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Troeltzsch D, Neckel N, Neyer J, Preissner S, Raguse JD, Motzkus Y, Heiland M, Vach K, Nahles S. Clinical and social success in epithetic ear rehabilitation - Retrospectively evaluating the long-term survival of auricular implants. J Craniomaxillofac Surg 2024; 52:884-889. [PMID: 39019745 DOI: 10.1016/j.jcms.2024.02.003] [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] [Received: 08/16/2023] [Revised: 11/25/2023] [Accepted: 02/01/2024] [Indexed: 07/19/2024] Open
Abstract
PURPOSE The aim of this study was to evaluate existing staging recommendations for peri-implantitis and its applicability for auricular bone anchoring. MATERIALS AND METHODS In this cross-sectional study, 44 patients treated with 47 ear epitheses and 128 implants were analyzed over 191.6 months (mean). Peri-implant sulcus depth, sulcus fluid flow rate, and peri-implant skin reaction, as well as cleaning habits and patients' quality of life, were analyzed. Mixed effect linear and mixed effect ordered logistic regression models were used. RESULTS Two of the 128 implants were lost (1.6 %). A total of 14.5 % of all patients presented light erythemas, 19.4 % showed stage 2, 4.8 % stage 3, and 12.9 % an acute infection according to Holgers. A correlation between skin reaction and sulcus fluid flow rate was observed, when grouping patients with acute signs of inflammation. Concerning patient satisfaction, 58.1 % of the patients were highly satisfied with their epitheses, 39.5 % very satisfied, and one patient was just satisfied. Younger age correlated with lower satisfaction rates. CONCLUSION Implant-retained auricular epitheses are a safe, highly sufficient and satisfying way of extending ear reconstruction. Sulcus depth and skin reaction are quick and valuable assessment tools in auricular implants, but skin reaction alone was clinically insufficient to predict peri-implant pocket inflammation.
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Affiliation(s)
- D Troeltzsch
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. M. Heiland), Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - N Neckel
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. M. Heiland), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J Neyer
- Department of Oral and Maxillofacial Surgery, (Head: Dr. Dr. T. Teltzrow), Klinikum Ernst von Bergmann Gemeinnützige GmbH, Charlottenstraße 72, 14467, Potsdam, Germany
| | - Saskia Preissner
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. M. Heiland), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J-D Raguse
- Department of Oral and Maxillofacial Surgery, (Head: PD Dr. Dr. J-D Raguse), Fachklinik Hornheide, Dorbaumstrasse 300, 48157, Münster, Germany
| | - Y Motzkus
- Berliner Zentrum für Künstliche Gesichtsteile/ BZkG, Augustenburger Platz 1, 13353, Berlin, Germany
| | - M Heiland
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. M. Heiland), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - K Vach
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - S Nahles
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. M. Heiland), Charité-Universitätsmedizin Berlin, Berlin, Germany
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2
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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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Hatamleh MM, Hatamlah HM, Nuseir A. Maxillofacial prosthetics and digital technologies: Cross-sectional study of healthcare service provision, patient attitudes, and opinions. J Prosthodont 2024; 33:231-238. [PMID: 37218377 DOI: 10.1111/jopr.13718] [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] [Received: 03/27/2023] [Accepted: 05/18/2023] [Indexed: 05/24/2023] Open
Abstract
PURPOSE Digital technologies are continuously improving the accuracy and quality of maxillofacial prosthetics, but their impact on patients remains unclear. This cross-sectional study aimed to analyze the impact of facial prosthetics service provision, patients' perception, and digital technology on prostheses construction. MATERIALS AND METHODS All patients who presented for evaluation and management of facial defects between January 2021 and December 2021 at the ENT clinic were eligible for study enrollment. Patients requiring prosthetic reconstruction of their missing facial parts were included in the study. Forty-five questionnaires were delivered, inquiring about the patients' prosthetic demographics, prosthesis manufacture using 3D technologies, and their perceptions and attitudes. RESULTS A total of 37 patients responded (29 males, eight females; mean age 20.50 years). The congenital cause was the highest among other causes (p = 0.001) with auricular defects being the highest (p = 0.001). A total of 38 prostheses were constructed and 17 prostheses were retained by 36 craniofacial implants (p = 0.014). The auricular and orbital implants success rates were 97% and 25%, respectively. The implant locations were digitally planned pre-operatively. Digital 3D technologies of defect capture, data designing, and 3D modeling were used and perceived as helpful and comfortable (p = 0.001). Patients perceived their prosthesis as easy to handle, suited them, and they felt confident with it (p = 0.001). They wore it for more than 12 h daily (p = 0.001). They were not worried that it would be noticed, and found it comfortable and stable during various activities (p = 0.001). Implant-retained prosthesis patients were more satisfied with it, and found it easy to handle and stable (p = 0.001). CONCLUSIONS Congenital defects are the main cause of facial defects in the study country. The overall acceptance of maxillofacial prostheses was good, showing high patient perception and satisfaction. Ocular and implant-retained silicone prostheses are better handled, more stable, and the latter is more satisfying than traditional adhesive prostheses. Digital technologies save time and effort invested in manufacturing facial prostheses.
