of a facial prosthesis mainly depends on retention. Most articles relate tissue health to long-term success, not retention. Anatomic undercuts, skin adhesives and implants are important factors to provide sufficient retention. Extra oral implant retained prosthesis have been proven to be a predictable treatment option for maxillofacial rehabilitation. This case report describes the clinical and laboratory procedures for fabricating implant-retained auricular prosthesis using magnets for retention. It describes how an initial planning for implant placement with Hader-bar retentive system was opted out due to intra-surgical situation. The use of craniofacial implants for retention of extra oral prosthesis, such as ears, offers excellent support and retentive abilities and improves a patient's appearance and quality of life. It has been shown in clinical and biomechanical studies that two implants are sufficient to retain an auricular prosthesis. Judicial treatment planning and implant placement according to the available remaining structures is prudent for a successful prosthesis.
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Affiliation(s)
- Deeksha Gupta
- Department of Prosthodontics, MP Dental College and Hospital, Vadodara, Gujarat, India
| | - Rahul Thakkur
- Department of Prosthodontics, MP Dental College and Hospital, Vadodara, Gujarat, India
| | - Bhumi Shah
- Department of Prosthodontics, MP Dental College and Hospital, Vadodara, Gujarat, India
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Carboxymethyl Dextran-Based Nanomicelle Coatings on Microarc Oxidized Titanium Surface for Percutaneous Implants: Drug Release, Antibacterial Properties, and Biocompatibility. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9225647. [PMID: 35865662 PMCID: PMC9296324 DOI: 10.1155/2022/9225647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/24/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022]
Abstract
Bacterial contamination and biofilm formation onpercutaneous implants can lead to device failure and be life-threatening. To solve this issue, we constructed a carboxymethyl dextran- (CMD-) based nanomicelle antibacterial coating on the microarc-oxidized titanium (MAO-Ti) surface (described in the supplementary file). The self-assembled CMD-based nanomicelles and octadecylamine (ODA) were developed as a drug carrier and loaded with minocycline (MC). The characterization and stability of the MC-loaded nanomicelles were determined. The surface roughness, hydrophilicity, and drug release property of the coatings were also investigated. Our findings showed that the cross-linked MC-loaded nanomicelles (MC@(ODA-CMD)CL) were more stable than the uncross-linked nanomicelles. Moreover, MC@(ODA-CMD)CL was successfully incorporated into the pores of MAO-Ti, which significantly increased the surface hydrophilicity of the coatings without influencing their surface roughness. In addition, the coatings demonstrated a sustained release time of 360 h, with a cumulative release rate reaching 86.6%. Staphylococcus aureus (S. aureus) was used to determine the antibacterial properties of the coatings, and human skin fibroblasts were seeded on them to investigate their biocompatibility. The results showed that the coatings significantly reduced the number of adhesive S. aureus and promoted the viability, adhesion, and morphology of the human skin fibroblasts compared to smooth titanium (S-Ti) sheets. In conclusion, MC-loaded CMD-based nanomicelles coated on MAO-Ti surface (MC@(ODA-CMD)CL-Ti) demonstrated sustained-release properties, excellent antibacterial properties and biocompatibility, and promising potential as coatings for percutaneous implants.
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Balshi TJ, Wolfinger GJ, Pellecchia R, Reiger W, Blakely JW, Balshi SF, Kachlan MO. 9-year follow up on maxillofacial implant-supported framework designed to accommodate childhood growth. J Prosthodont 2022; 31:551-561. [PMID: 35544676 DOI: 10.1111/jopr.13528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/24/2022] [Indexed: 10/18/2022] Open
Abstract
This clinical report focuses on the challenges and solutions for a child subjected to craniofacial trauma from a wild hyena biting off his nose and anterior maxilla. Unique considerations in prosthodontics and biomedical engineering were required based on future craniofacial growth and development of the child. The physical requirement of a maximum retentive prosthesis for an active, athletic child required unique engineering designs and executions. The sequence of treatment and prosthesis fabrication are detailed. The patient has been followed for nine years without physiologic complications and only minor prosthodontic complications. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Thomas J Balshi
- Founder and Prosthodontist, Pi Dental Center (Prosthodontics Intermedica, LLC), Institute for Facial Esthetics, currently Private mentoring implant surgery, Fort Washington, Pennsylvania, USA
| | - Glenn J Wolfinger
- Prosthodontist and President, Pi Dental Center, Institute for Facial Esthetics, Fort Washington, Pennsylvania, USA
| | - Robert Pellecchia
- Chairman and Program Director, Lincoln Hospital, Bronx, New York, USA
| | - William Reiger
- Maxillofacial Prosthodontist, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania, USA
| | - James W Blakely
- Maxillofacial Anaplastologist, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania, USA
| | - Stephen F Balshi
- Director of Research and Biomedical Engineering, Pi Dental Center, Institute for Facial Esthetics, Fort Washington, Pennsylvania, USA.,President, CM Prosthetic, Inc., Fort Washington, Pennsylvania, USA
| | - Mamdouh O Kachlan
- Prosthodontic Resident, University of Maryland School of Dentistry, Baltimore, Maryland, USA.,Research Associate, Pi Dental Center, Institute for Facial Esthetics, Fort Washington, Pennsylvania, USA
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Canallatos P, Jayanetti J, Beumer J. An implant-retained auricular prosthesis complicated by a modified temporal bone resection. J Prosthet Dent 2021; 128:1375-1379. [PMID: 33879317 DOI: 10.1016/j.prosdent.2021.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 10/21/2022]
Abstract
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. The purpose of this report was to describe the fabrication of an implant-retained auricular prosthesis with implants in suboptimal positions. Challenges included optimization of the stability and retention of the prosthesis, effectively managing the prosthetic space without compromising the esthetic outcome, providing adequate hygiene access for the implant connecting bar, and maintaining the health of the peri-implant tissues when the implant emerged through hair-bearing skin.
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Affiliation(s)
- Paul Canallatos
- Fellow, Maxillofacial Prosthetics Fellowship, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, Calif; Maxillofacial Prosthodontist, Department of Oral Oncology and Maxillofacial Prosthetics, Erie County Medical Center, Buffalo, NY.
| | - Jay Jayanetti
- Associate Director of Maxillofacial Prosthetics, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, Calif
| | - John Beumer
- Professor Emeritus, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, Calif
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Vitomir KS, Filip I, Vojkan L, Igor Đ, Lukasz P. Survival rate of disk and screw-type implants used for the retention of extraoral prostheses. J Prosthet Dent 2020; 127:499-507. [PMID: 33323178 DOI: 10.1016/j.prosdent.2020.07.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/16/2020] [Accepted: 07/16/2020] [Indexed: 11/18/2022]
Abstract
STATEMENT OF PROBLEM Implant-supported and implant-retained extraoral prostheses are reliable treatment options for patients with craniofacial defects. They provide stable retention and therefore enhance the patient's appearance and quality of life. Despite studies on survival rates of extraoral implants, little attention has been paid to the design of the implants used to support and retain extraoral prostheses. PURPOSE The purpose of this longitudinal clinical study was to assess the long-term survival rate (1 to 12 years, mean 6 years) of 2 different designs of implants (disk: single, double, and triple and screw-type) used for extraoral epithesis anchorage. MATERIAL AND METHODS Twenty-six participants with orbital and nasal defects, 10 of whom had had radiation treatment, were included in the study. Disk implants and extraoral (EO) screw implants were used and placed in the periorbital (15 participants) and perinasal regions (11 participants). Data were analyzed by using the Chi-square test and the Fisher Exact test for qualitative variables and the Mann-Whitney U test for comparison of quantitative variables. Implant survival rates were calculated by Kaplan-Meier analysis. RESULTS The overall 12-year survival rate of all implants was 90.3% (mean=79 months), with 92.9% for nasal (mean=84 months) and 88.2% for orbital (mean=75 months) implants. Related to the implant design, survival rates were as follows: for single-disk implants, 90.2%; for double disks, 94.6%; for triple disks, 88.3%; and for screw implants, 83.3%. In nonradiated participants, the implant survival rate was 97.6%, and for radiated participants, 76.1%. CONCLUSIONS Survival rates for implant-retained craniofacial prostheses are limited. The nasal site seems to be a more predictable implant site than the orbital site, with a higher overall survival rate. Also, implants inserted in radiated tissues have lower survival rates for both anatomic sites, with statistically significantly lower results in the orbital region. The most reliable type of implant among the disk implants used was the double disk in the orbital site and the single disk in the nasal site, which may indicate the advantages of some designs in specific areas.
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Affiliation(s)
- Konstantinović S Vitomir
- Professor, Clinic for Maxillofacial Surgery, School of Dentistry, University of Belgrade, Belgrade, Serbia
| | - Ivanjac Filip
- Clinic for Maxillofacial Surgery, School of Dentistry, University of Belgrade, Belgrade, Serbia
| | - Lazić Vojkan
- Professor, Department of Maxillofacial Prosthodontics, Clinic for Maxillofacial Surgery, School of Dentistry, University of Belgrade, Belgrade, Serbia
| | - Đorđević Igor
- Associate Professor, Department of Maxillofacial Prosthodontics, Clinic for Maxillofacial Surgery, School of Dentistry, University of Belgrade, Belgrade, Serbia
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Pruthi G, Bansal K, Jain V, Kumar Koli D. Retrospective study of treatment outcomes with implant retained auricular prostheses at a tertiary referral care centre. J Oral Biol Craniofac Res 2020; 10:266-275. [PMID: 32509517 DOI: 10.1016/j.jobcr.2020.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 04/11/2020] [Accepted: 04/11/2020] [Indexed: 10/24/2022] Open
Abstract
Purpose To discuss the indications, technical steps for fabrication of implant retained auricular prosthesis (IRAP), and treatment outcome at various follow up visits. Materials and methods We performed retrospective data collection of all consecutively treated patients referred to us for auricular reconstruction from 2006 till 2018. Each case was analysed for: feasibility of autogenous reconstruction vs IRAP, surgical procedure, type of anaesthesia, type of implants, soft tissue response, implant success and survival rate, prosthetic attachment, aesthetic outcome, complications and patient acceptance. Procedure for fabrication of IRAP has also been written in detail to benefit readers. Results IRAP was considered feasible and performed in eight out of 27 patients referred for auricular reconstruction. 20 implants were placed and total 10 prostheses were fabricated. Implant success rate and survival rate was 90% and 100% respectively till last follow-up of each patient. Bar and clip attachments were used in 60% and stud attachments in 40% of prostheses. After stage II surgery, grade I soft tissue inflammation was reported around two implants (10%), and grade III around one implant (5%). Implant with grade III inflammation showed features of recurrent infection and thus was left buried under soft tissues. These prostheses were aesthetically pleasing in all cases in the early post-operative period. Conclusions A systematic, step wise procedure with multi-disciplinary approach is a key to success for the fabrication of implant retained auricular prosthesis.
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Implant prognosis in irradiated versus non-irradiated nasal, orbital and auricular sites. Int J Oral Maxillofac Surg 2019; 49:636-648. [PMID: 31668784 DOI: 10.1016/j.ijom.2019.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 07/06/2019] [Accepted: 09/12/2019] [Indexed: 01/08/2023]
Abstract
The purpose of this systematic review was to evaluate implant survival in irradiated nasal, auricular, orbital sites and to compare them with non-irradiated respective sites. Four electronic databases and seven related journals were searched until December and March 2018, respectively. A total of 7892 articles were identified, 18 of which were included in this review; one non-randomized clinical trial, two prospective cohort, eight retrospective cohort and seven cross-sectional studies. Using the ROBIN-I Cochrane tool for risk assessment, 13 studies were judged at serious, one at moderate and four at critical risk of bias. Thirteen were included in 18 meta-analyses, the results of which showed a significant difference between irradiated and non-irradiated sites, favouring non-irradiated with risk ratio (RR) = 0.93, 95% confidence interval (CI) 0.89-0.97, P=0.001. Comparisons among nasal, auricular and orbital sites revealed no significant differences, whether in irradiated or non-irradiated patients at P<0.05. Hence, it was concluded that, within the limitations of this review, survival of craniofacial implants is negatively affected by radiotherapy, especially in orbital sites. Level of evidence is moderate. Therefore, further prospective cohort studies with calculated sample sizes, restricted or properly managed confounders and no deviations from intended interventions might produce different results.
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Moore P, Grinsell D, Lyons B, Hewson I. Outcomes of dental and craniofacial osseointegrated implantation in head and neck cancer patients. Head Neck 2019; 41:3290-3298. [DOI: 10.1002/hed.25845] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 05/11/2019] [Accepted: 06/04/2019] [Indexed: 12/12/2022] Open
Affiliation(s)
- Phillip Moore
- ENT/Head and Neck UnitSt Vincent's Hospital Melbourne Victoria Australia
| | - Damien Grinsell
- Plastic, Reconstructive, and Hand Surgery UnitSt Vincent's Hospital Melbourne Victoria Australia
| | - Bernard Lyons
- ENT/Head and Neck UnitSt Vincent's Hospital Melbourne Victoria Australia
| | - Ian Hewson
- ENT/Head and Neck UnitSt Vincent's Hospital Melbourne Victoria Australia
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Jazayeri HE, Kang S, Masri RM, Kuhn L, Fahimipour F, Vanevenhoven R, Thompson G, Gheisarifar M, Tahriri M, Tayebi L. Advancements in craniofacial prosthesis fabrication: A narrative review of holistic treatment. J Adv Prosthodont 2018; 10:430-439. [PMID: 30584472 PMCID: PMC6302084 DOI: 10.4047/jap.2018.10.6.430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 06/28/2018] [Accepted: 08/13/2018] [Indexed: 01/17/2023] Open
Abstract
The treatment of craniofacial anomalies has been challenging as a result of technological shortcomings that could not provide a consistent protocol to perfectly restore patient-specific anatomy. In the past, wax-up and impression-based maneuvers were implemented to achieve this clinical end. However, with the advent of computer-aided design and computer-aided manufacturing (CAD/CAM) technology, a rapid and cost-effective workflow in prosthetic rehabilitation has taken the place of the outdated procedures. Because the use of implants is so profound in different facets of restorative dentistry, their placement for craniofacial prosthesis retention has also been widely popular and advantageous in a variety of clinical settings. This review aims to effectively describe the well-rounded and interdisciplinary practice of craniofacial prosthesis fabrication and retention by outlining fabrication, osseointegrated implant placement for prosthesis retention, a myriad of clinical examples in the craniofacial complex, and a glimpse of the future of bioengineering principles to restore bioactivity and physiology to the previously defected tissue.