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Affiliation(s)
| | - Heba Mohammad Hatamlah
- Department of Hospital Management, Faculty of Business, Philadelphia University, Amman, Jordan
| | - Amjad Nuseir
- ENT Department, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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4
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Özcivelek T, Basmacı F, Turgut B, Akbulut K, Kılıçarslan MA. Perception of color mismatch or conspicuous marginal adaptation in extraoral prostheses with eye-tracking. J Prosthet Dent 2024; 131:332-339. [PMID: 38161076 DOI: 10.1016/j.prosdent.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 01/03/2024]
Abstract
STATEMENT OF PROBLEM Color matching and marginal integrity are major challenges when providing extraoral maxillofacial prostheses. Which of the color and marginal harmony features are more important for the extraoral prostheses to be inconspicuous is unclear. Studies on the perception of these prostheses with objective evaluation criteria are lacking. PURPOSE The purpose of this observational study was to investigate the significance of color mismatch and conspicuous marginal adaptation in the perception of extraoral maxillofacial prostheses using eye-tracking technology. The secondary aim was to evaluate the perception of extraoral maxillofacial prostheses with regard to the observers' sex. MATERIAL AND METHODS Twenty-seven face images, in 3 groups, representing well-fitting orbital prostheses with a color mismatch (IC), prostheses with a good color match but distinct marginal adaptation (IM), and symmetrical face images, were viewed for 5 seconds by 52 laypeople. Time to first fixation (TFF), fixation duration (FD), and fixation count (FC) at defined areas of interest were recorded and analyzed by an eye-tracking device. Because of the nested structure of data, a sex- and age-adjusted random intercept linear mixed effects model was used to assess the difference between IC, IM, and SI. Bonferroni corrected P values were used for pairwise comparisons. The difference between observers' sex was evaluated with random intercept mixed model by adjusting for age for each image. For repeated measurement analysis, the lm4, lmerTest, and emmeans libraries in R version 4.3.1 (R Foundation for Statistical Computing) were used (α=.05 for all tests). RESULTS Significant differences were found between the symmetrical image group and other study groups at the facial prosthesis region in all parameters (each P<.001). Observers first focused on the facial prostheses in IC (0.72 seconds) and in IM (0.789 seconds). Longer fixation durations, 1.909, 1.989 seconds for IC and IM (PIC<.001, PIM<.001), respectively, and a higher fixation count for IC (5.28) (P<.001) and for IM (5.45) (P<.001) were recorded on facial prostheses compared with other areas of interest. Women were more focused on the prosthesis than men in the IC and IM groups considering FD (PIC=.003, PIM<.001) and FC values (PIC=.016, PIM<.001, PSI<.001). Fixation duration for women and men was 2.097 seconds and 1.739 seconds in the IC group, 2.219 seconds and 1.78 seconds in the IM group, and 1.364 seconds and 1.222 seconds in the SI group, respectively. CONCLUSIONS Since the color mismatch and distinct marginal adaptation of maxillofacial prostheses were recognized using eye-tracking technology, both features appeared to be equally significant to be considered in fabrication procedures.
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Affiliation(s)
- Tuğgen Özcivelek
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Health Sciences University Gulhane, Ankara, Turkey.
| | - Fulya Basmacı
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Berna Turgut
- Researcher, Department of Dentistry, Ankara Memorial Hospital, Ankara, Turkey
| | - Kuddusi Akbulut
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Cappadocia University, Nevşehir, Turkey
| | - Mehmet Ali Kılıçarslan
- Professor, Department of Prosthodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
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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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Abdalqadir M, Mohammed K, Azhdar B. The impact of zirconium dioxide nanoparticles on the color stability of artificially aged heat-polymerized maxillofacial silicone elastomer. Sci Prog 2023; 106:368504231205392. [PMID: 37814535 PMCID: PMC10566275 DOI: 10.1177/00368504231205392] [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: 10/11/2023]
Abstract
The limited service life of craniofacial prostheses due to degradation and color instability is a significant challenge. This in vitro study aimed to determine how zirconium dioxide (ZrO2) nanoparticles affect the color stability of M511 heat temperature vulcanizing (HTV) maxillofacial silicone elastomers after artificial aging. ZrO2 nanoparticles were added at concentrations of 1, 2, and 3 wt% to M511 HTV silicone elastomer. Two intrinsic silicone pigments were used (red and mocha). Silicone with pigment and without ZrO2 nanoparticles were used as the control. Eighty disk-shaped specimens were fabricated and divided into eight experimental groups, each containing ten specimens (n = 10). All specimens were subjected to artificial aging, and color changes were recorded at 252, 504, and 1008 h intervals. The L*a *b * values were measured using a colorimeter and the CIE-Lab system. To interpret the recorded color differences, a 50:50 percent perceptibility threshold (ΔE* = 1.1) and acceptability threshold (ΔE* = 3.0) were implemented. A one-way analysis of variance and Tukey's post hoc test at a significance level of 0.05 were used for the statistical analysis. We found that every evaluated specimen group exhibited a chromatic change (ΔE* > 0). The ΔE* values for the mocha pigments with and without ZrO2 nanoparticles were below the perceptible threshold (1.1 units). The ΔE* values of the red pigment with and without ZrO2 nanoparticles were significantly higher than the acceptable threshold (P < 0.000). According to the findings of this in vitro study, all the specimens underwent color changes (ΔE* > 0). The red pigment exhibited highly significant chromatic alterations. In contrast, mocha pigments with and without ZrO2 nanoparticles exhibited the least color change and were below the perceptible threshold. ZrO2 nanoparticles provided important protection and showed a reduction in color change.
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Affiliation(s)
- Mohammed Abdalqadir
- Department of Prosthodontics, College of Dentistry, University of Sulaimani, Sulaimani, Iraq
| | - Kaml Mohammed
- Department of Prosthodontics, College of Dentistry, University of Sulaimani, Sulaimani, Iraq
| | - Bruska Azhdar
- Nanotechnology Research Laboratory, Department of Physics, College of Science, University of Sulaimani, Sulaimani, Iraq
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Gaudin R, Raguse JD, Krause S, Mumm J, Motzkus Y, Ghanad I, Nahles S, Doll C, Sedaghat A, Rendenbach C, Heiland M, Troeltzsch D. Quality of life and psychological evaluation of patients after anaplastology. J Craniomaxillofac Surg 2023; 51:485-489. [PMID: 37550115 DOI: 10.1016/j.jcms.2023.06.005] [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] [Received: 11/29/2022] [Revised: 02/28/2023] [Accepted: 06/25/2023] [Indexed: 08/09/2023] Open
Abstract
A comprehensive questionnaire with 43 questions was designed to evaluate quality of life, based on rehabilitation with a facial prosthesis. Each patient's psychological situation was assessed using the validated questionnaire and associated scales. Different patient groups were compared with each other in terms of questionnaire scores and general data. In total, 76 patients with a prosthesis of the orbit, nose, or ear, or a combination thereof, were included. There was a highly significant difference in overall satisfaction with defect reconstruction via a prosthesis of the ear compared with the orbit and nose (F(3) = 6.511, p = 0.001). Patients with congenital defects showed a significantly higher level of general satisfaction compared with patients with acquired defects (F(2) = 5.795, p = 0.001). Patients who returned to work were significantly more satisfied with their quality of life (T(57) = 2.626, p = 0.011). With regard to improvements to the state-of-the-art prostheses, the majority of patients suggested better retention, more durable colors, make-up possibilities, less noticeable margins, softer materials, and a movable orbital prosthesis. Within the limitations of the study it seems that facial epitheses improved mental wellbeing and increased quality of life among patients with facial defects. Multiple factors, such as type of facial defect, location of residence, and education can have a potential influence on the quality of life of affected patients. However, further studies are needed, since the psychological and social challenges remain.