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Affiliation(s)
- Hossein E Jazayeri
- Oral and Maxillofacial Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Steve Kang
- Oral and Maxillofacial Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Radi M Masri
- Department of Endodontics, Prosthodontics and Operative Dentistry, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Lauren Kuhn
- Department of Oral Rehabilitation, Division of Endodontics, Medical University of South Carolina, Charleston, SC, USA
| | | | - Rabecca Vanevenhoven
- Division of Oral and Maxillofacial Surgery and Dentistry, New York Presbyterian Weill Cornell Medical Center, New York City, NY, USA
| | - Geoffrey Thompson
- Department of Prosthodontics, Marquette University School of Dentistry, Milwaukee, WI, USA
| | - Maryam Gheisarifar
- Department of Prosthodontics, Marquette University School of Dentistry, Milwaukee, WI, USA
| | | | - Lobat Tayebi
- Marquette University School of Dentistry, Milwaukee, WI, USA
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Risk factors for periimplantitis and implant loss in orbital implants. J Craniomaxillofac Surg 2018; 46:2214-2219. [DOI: 10.1016/j.jcms.2018.09.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 08/15/2018] [Accepted: 09/25/2018] [Indexed: 11/20/2022] Open
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Subramaniam S, Breik O, Cadd B, Peart G, Wiesenfeld D, Heggie A, Gibbons S, Nastri A. Long-term outcomes of craniofacial implants for the restoration of facial defects. Int J Oral Maxillofac Surg 2018; 47:773-782. [DOI: 10.1016/j.ijom.2018.01.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 01/14/2018] [Accepted: 01/17/2018] [Indexed: 10/18/2022]
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15
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de Oliveira FM, Salazar-Gamarra R, Öhman D, Nannmark U, Pecorari V, Dib LL. Quality of life assessment of patients utilizing orbital implant-supported prostheses. Clin Implant Dent Relat Res 2018; 20:438-443. [PMID: 29508545 DOI: 10.1111/cid.12602] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/31/2018] [Accepted: 02/01/2018] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM Evaluate the effect of orbital prosthesis retained by implants through a specific quality of life (QOL) questionnaire provides important information on patients QOL, great incentive for the multidisciplinary team and public health support to continue work in this area. PURPOSE The objective of the study was to evaluate patient satisfaction with orbital implant-supported prostheses using an adapted quality of life questionnaire. MATERIALS AND METHODS Forty five patients using orbital implant-supported prostheses for a period ranging from six to 120 months. The subjects answered a questionnaire that consisted of 10 questions covering appearance, retention, conspicuousness, self-confidence, difficulty of placement, difficulty of removal, cleaning, limitation of activities, discomfort of tissues, and recommendation of the method to other patients. Answers were expressed using a visual 100-mm scale. The arithmetic mean of the responses was converted into a percentage to represent the satisfaction index. RESULTS Patients demonstrated a high level of satisfaction on all items, with the lowest rate being for aesthetics and the highest being for recommending the method to other patients. High satisfaction rates regarding the placement and removal of the prosthesis, discomfort to the tissues, and cleaning suggest the ease of handling of the prosthesis. High satisfaction with retention, self-confidence, conspicuousness of the prosthesis, and limitation of activities indicated an association with a better social life. CONCLUSIONS The results showed that use of bone anchorage technique of extraoral prostheses provided a high level of satisfaction among patients, confirming that osseointegrated implants are a very important resource for the rehabilitation of orbital deformities.
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Affiliation(s)
| | | | - David Öhman
- Maxillofacial Department, Dental School, University of Gothenburg, Gothenburg, Sweden
| | - Ulf Nannmark
- Maxillofacial Department, Dental School, University of Gothenburg, Gothenburg, Sweden
| | - Vanessa Pecorari
- UNIP Postgraduate Dental Program, Universidade Paulista, São Paulo, Brazil
| | - Luciano Lauria Dib
- UNIP Postgraduate Dental Program, Universidade Paulista, São Paulo, Brazil
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Wheeler KJ, Early JO. Using Photovoice to Explore Quality of Life Factors of Adults With Crouzon Syndrome. QUALITATIVE HEALTH RESEARCH 2018; 28:357-370. [PMID: 29224414 DOI: 10.1177/1049732317742624] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In the United States, one in 60,000 adults live with Crouzon Syndrome (CS) and facial malformations. Phenomenological studies about their lived experiences and quality of life are lacking. The purpose of this participatory action research study was to gain a richer understanding of the perceived biopsychosocial and socioecological factors that impact quality of life for adults living with CS using Photovoice. Another aim was to develop a conceptual framework of quality of life for those experiencing CS to enhance tailored health education and services. A purposeful sample of nine adults with CS were recruited from U.S. national surgery centers and support groups. Participants used photography to represent their experiences and participated in individual interviews and focus groups. Data were analyzed with the participants using thematic analysis, and 44 themes emerged which informed the development of a quality of life conceptual framework and action plan described in this article.
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Affiliation(s)
| | - Jody O Early
- 2 University of Washington Bothell, Bothell, Washington, USA
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Conical Modification of Forearm Free Flaps for Single-Stage Reconstruction After Total Orbital Exenteration. J Craniofac Surg 2017; 28:e767-e769. [DOI: 10.1097/scs.0000000000003944] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Brandão TB, Vechiato Filho AJ, de Souza Batista VE, Prado Ribeiro AC, Filho HN, Chilvarquer I, Nunn ME, Santos-Silva AR, Barão VAR, Wee AG. Assessment of treatment outcomes for facial prostheses in patients with craniofacial defects: A pilot retrospective study. J Prosthet Dent 2017; 118:235-241. [DOI: 10.1016/j.prosdent.2016.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 10/17/2016] [Accepted: 10/17/2016] [Indexed: 10/20/2022]
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Cobein MV, Coto NP, Crivello Junior O, Lemos JBD, Vieira LM, Pimentel ML, Byrne HJ, Dias RB. Retention systems for extraoral maxillofacial prosthetic implants: a critical review. Br J Oral Maxillofac Surg 2017; 55:763-769. [PMID: 28552609 DOI: 10.1016/j.bjoms.2017.04.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 04/23/2017] [Indexed: 10/19/2022]
Abstract
We describe the techniques available for retention of implant-supported prostheses: bar-clips, O-rings, and magnets. We present reported preferences and, although this is limited by the heterogeneity of methods used and patients studied, we hope we have identified the best retention systems for maxillofacial prosthetic implants. If practitioners know the advantages and disadvantages of each system, they can choose the most natural and comfortable prosthesis. We searched the PubMed and Scopus databases, and restricted our search to papers published 2001-13. MeSH terms used were Maxillofacial prosthesis and Craniofacial prosthesis OR Craniofacial prostheses. We found a total of 2630 papers, and after duplicates had been removed we analysed the rest and found 25 papers for review. Of these, 12 were excluded because they were case reports or non-systematic reviews. Of the remaining 13, 10 described group analyses and seemed appropriate to find practitioner's choices, as cited in the abstract (n=1611 prostheses). Three papers did not mention the type of prosthetic connection used, so were excluded. The most popular choices for different conditions were analysed, though the sites and retention systems were not specified in all 10 papers. The bar-clip system was the most used in auricular (6/10 papers) and nasal prostheses (4/10). For the orbital region, 6/10 favoured magnets. Non-osseointegrated mechanical or adhesive retention techniques are the least expensive and have no contraindications. When osseointegrated implants are possible, each facial region has a favoured system. The choice of system is influenced by two factors: standard practice and the abilities of the maxillofacial surgeon and maxillofacial prosthetist.
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Affiliation(s)
- M V Cobein
- Oral and Maxillofacial Surgeon, Hospital Regional Sul, São Paulo, Brazil; Department of Maxillofacial Surgery, Prosthetics and Traumatology - Area of Maxillofacial Prosthetics, School of Dentistry of University of São Paulo, São Paulo, Brazil.
| | - N P Coto
- Department of Maxillofacial Surgery, Prosthetics and Traumatology - Area of Maxillofacial Prosthetics, School of Dentistry of University of São Paulo, São Paulo, Brazil.
| | - O Crivello Junior
- Department of Maxillofacial Surgery, Prosthetics and Traumatology - Area of Maxillofacial Traumatology, School of Dentistry of University of São Paulo, São Paulo, Brazil.
| | - J B D Lemos
- Department of Maxillofacial Surgery, Prosthetics and Traumatology - Area of Maxillofacial Traumatology, School of Dentistry of University of São Paulo, São Paulo, Brazil.
| | - L M Vieira
- Department of Maxillofacial Surgery, Prosthetics and Traumatology - Area of Maxillofacial Prosthetics, School of Dentistry of University of São Paulo, São Paulo, Brazil.
| | - M L Pimentel
- Department of Maxillofacial Surgery, Prosthetics and Traumatology - Area of Maxillofacial Prosthetics, School of Dentistry of University of São Paulo, São Paulo, Brazil.
| | - H J Byrne
- FOCAS Research Institute of Dublin Institute of Technology, Dublin, Ireland.
| | - R B Dias
- Department of Maxillofacial Surgery, Prosthetics and Traumatology - Area of Maxillofacial Prosthetics, School of Dentistry of University of São Paulo, São Paulo, Brazil.
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Initial investigation of the corrosion stability of craniofacial implants. J Prosthet Dent 2017; 119:185-192. [PMID: 28533010 DOI: 10.1016/j.prosdent.2017.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 02/15/2017] [Accepted: 02/15/2017] [Indexed: 11/23/2022]
Abstract
STATEMENT OF PROBLEM Although craniofacial implants have been used for retention of facial prostheses, failures are common. Titanium undergoes corrosion in the oral cavity, but the corrosion of craniofacial implants requires evaluation. PURPOSE The purpose of this in vitro study was to investigate the corrosion stability of commercially pure titanium (CP Ti) exposed to simulated human perspiration at 2 different pH levels (5.5 and 8). MATERIAL AND METHODS Fifteen titanium disks were divided into 3 groups (n=5 per group). The control group was subjected to simulated body fluid (SBF) (control). Disks from the 2 experimental groups were immersed in simulated alkaline perspiration (SAKP) and simulated acidic perspiration (SACP). Electrochemical tests, including open circuit potential (3600 seconds), electrochemical impedance spectroscopy, and potentiodynamic tests were performed according to the standardized method of 3-cell electrodes. Data were analyzed by 1-way ANOVA and the Tukey honestly significant difference tests (α=.05). RESULTS Simulated human perspiration reduced the corrosion stability of CP Ti (P<.05). The SBF group presented the lowest capacitance values (P<.05). SAKP and SACP groups showed increased values of capacitance and showed no statistically significant differences (P>.05) from each other. The increase in capacitance suggests that the acceleration of the ionic exchanges between the CP Ti and the electrolyte leads to a lower corrosion resistance. SAKP reduced the oxide layer resistance of CP Ti (P<.05), and an increased corrosion rate was noted in both simulated human perspiration groups. CONCLUSIONS Craniofacial implants can corrode when in contact with simulated human perspiration, whereas alkaline perspiration shows a more deleterious effect. Perspiration induces a more corrosive effect than simulated body fluid.
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Craniofacial implants at a single centre 2005-2015: retrospective review of 451 implants. Br J Oral Maxillofac Surg 2017; 55:242-245. [DOI: 10.1016/j.bjoms.2016.11.324] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 11/04/2016] [Indexed: 11/23/2022]
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Wang J, Wu G, Liu X, Sun G, Li D, Wei H. A decomposable silica-based antibacterial coating for percutaneous titanium implant. Int J Nanomedicine 2017; 12:371-379. [PMID: 28123297 PMCID: PMC5229168 DOI: 10.2147/ijn.s123622] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Although percutaneous titanium implants have become one of the best choices as retainers in the facial defects, peri-implantitis still occurs at a significant rate. This unwanted complication occurs due to adhesion of bacteria and subsequent biofilm formation. To solve this problem, we have developed a novel antibiotic nanodelivery system based on self-decomposable silica nanoparticles. In this study, silica-gentamycin (SG) nanoparticles were successfully fabricated using an innovative one-pot solution. The nanoparticles were incorporated within a gelatin matrix and cross-linked on microarc-oxidized titanium. To characterize the SG nanoparticles, their particle size, zeta potential, surface morphology, in vitro drug release, and decomposition process were sequentially evaluated. The antibacterial properties against the gram-positive Staphylococcus aureus, including bacterial viability, antibacterial rate, and bacteria morphology, were analyzed using SG-loaded titanium specimens. Any possible influence of released gentamycin on the viability of human fibroblasts, which are the main component of soft tissues, was investigated. SG nanoparticles from the antibacterial titanium coating continuously released gentamycin and inhibited S. aureus growth. In vitro investigation showed that the obtained nanodelivery system has good biocompatibility. Therefore, this design can be further investigated as a method to prevent infection around percutaneous implants.
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Affiliation(s)
- Jia Wang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an
| | - Guofeng Wu
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing
| | - Xiangwei Liu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Guanyang Sun
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an
| | - Dehua Li
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Hongbo Wei
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, People’s Republic of China
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Datarkar A, Daware S, Dande R, Datarkar U. Rehabilitation of Unilateral Congenital Microtia by Implant-retained Prosthesis. Ann Maxillofac Surg 2017; 7:291-295. [PMID: 29264301 PMCID: PMC5717910 DOI: 10.4103/ams.ams_69_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
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. Extraoral implant-retained ear prosthesis has been proven to be a predictable treatment option for rehabilitation of such congenital anomalies. This paper aims to present principles of maxillofacial implants, review of literature, advantages, disadvantages, and considerations in treatment planning and treatment phases of an implant-supported auricular prosthesis and prospective developments for ear prosthesis are also discussed. Implant supported ear reconstruction provides excellent support, good retention, and esthetically acceptable appearance to the patient.