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Affiliation(s)
- Robert Gaudin
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - Jan Dirk Raguse
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Oral and Maxillofacial Surgery, Fachklinik Hornheide, Münster, Germany
| | - Sophie Krause
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jennifer Mumm
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Yvonne Motzkus
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Iman Ghanad
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Susanne Nahles
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christian Doll
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ahmad Sedaghat
- Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
| | - Carsten Rendenbach
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Daniel Troeltzsch
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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8
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İnal CB, Bankoğlu Güngör M, Karakoca Nemli S. Using a smartphone three dimensional scanning application (Polycam) to three dimensionally print an ear cast: A technique. J Prosthet Dent 2023:S0022-3913(23)00283-4. [PMID: 37270302 DOI: 10.1016/j.prosdent.2023.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 06/05/2023]
Abstract
This technique describes the use of a smartphone application for scanning an ear for 3-dimensional (3D) printing of an auricular prosthesis cast. The intact ear was scanned by using a smartphone and a 3D scan application (Polycam). The standard tessellation language (STL) file of the 3D data was used to produce a mirror image of the ear, which was sent to the 3D printing center where a resin cast was printed. This technique is harmless for the patient compared with radiological imaging methods, more comfortable, and cost-effective and is straightforward for the maxillofacial prosthodontist.
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Affiliation(s)
| | - Merve Bankoğlu Güngör
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Seçil Karakoca Nemli
- Professor, Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Eyzaguirre D, Salazar-Gamarra R, Binasco Lengua S, Lauria Dib L. Evaluation of additive manufacturing processes in the production of oculo-palpebral prosthesis. F1000Res 2023; 11:505. [PMID: 38249120 PMCID: PMC10799225 DOI: 10.12688/f1000research.111231.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 01/23/2024] Open
Abstract
Background: Prosthetic restorations are made to adapt or attach missing human parts in order to restore function and appearance. Maxillofacial defects connote a greater impact on patients, since the face cannot be concealed, and all the senses of the human body are expressed in it. Therefore, in order to restore the patient's quality of life, they are the ones that require the best possible adaptation to the characteristics of the patients. Methods: For the maxillofacial prostheses to fit patients, they must be personalized for each patient. The NGO "Mais Identidade" is a multidisciplinary team that specializes in the rehabilitation of patients with maxillofacial trauma. They use digital manufacturing as a tool to manufacture personalized maxillofacial prostheses for patients. With the help of the NGO, the following research is conducted with the purpose of evaluating different methods of additive manufacturing, 3D printing, in order to select the equipment that suits the needs of the method used in the manufacture of maxillofacial prostheses. To this end, eyelid models will be manufactured in different additive manufacturing equipment, and these will be evaluated according to their economic, physical, and aesthetic characteristics.