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Affiliation(s)
- Abhay Datarkar
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Surendra Daware
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Ravi Dande
- Department of Dentistry, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Ujwala Datarkar
- Devanshi Dental Institute and Research Centre, Nagpur, Maharashtra, India
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Brandão TB, Vechiato Filho AJ, de Souza Batista VE, de Oliveira MCQ, Visser A, de Faria JCM, Júnior GDC, Santos-Silva AR. A systematic comparison of bar-clips versus magnets. J Prosthet Dent 2016; 117:321-326.e2. [PMID: 27666496 DOI: 10.1016/j.prosdent.2016.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 05/04/2016] [Accepted: 05/06/2016] [Indexed: 10/21/2022]
Abstract
STATEMENT OF PROBLEM Currently, which type of suprastructure is preferred when fabricating implant-retained craniofacial prostheses is unknown. PURPOSE The purpose of this systematic review was to identify the best retention system (bar-clips versus magnets) for implant-retained craniofacial prostheses. MATERIAL AND METHODS This systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic search of Medline/PubMed and Web of Science databases for clinical trials was conducted on implant-retained craniofacial prostheses published between 2005 and 2015. English-language studies that directly compared different types of retention systems or presented information on implant survival, periimplant soft tissue reactions, and prosthetic complications were included. Nonclinical studies were excluded to eliminate bias. RESULTS A total to 173 studies were identified, of which 10 satisfied the inclusion criteria. In total, 492 participants were included in these studies. Four selected studies displayed detailed information with regard to the number of implant failures according to the retention system. As reported, 29 (18.2%) of 159 implants with magnets failed, whereas 25 (31.6%) of 79 implants with bars failed. Overall auricular superstructures showed the highest survival (99.08%). In addition, 55.4% of all participants in the selected studies showed grade 0 of periimplant soft tissue reactions. CONCLUSIONS A systematic search for clinical studies resulted in few studies with a short-term follow-up and small number of participants. The limited data collected indicated that magnets show fewer complications than bar superstructures; however, no hard conclusions could be drawn. Further research, preferably in the form of clinical trials, is needed to validate these findings.
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Affiliation(s)
- Thais Bianca Brandão
- Coordinator, Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
| | - Aljomar José Vechiato Filho
- Assistant, Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Victor Eduardo de Souza Batista
- Doctoral student, Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Sao Paulo State University, São Paulo, Brazil
| | - Maria Cecília Querido de Oliveira
- Assistant, Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Anita Visser
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - José Carlos Marques de Faria
- Associate Professor, Plastic Surgery, University of São Paulo, São Paulo, Brazil; and Head, Plastic Surgery, Pontificia Universidade Catolica, Medical School, Campinas, São Paulo, Brazil
| | - Gilberto de Castro Júnior
- Attending Physician, Clinical Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Professor, Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Sao Paulo, Brazil
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Chrcanovic BR, Nilsson J, Thor A. Survival and complications of implants to support craniofacial prosthesis: A systematic review. J Craniomaxillofac Surg 2016; 44:1536-1552. [PMID: 27591092 DOI: 10.1016/j.jcms.2016.07.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 06/17/2016] [Accepted: 07/29/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To assess the survival rate of craniofacial implants (CIs) to support facial prosthesis/epithesis and the prevalence of surgical/biological complications based on previously published studies. METHODS An electronic search was undertaken in March/2016. Only studies with a minimum of 5 patients were included. Untransformed proportions of implant failures for different regions were calculated. A meta-analysis evaluated the influence of radiotherapy on the failure rates. A meta-regression was performed considering the follow-up period as covariate. RESULTS Seventy publications included 2355 patients and 8184 CIs (545 failures). The probability of a failure was 5.5% for all CIs (95%CI 4.5-6.5, P < 0.001), 1.2% for CIs in the auricular region (95%CI 0.8-1.5, P < 0.001), 12.2% for the nasal region (95%CI 9.0-15.5, P = 0.017), and 12.1% for the orbital region (95%CI 9.3-15.0, P < 0.001). Radiotherapy statistically affected the CIs rates (OR 5.80, 95%CI 3.77-8.92, P < 0.00001). There was no statistically significant influence of the follow-up time on the proportion of implant failures (P = 0.814). Soft tissue adverse reactions were the most common complications. CONCLUSIONS Implants placed in the auricular region have a lower probability of failure than those in the nasal and orbital regions. Soft tissue adverse reactions were the most common complications. Radiotherapy significantly affected the CIs failure rates.
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Affiliation(s)
- Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology (Head: Dr. A. Wennerberg, DDS, PhD), Malmö University, Carl Gustafs väg 34, SE-205 06, Malmö, Sweden.
| | - Johanna Nilsson
- Department of Oral and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark; Department of Surgical Sciences, Oral and Maxillofacial Surgery (Head: Dr. Per Hellman, MD, PhD), Uppsala University, Uppsala, Sweden.
| | - Andreas Thor
- Department of Surgical Sciences, Oral and Maxillofacial Surgery (Head: Dr. Per Hellman, MD, PhD), Uppsala University, Uppsala, Sweden.
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Dawood A, Kalavrezos N, Barrett M, Tanner S. Percutaneous implant retention of a nasal prosthesis. J Prosthet Dent 2016; 117:186-190. [PMID: 27492986 DOI: 10.1016/j.prosdent.2016.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 05/26/2016] [Accepted: 05/27/2016] [Indexed: 12/22/2022]
Abstract
This report describes an approach to the simultaneous retention of a nasal prosthesis and an intraoral prosthesis for a patient who had undergone a total rhinectomy with resection of the upper lip and premaxilla. At the time of the nasal resection, 2 dental implants were placed adjacent to the resection margins in the first premolar positions. These were used to anchor an intraoral, milled titanium bar and overdenture to replace the missing anterior teeth and provide support for the upper lip, which had been reconstructed with a vascularized radial forearm free-flap. The titanium bar also incorporated a connection for a tissue-penetrating percutaneous nasal extension, which pierced the radial forearm flap near the junction with the hard palate. Magnetic attachments screwed to the nasal extension retained a nasal prosthesis. The predictable and straightforward implementation of this novel concept with digital design and manufacture of the titanium components and guided placement of the nasal extension was made possible with software planning.
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Affiliation(s)
- Andrew Dawood
- Honorary consultant, Department of Head and Neck Surgery, University College Hospital London, United Kingdom.
| | - Nicholas Kalavrezos
- Consultant, Department of Head and Neck Surgery University College London Hospital, United Kingdom
| | - Mark Barrett
- Consultant, University College London Hospital, United Kingdom
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Treatment Outcome of the Transfacial Titanium Epiplating System for Total Nasal Defects. Plast Reconstr Surg 2016; 137:405e-413e. [PMID: 26818331 DOI: 10.1097/01.prs.0000475792.38984.37] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Malignant tumors are the most frequent reason for acquired defects of the nose. Bone-anchored craniofacial prostheses represent a secure, uncomplicated, and cosmetically acceptable rehabilitative alternative to surgical reconstruction. The aim of this study was to determine a potential benefit of the Titanium Epiplating System (Fa. Medicon, Tuttlingen, Germany) as a grouped implant system in the anatomically difficult nasal region with limited bone supply. METHODS Patients with complete nasal defects who received a transfacial Titanium Epiplating System between January of 2009 and December of 2013 for nasal prostheses were included. The Epiplating titanium plates are specially adapted to the nasal region and were modified individually. Implant survival, periimplantitis, clinical course, and risk factors for implant survival were assessed retrospectively, including univariate statistics. RESULTS Fifty-three patients were included in this study. At the time of last follow-up, 51 of 53 Epiplating systems (96.2 percent) were stable in situ. One titanium plate had to be renewed because of a traumatic accident and one plate had to be removed because of disease recurrence. Periimplantitis occurred in 7.5 percent and could be treated successfully by either local or systemic antibiotic therapy without any loss of stability in bone anchorage. Only smoking significantly increased the risk of periimplantitis (p = 0.013), whereas age, irradiation, chemotherapy, and immunosuppression did not influence the outcome of therapy. The median healing time with use of the Titanium Epiplating System was 3.6 ± 2.7 months. CONCLUSIONS The Titanium Epiplating System is a safe and uncomplicated system for bone-anchored retention of nasal prostheses. Good aesthetic results can be achieved. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Balik A, Ozdemir-Karatas M, Peker K, Cifter ED, Sancakli E, Gökcen-Röhlig B. Soft Tissue Response and Survival of Extraoral Implants: A Long-Term Follow-up. J ORAL IMPLANTOL 2016; 42:41-5. [DOI: 10.1563/aaid-joi-d-14-00086] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Maxillofacial defects may be reconstructed by plastic surgery or treated by prosthetic mean rehabilitation. In case of large defects, prosthetic rehabilitation rather than surgical reconstruction is preferred due to the insufficient esthetic results of surgical interventions. However, retention of the craniofacial prosthesis is a great problem despite the satisfactory esthetic results. With the presentation of extraoral implants, the retention of maxillofacial prostheses was improved, and osseointegrated craniofacial implants have become indispensable for retention and stability. However, there are conflicting results regarding the success rates of osseointegrated implants used at the craniofacial region. A total of 24 patients with 64 implants (30 in auricular region of 13 patients, 24 in nasal region of 8 patients, and 10 in orbital region of 3 patients) ranging in age from 16 to 83 years (mean age = 45.45 years) were evaluated. One patient among 13 patients (1/13) has lost his implants in the auricular area, 1 patient among 8 patients (1/8) lost his implants, and 1 patient among 3 patients (1/3) has lost all of her implants. Peri-implant soft tissue response was evaluated for a 60-month period and a total of 654 visits/sites recorded. Grade 0 (no irritation) was present in 72.8% (476/654) of the visits/sites. Grade 1 (slight redness) was observed for 18.8% (123/654). Grade 2 (red and slightly moist tissue) was scored in 6.9% (45/654). Grade 3 (red and slightly moist tissue with granulation) was noted in 1.5% (10/654) and grade 4 (infection) could not be found. Ossseointegrated implants provide reasonable support and show successful results when used with maxillofacial prostheses.
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Affiliation(s)
- Ali Balik
- Department of Maxillofacial Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Capa, Turkey
| | - Meltem Ozdemir-Karatas
- Department of Maxillofacial Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Capa, Turkey
| | - Kadriye Peker
- Department of Dental Public Health, Faculty of Dentistry, Istanbul University, Fatih/Çapa, Istanbul, Turkey
| | - Ebru Demet Cifter
- Department of Maxillofacial Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Capa, Turkey
| | - Erkan Sancakli
- Department of Maxillofacial Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Capa, Turkey
| | - Bilge Gökcen-Röhlig
- Department of Maxillofacial Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Capa, Turkey
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Wondergem M, Lieben G, Bouman S, van den Brekel MWM, Lohuis PJFM. Patients' satisfaction with facial prostheses. Br J Oral Maxillofac Surg 2015; 54:394-9. [PMID: 26508540 DOI: 10.1016/j.bjoms.2015.09.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 09/14/2015] [Indexed: 11/17/2022]
Abstract
We assessed the "impact on wellbeing" and "satisfaction" of patients who had a facial prosthesis (of the ear, nose, or orbit) fitted in The Netherlands Cancer Institute. Patients had either an adhesive-retained or an implant-retained facial prosthesis between 1951 and 2011. We did a cross-sectional survey of 104 patients, then gave a questionnaire to the final study group of 71 (68%), a year or more later. All were satisfied with their prostheses (visual analogue scale (VAS): mean (SD) 8.1(1.5). The implant-retained group were the most satisfied (p=0.022), and the adhesive-retained group felt more self-conscious (p=0.013). Three-quarters of all patients said that the prosthesis was not painful and there were no problems with the way it functioned. A well-designed facial prosthesis has obvious benefits, but there were no appreciable differences between the two groups. Each patient must make a careful decision about which type of prosthesis to choose, taking into account the quality of their remaining tissue, the site of the defect, and their general health.
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Affiliation(s)
- Marloes Wondergem
- The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Head and Neck Surgery, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands; The University Medical Centre Groningen, Department of Otorhinolaryngology, P.O. Box 30001, 9700 RB Groningen, The Netherlands.
| | - George Lieben
- The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Head and Neck Surgery, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands.
| | - Shirley Bouman
- The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Head and Neck Surgery, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands.
| | - Michiel W M van den Brekel
- The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Head and Neck Surgery, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands; Academic Medical Centre of the University of Amsterdam, Department of Oral and Maxillofacial Surgery, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - Peter J F M Lohuis
- The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Head and Neck Surgery, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands.
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Quality of implant anchored craniofacial and intraoral prostheses: patient's evaluation. J Craniofac Surg 2015; 25:e202-7. [PMID: 24621771 DOI: 10.1097/scs.0000000000000381] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUNDS Bone-anchored prostheses have become a major issue in the rehabilitation of patients with facial defects. The objective of this study was to analyze how patients perceived the quality of implant-retained orbit, ear, nose, maxilla, or partial face prosthesis. METHODS The patients' satisfaction from implant-retained prostheses usage was evaluated by a group of 30 patients with various facial defects. The survey referred exclusively to oncologic patients. Surveyors were classified basing on their age, sex, and defect localization, and their satisfaction was assessed by standardized questionnaire with 6-grade scale. RESULTS Overall, acknowledging some weaknesses, such as reduced condition of surrounding soft tissue and necessity to enhance hygienic care, most of the patients assessed their prostheses as "good" emphasizing excellent mechanical retention and high wearing comfort. More detailed analysis revealed itemized outcome: (i) auricular prosthesis was indicated as the most comfortable solution by the patients; (ii) women and patients older than 55 years were more satisfied with the treatment results than men and patients younger than 55 years; and (iii) implant-retained prostheses were generally rated better than conventional adhesive-retained solutions. CONCLUSIONS The results of the study proved that generally implants improve the satisfaction of patients with craniofacial prostheses. However, the actual level of satisfaction depends, to a large extent, on the defect's localization, sex, and age of the patient.
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Li S, Xiao C, Duan L, Fang C, Huang Y, Wang L. CT image-based computer-aided system for orbital prosthesis rehabilitation. Med Biol Eng Comput 2015; 53:943-50. [DOI: 10.1007/s11517-015-1307-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 05/04/2015] [Indexed: 11/30/2022]
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Goh B, Teoh K. Orbital implant placement using a computer-aided design and manufacturing (CAD/CAM) stereolithographic surgical template protocol. Int J Oral Maxillofac Surg 2015; 44:642-8. [DOI: 10.1016/j.ijom.2014.11.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 08/31/2014] [Accepted: 11/20/2014] [Indexed: 11/28/2022]
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Shrestha B, Fatmasari F, Thaworanunta S, Srithavaj T. Prosthodontic rehabilitation of congenital auricular defect: a clinical report. Cleft Palate Craniofac J 2015; 52:229-33. [PMID: 25714270 DOI: 10.1597/13-074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This clinical report presents the prosthetic rehabilitation of a congenital auricular defect. The rehabilitation was initially performed with an adhesive retained silicone prosthesis. After careful evaluation of the patient's retentive needs, two endo-osseous craniofacial implants were placed in the mastoid region. After integration, an implant-retained silicone prosthesis was fabricated using a Hader bar with two ERA attachments, which restored the defect with good aesthetic and functional outcome. Prosthetic rehabilitation is a viable treatment option for restoring auricular defects and can be indicated in situations where surgical reconstruction may not be feasible.