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Affiliation(s)
| | - Rodrigo Salazar-Gamarra
- Plus Identity Institute, Sao Paulo, Brazil
- Norbert Wiener University - Digital Transformation Research Center, Lima, Peru
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10
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Slijepcevic AA, Afshari A, Vitale AE, Couch SM, Jeanpierre LM, Chi JJ. A Contemporary Review of the Role of Facial Prostheses in Complex Facial Reconstruction. Plast Reconstr Surg 2023; 151:288e-298e. [PMID: 36696329 DOI: 10.1097/prs.0000000000009856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Maxillofacial prostheses provide effective rehabilitation of complex facial defects as alternatives to surgical reconstruction. Although facial prostheses provide aesthetically pleasing reconstructions, multiple barriers exist that prevent their routine clinical use. The accessibility of facial prostheses is limited by the scarce supply of maxillofacial prosthodontists, significant time commitment and number of clinic appointments required of patients during prosthesis fabrication, short lifespan of prostheses, and limited outcomes data. METHODS A literature review was completed using PubMed and Embase databases, with search phrases including face and maxillofacial prostheses. Patient cases are included to illustrate the use of facial prostheses to reconstruct complex facial defects. RESULTS The clinical use of facial prostheses requires a multidisciplinary team including a reconstructive surgeon, a maxillofacial prosthodontist, and an anaplastologist, if available, to provide patients with aesthetically appropriate facial prostheses. Developing technology including computer-aided design and three-dimensional printing may improve the availability of facial prostheses by eliminating multiple steps during prosthesis fabrication, ultimately decreasing the time required to fabricate a prosthesis. In addition, enhanced materials may improve prosthesis durability. Long-term outcomes data using validated measures is needed to support the continued use of facial prostheses. CONCLUSIONS Facial prostheses can be used to reconstruct complex facial defects, and bone-anchored prostheses are associated with high patient satisfaction. Multiple barriers prevent prostheses from being used for facial reconstruction. New technologies to assist the design and fabrication of prostheses, and cost reduction measures, may allow their use in the appropriately selected patient.
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Affiliation(s)
| | - Azadeh Afshari
- Division of Maxillofacial Prosthodontics, Barnes-Jewish Hospital
| | - Ann E Vitale
- Division of Maxillofacial Prosthodontics, Barnes-Jewish Hospital
| | | | | | - John J Chi
- Division of Facial Plastic and Reconstructive Surgery, Washington University in St. Louis
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11
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Salazar-Gamarra R, Binasco S, Seelaus R, Dib LL. Present and future of extraoral maxillofacial prosthodontics: Cancer rehabilitation. FRONTIERS IN ORAL HEALTH 2022; 3:1003430. [PMID: 36338571 PMCID: PMC9627490 DOI: 10.3389/froh.2022.1003430] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022] Open
Abstract
Historically, facial prosthetics have successfully rehabilitated individuals with acquired or congenital anatomical deficiencies of the face. This history includes extensive efforts in research and development to explore best practices in materials, methods, and artisanal techniques. Presently, extraoral maxillofacial rehabilitation is managed by a multiprofessional team that has evolved with a broadened scope of knowledge, skills, and responsibility. This includes the mandatory integration of different professional specialists to cover the bio-psycho-social needs of the patient, systemic health and pathology surveillance, and advanced restorative techniques, which may include 3D technologies. In addition, recent digital workflows allow us to optimize this multidisciplinary integration and reduce the active time of both patients and clinicians, as well as improve the cost-efficiency of the care system, promoting its access to both patients and health systems. This paper discusses factors that affect extraoral maxillofacial rehabilitation's present and future opportunities from teamwork consolidation, techniques utilizing technology, and health systems opportunities.
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Affiliation(s)
- Rodrigo Salazar-Gamarra
- Department of Research, Plus Identity Institute, São Paulo, Brazil
- Centro de Investigación en Transformación Digital, Universidad Norbert Wiener (UNW), Lima, Perú
| | - Salvatore Binasco
- Department of Research, Plus Identity Institute, São Paulo, Brazil
- Postgraduation Program in Engineering, Universidade Paulista (UNIP), São Paulo, Brazil
| | - Rosemary Seelaus
- Department of Research, Plus Identity Institute, São Paulo, Brazil
- The Craniofacial Center, University of Illinois at Chicago, Chicago, IL, United States
| | - Luciando Lauria Dib
- Department of Research, Plus Identity Institute, São Paulo, Brazil
- Postgraduation Program in Dentistry, Universidade Paulista (UNIP), São Paulo, Brazil
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12
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Xu Y, Zhang F, Zhai W, Cheng S, Li J, Wang Y. Unraveling of Advances in 3D-Printed Polymer-Based Bone Scaffolds. Polymers (Basel) 2022; 14:566. [PMID: 35160556 PMCID: PMC8840342 DOI: 10.3390/polym14030566] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 02/04/2023] Open
Abstract
The repair of large-area irregular bone defects is one of the complex problems in orthopedic clinical treatment. The bone repair scaffolds currently studied include electrospun membrane, hydrogel, bone cement, 3D printed bone tissue scaffolds, etc., among which 3D printed polymer-based scaffolds Bone scaffolds are the most promising for clinical applications. This is because 3D printing is modeled based on the im-aging results of actual bone defects so that the printed scaffolds can perfectly fit the bone defect, and the printed components can be adjusted to promote Osteogenesis. This review introduces a variety of 3D printing technologies and bone healing processes, reviews previous studies on the characteristics of commonly used natural or synthetic polymers, and clinical applications of 3D printed bone tissue scaffolds, analyzes and elaborates the characteristics of ideal bone tissue scaffolds, from t he progress of 3D printing bone tissue scaffolds were summarized in many aspects. The challenges and potential prospects in this direction were discussed.