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Vera C, Barrero C, Shockley W, Rothenberger S, Minsley G, Drago C. Prosthetic reconstruction of a patient with an acquired nasal defect using extraoral implants and a CAD/CAM copy-milled bar. J Prosthodont 2014; 23:582-7. [PMID: 25041262 DOI: 10.1111/jopr.12165] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2013] [Indexed: 11/27/2022] Open
Abstract
Traditionally, patients with maxillofacial defects have been challenging to treat. A multitude of challenges associated with maxillofacial prosthetic treatment are not typically seen with patients who need conventional prosthodontic treatment. These types of patients generally require replacement of significant amounts of hard and soft tissues than do conventional prosthodontic patients. Most maxillofacial patients also warrant more emotional support than do conventional prosthodontic patients. Successful maxillofacial prosthetics still need to embrace the traditional goals of prosthodontic treatment: stability, support, retention, and esthetics. It is unlikely that a maxillofacial prosthesis will exactly duplicate the anatomy and function of missing or damaged structures. Although craniofacial implants (CFI's) have lower cumulative survival rates (CSR's) than intraoral endosseous implants, osseointegrated CFI's have proven to be significant adjuncts to improving retention of maxillofacial prostheses. However, CSR's of CFI's have been reported to be lower than CSR's for intraoral endosseous implants. Lately, computer-assisted design and computer-assisted machining (CAD/CAM) has been used in dentistry to facilitate fabrication of implant-supported frameworks. CAD/CAM protocols have numerous advantages over conventional casting techniques, including improved accuracy and biocompatibility, and decreased costs. The purpose of this paper is to review the literature on cumulative survival rates (CSR's) reported for CFI's and to illustrate the treatment of a maxillofacial patient using CFI's and a CAD/CAM copy-milled framework for retention and support of a nasal prosthesis.
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Affiliation(s)
- Carolina Vera
- Department of Prosthodontics, The University of North Carolina School of Dentistry, Chapel Hill, NC
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Extraoral implants for orbit rehabilitation: a comparison between one-stage and two-stage surgeries. Int J Oral Maxillofac Surg 2014; 43:341-7. [DOI: 10.1016/j.ijom.2013.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 06/01/2013] [Accepted: 09/02/2013] [Indexed: 11/23/2022]
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Oliveira JAPD, Abrahão M, Dib LL. Extraoral implants in irradiated patients. Braz J Otorhinolaryngol 2013; 79:185-9. [PMID: 23670324 PMCID: PMC9443833 DOI: 10.5935/1808-8694.20130033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 12/14/2012] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED The aim of this study is to analyze the success of extraoral osseointegrated implants used to support designed to rehabilitate craniofacial deformities. METHOD This study was based on the retrospective assessment of charts from 59 patients submitted to cancer surgery and who received 164 extraoral implants to contain facial prosthesis. RESULTS Among 164 implants, 42 were fixed in previously irradiated regions. Eight of the implants did not have osseointegration; and from these, two were fixed in irradiated bone. The result show 116 (95.1%) successfully osseointegrated implants in non-irradiated sites. The success rate among 42 implants fixed in previously irradiated bones was 40 (95.3%) osseointegrated implants. CONCLUSION The use of extraoral craniofacial implants represents a safe and effective approach to treat facial deformities as a support for the rehabilitation prosthesis. Radiotherapy treatment does not prevent osseointegration.
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Nemli SK, Aydin C, Yilmaz H, Bal BT, Arici YK. Quality of life of patients with implant-retained maxillofacial prostheses: a prospective and retrospective study. J Prosthet Dent 2013; 109:44-52. [PMID: 23328196 DOI: 10.1016/s0022-3913(13)60010-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
STATEMENT OF PROBLEM Clinical studies on implant-retained maxillofacial prostheses have focused on biological outcomes. An assessment of the effect of prostheses on patients' quality of life (QOL) by using specific questionnaires developed for this patient population provides important information on treatment outcomes from the patients' perspectives. PURPOSE The purpose of this study was to report patient-based outcomes of implant-retained maxillofacial prostheses and to evaluate the effect of implant-retained maxillofacial prostheses on QOL of participants in a prospective study. MATERIAL AND METHODS Eighty-two participants were treated with implant-retained maxillofacial prostheses. Participants were divided into 2 groups: a retrospective group (participants treated and under care) and a prospective group (participants willing to be treated). The posttreatment patient satisfaction scores for each question were statistically analyzed by 2-way ANOVA with variables of defect type and retention type. The Student-Newman-Keuls test was used to determine any significant differences among the groups. In the prospective group, mean scores before and after prosthetic treatment were compared with the paired t test (α=.05). RESULTS The details of 54 retrospective and 28 prospective participants were reviewed. The posttreatment results of 82 patients showed that patient satisfaction with implant-retained maxillofacial prostheses was significantly different for cleaning the prostheses and recommending treatment to other people, depending on the defect and retention type. In the prospective group, participants reported significant increases in satisfaction for all questions. CONCLUSIONS Implant-retained prostheses were considered highly satisfactory, indicating good QOL for patients with maxillofacial defects. A comparison of pretreatment and posttreatment assessments revealed that implant-retained maxillofacial prostheses increased patient QOL.
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Affiliation(s)
- Secil Karakoca Nemli
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Langlois B, Jacomet PV, Putterman M, Morax S, Galatoire O. Évaluation des techniques de reconstruction après exentération orbitaire. À propos de 56 cas. J Fr Ophtalmol 2012; 35:667-77. [DOI: 10.1016/j.jfo.2011.10.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 10/12/2011] [Accepted: 10/19/2011] [Indexed: 01/28/2023]
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Sophie Yi JY, Dierks EJ, Over LM, Hauck MJ. Prosthetic Reconstruction of the Orbit/Globe. Oral Maxillofac Surg Clin North Am 2012; 24:697-712. [DOI: 10.1016/j.coms.2012.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Curi MM, Oliveira MF, Molina G, Cardoso CL, Oliveira LDG, Branemark PI, Ribeiro KDCB. Extraoral implants in the rehabilitation of craniofacial defects: implant and prosthesis survival rates and peri-implant soft tissue evaluation. J Oral Maxillofac Surg 2012; 70:1551-7. [PMID: 22698291 DOI: 10.1016/j.joms.2012.03.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Revised: 03/13/2012] [Accepted: 03/14/2012] [Indexed: 11/19/2022]
Abstract
PURPOSE Few reports have evaluated cumulative survival rates of extraoral rehabilitation and peri-implant soft tissue reaction at long-term follow-up. The objective of this study was to evaluate implant and prosthesis survival rates and the soft tissue reactions around the extraoral implants used to support craniofacial prostheses. MATERIALS AND METHODS A retrospective study was performed of patients who received implants for craniofacial rehabilitation from 2003 to 2010. Two outcome variables were considered: implant and prosthetic success. The following predictor variables were recorded: gender, age, implant placement location, number and size of implants, irradiation status in the treated field, date of prosthesis delivery, soft tissue response, and date of last follow-up. A statistical model was used to estimate survival rates and associated confidence intervals. We randomly selected 1 implant per patient for analysis. Data were analyzed using the Kaplan-Meier method and log-rank test to compare survival curves. RESULTS A total of 150 titanium implants were placed in 56 patients. The 2-year overall implant survival rates were 94.1% for auricular implants, 90.9% for nasal implants, 100% for orbital implants, and 100% for complex midfacial implants (P = .585). The implant survival rates were 100% for implants placed in irradiated patients and 94.4% for those placed in nonirradiated patients (P = .324). The 2-year overall prosthesis survival rates were 100% for auricular implants, 90.0% for nasal implants, 92.3% for orbital implants, and 100% for complex midfacial implants (P = .363). The evaluation of the peri-implant soft tissue response showed that 15 patients (26.7%) had a grade 0 soft tissue reaction, 30 (53.5%) had grade 1, 6 (10.7%) had grade 2, and 5 (8.9%) had grade 3. CONCLUSIONS From this study, it was concluded that craniofacial rehabilitation with extraoral implants is a safe, reliable, and predictable method to restore the patient's normal appearance.
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Affiliation(s)
- Marcos Martins Curi
- Chairman of Department of Stomatology, Hospital Santa Catarina, São Paulo, Brazil.
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de Negreiros WA, Verde MARL, da Silva AM, Pinto LP. Surgical and Prosthetic Considerations to Rehabilitate an Ocular Defect Using Extraoral Implants: A Clinical Report. J Prosthodont 2012; 21:205-8. [DOI: 10.1111/j.1532-849x.2011.00816.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Thimmappa B, Girod SC. Principles of implant-based reconstruction and rehabilitation of craniofacial defects. Craniomaxillofac Trauma Reconstr 2011; 3:33-40. [PMID: 22110816 DOI: 10.1055/s-0030-1249372] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
The final stages of reconstruction following craniofacial trauma or tumor resection often involve the fitting of prostheses. Development of osseointegrated implants for retention of prostheses has improved function and aesthetic outcome. Placement of osseointegrated implants requires coordinated care from multiple specialists and a lifetime commitment of the patient. The workup and surgical treatment algorithms for placement of intraoral compared with extraoral implants are discussed. The quality and quantity of bone available are the most important factors influencing design and placement. The long-term retention of implants is influenced by implant site, local tissue bed preparation, and hygiene. Osseointegrated implants are a part of the complete rehabilitation of patients with craniomaxillofacial defects. Although final fitting and maintenance of prostheses is completed by prosthodontists and patients, successful placement and preservation of implants is affected largely by the plan set forth by the reconstructive surgeon.
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Affiliation(s)
- Brinda Thimmappa
- Division of Plastic and Reconstructive Surgery, Stanford University, Stanford University Medical Center and Lucile Packard Children's Hospital, Palo Alto, California
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Goiato MC, dos Santos DM, de Carvalho Dekon SF, Pellizzer EP, Santiago JF, Moreno A. Craniofacial Implants Success in Facial Rehabilitation. J Craniofac Surg 2011; 22:241-2. [DOI: 10.1097/scs.0b013e3181f7b702] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
The health of a peri-implant tissue is a critical factor for the long-term success of treatment with extraoral implants. However, infection and inflammation may occur and lead to implant loss and prostheses failure. Therefore, some postsurgical care as hygiene with soap and water, soft toothbrush, and Superfloss type dental floss and medication with anti-inflammatory and antibiotic are suggested to avoid complications. In addition, a thin and smooth layer of subcutaneous tissue in the peri-implant area should be preserved during implant insertion to favor the assistance recommended in this phase.
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Karakoca S, Aydin C, Yilmaz H, Bal BT. Retrospective study of treatment outcomes with implant-retained extraoral prostheses: survival rates and prosthetic complications. J Prosthet Dent 2010; 103:118-26. [PMID: 20141816 DOI: 10.1016/s0022-3913(10)60015-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM Implant-retained extraoral prostheses are an acceptable solution for patients with facial defects. However, these prostheses have a limited service life. Little has been reported on survival periods of implant-retained extraoral prostheses and prosthetic complications of this treatment modality. PURPOSE The purpose of this study was to estimate the survival rates of implant-retained extraoral prostheses and to analyze the frequency of prosthetic complications. MATERIAL AND METHODS Seventy patients were treated with implant-retained extraoral prostheses. Each patient was examined with respect to the prosthesis appearance and abutment and attachment component complications at 6-month intervals over a period of 10 to 46 months. The Kaplan-Meier survival estimation method was used for the first and subsequent prostheses. The reasons for remaking prostheses were recorded. Complications of the abutment and attachment components and the prostheses were recorded. Frequency of complications was evaluated. Data were analyzed using the Fisher exact test (alpha=.05). RESULTS Thirty-two auricular, 25 orbital, and 13 nasal prostheses were evaluated. The Kaplan-Meier analysis revealed an estimated mean survival time of 14.5 months for the patients' first prostheses. The survival times for the first implant-retained auricular, orbital, and nasal prostheses were 14.1, 13.4, and 17.6 months, respectively. The survival times for the second implant-retained auricular, orbital, and nasal prostheses were 14.4, 15.3, and 14.0 months, respectively. CONCLUSIONS Implant-retained extraoral prostheses had limited survival rates. The primary reasons for making new prostheses were discoloration, tearing, and mechanical failures of the acrylic resin substructure or retentive elements. Common complications were the need for clip activation, loosening of bar screws and abutments, and loss of attachment between silicone and the acrylic resin substructure. (J Prosthet Dent 2010;103:118-126).
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Affiliation(s)
- Secil Karakoca
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Radiation-induced leiomyosarcoma of the maxillofacial region: facial reconstruction with implant-retained prosthesis. J Craniofac Surg 2010; 21:262-6. [PMID: 20098194 DOI: 10.1097/scs.0b013e3181c5a392] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Radiation-induced sarcoma represents an exceptional rarity in the head and neck region. The treatment is surgical excision with negative margins and follow-up. After surgery, reconstruction of the defects can be accomplished either surgically or prosthetically. Implant-retained maxillofacial prostheses may offer an acceptable solution. In this report, a large facial defect resulting from radiation-induced leiomyosarcoma was reconstructed with implant-retained prosthesis. A patient with a large facial defect resulting from tumor surgery presented for reconstructive treatment. The primary tumor was fibrous histiosarcoma. Four years after the patient was treated with surgical resection and subsequent irradiation, leiomyosarcoma was diagnosed in the defect site. Leiomyosarcoma was treated with complete surgical resection, and the defect was reconstructed with implant-retained prosthesis. The patient was evaluated every 6 months. Implants provided secure retention to the prosthesis. The patient was satisfied with the appearance of the prosthesis. At 12 months' examination, functioning implants were successful; however, color fade of the prosthesis was observed. Radiation-induced leiomyosarcoma, which is an uncommon tumor in the head and neck region, was treated by means of large surgical resection. Implant-retained prosthetic rehabilitation of the patient resulted in acceptable functional and cosmetic results, and the patient has resumed social activities.
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Ozçelik TB, Tanner PB. A surgical guide for craniofacial implant placement for an implant-retained auricular prosthesis. J Prosthet Dent 2010; 103:253-5. [PMID: 20362769 DOI: 10.1016/s0022-3913(10)60040-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Craniofacial implants provide excellent stability and retention for auricular prosthetic rehabilitation. Accurate location of implants is important to achieve optimal prosthetic results. This article describes an alternative procedure for fabricating an acrylic resin surgical template for craniofacial implant placement with the assistance of a 6-inch contour duplication gauge.
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