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Affiliation(s)
- Yuanhang Xu
- Basic Research Key Laboratory of General Surgery for Digital Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China; (Y.X.); (F.Z.); (W.Z.); (S.C.)
| | - Feiyang Zhang
- Basic Research Key Laboratory of General Surgery for Digital Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China; (Y.X.); (F.Z.); (W.Z.); (S.C.)
| | - Weijie Zhai
- Basic Research Key Laboratory of General Surgery for Digital Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China; (Y.X.); (F.Z.); (W.Z.); (S.C.)
| | - Shujie Cheng
- Basic Research Key Laboratory of General Surgery for Digital Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China; (Y.X.); (F.Z.); (W.Z.); (S.C.)
| | - Jinghua Li
- Basic Research Key Laboratory of General Surgery for Digital Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China; (Y.X.); (F.Z.); (W.Z.); (S.C.)
| | - Yi Wang
- Basic Research Key Laboratory of General Surgery for Digital Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China; (Y.X.); (F.Z.); (W.Z.); (S.C.)
- National United Engineering Laboratory for Advanced Bearing Tribology, Henan University of Science and Technology, Luoyang 471000, China
- Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
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13
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Jablonski RY, Veale BJ, Coward TJ, Keeling AJ, Bojke C, Pavitt SH, Nattress BR. Outcome measures in facial prosthesis research: A systematic review. J Prosthet Dent 2021; 126:805-815. [PMID: 33581868 PMCID: PMC8664412 DOI: 10.1016/j.prosdent.2020.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 11/25/2022]
Abstract
STATEMENT OF PROBLEM Facial prosthesis research uses a wide variety of outcome measures, which results in challenges when comparing the effectiveness of interventions among studies. Consensus is lacking regarding the most appropriate and meaningful outcome measures to use in facial prosthesis research to capture important perspectives. PURPOSE The purpose of the systematic review was to identify and synthesize outcome measures used in facial prosthesis research. MATERIAL AND METHODS Electronic searches were performed in 11 databases (including nonpeer-reviewed literature). The citations were searched, and expert societies were contacted to identify additional studies. Inclusion criteria comprised studies of participants with facial defects who required or had received prosthetic rehabilitation with an external facial prosthesis. Exclusion criteria comprised participants with ocular prostheses, case reports, case series with fewer than 5 participants, laboratory-based studies, and studies published before 1980. Study selection was performed independently by 2 reviewers. Discrepancies were resolved through discussion or by a third reviewer. Outcome measures were synthesized with a categorization approach based on the perspective, theme, and subtheme of the outcome measures. Quality assessment was performed with an appraisal tool that enabled evaluation of studies with diverse designs. RESULTS Database searching identified 13 058 records, and 7406 remained after duplications were removed. After initial screening, 189 potentially relevant records remained, and 186 full texts were located (98% retrieval rate). After full-text screening, 124 records were excluded. Citation searches and contact with expert societies identified 4 further records. In total, 69 articles (grouped into 65 studies) were included. Studies were categorized as per the perspective of their outcome measures, with the following findings: patient-reported (74% of studies), clinical indicators (34%), clinician-reported (8%), multiple viewpoints (6%), and independent observer-reported (3%). Patient-reported outcome measures included tools to assess satisfaction, quality of life, and psychologic health. Variability in the choice of outcome measures was evident among the studies, with many self-designed, unvalidated, condition-specific questionnaires reported. A greater number of outcome measure themes emerged over time; themes such as service delivery and health state utility have recently been evaluated. CONCLUSIONS Over the past 40 years, facial prosthesis research has focused on patient-reported outcome measures. Outcome measures relating to other perspectives have been used less frequently, although new themes appear to be emerging in the literature. Future research should use outcome measures with appropriate measurement properties for use with facial prosthetics.
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Affiliation(s)
- Rachael Y Jablonski
- Specialty Registrar in Restorative Dentistry and NIHR Doctoral Fellow, Department of Restorative Dentistry, School of Dentistry, University of Leeds, Leeds, UK.
| | - Benjamin J Veale
- Medical Student, Hull York Medical School, University of York, York, UK
| | - Trevor J Coward
- Reader and Honorary Consultant in Maxillofacial and Craniofacial Rehabilitation, Academic Centre of Reconstructive Science, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Andrew J Keeling
- Clinical Associate Professor, Department of Restorative Dentistry, School of Dentistry, University of Leeds, Leeds, UK
| | - Chris Bojke
- Professor of Health Economics, Academic Unit of Health Economics, School of Medicine, University of Leeds, Leeds, UK
| | - Sue H Pavitt
- Professor of Translational and Applied Health Research, Dental Translational and Clinical Research Unit, School of Dentistry, University of Leeds, Leeds, UK
| | - Brian R Nattress
- Clinical Professor and Honorary Consultant, Department of Restorative Dentistry, School of Dentistry, University of Leeds, Leeds, UK
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14
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Systematic Review of Clinical Applications of CAD/CAM Technology for Craniofacial Implants Placement and Manufacturing of Orbital Prostheses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111349. [PMID: 34769865 PMCID: PMC8582823 DOI: 10.3390/ijerph182111349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 11/28/2022]
Abstract
This systematic review was aimed at gathering technical and clinical applications of CAD/CAM technology for the preoperative planning of craniofacial implants placement, designing of molds and substructures and fabrication of orbital prostheses. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, an electronic search was executed. Human studies that utilized digital planning systems for the prosthetic rehabilitation of orbital defects were included. A total of 16 studies of 30 clinical cases, which were virtually planned through various digital planning and designing software, were included. The most common preoperative data required for digital planning were CT scans in 15 cases, the 3DSS-STD-II scanning system in 5 cases, an Artec Color 3D scanner in 3 cases and a NextEngine Desktop 3D laser scanner in 2 cases. Meanwhile, the digital designing software were Ease Orbital Implant Planning EOIPlan software in eight cases, Geomagic software in eight cases, Simplant software in four cases and Artec Studio 12 Professional in three cases. Surgical templates were fabricated for 12 cases to place 41 craniofacial implants in the orbital defect area. An image-guided surgical navigation system was utilized for the placement of five orbital implants in two cases. Digital designing and printing systems were reported for the preoperative planning of craniofacial implants placement, designing of molds and substructures and fabrication of orbital prostheses. The studies concluded that the digital planning, designing and fabrication of orbital prostheses reduce the clinical and laboratory times, reduces patient visits and provide a satisfactory outcome; however, technical skills and equipment costs are posing limitations on the use of these digital systems.
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15
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Aldhuwayhi S, Shaikh SA, Thakare AA, Mustafa MZ, Mallineni SK. Remote Management of Prosthodontic Emergencies in the Geriatric Population During the Pandemic Outbreak of COVID-19. Front Med (Lausanne) 2021; 8:648675. [PMID: 34395459 PMCID: PMC8355538 DOI: 10.3389/fmed.2021.648675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/31/2021] [Indexed: 12/23/2022] Open
Abstract
The global pandemic outbreak of coronavirus disease 2019 (COVID-19) has put the world in a panic situation. It has been evident that the geriatric population is more susceptible to acquire this infection. Thus, due to this ongoing crisis, geriatric individuals cannot visit a dental operatory, and there is the possibility of their dental needs and emergencies to remain unattended. Partial or complete edentulism is very prevalent among the geriatric population, and prosthodontic management of these patients is essential for their well-being. However, the prosthesis can lead to various emergencies of the oral and its supporting structures. There are currently no available recommendations to address these prosthodontic emergencies in geriatric individuals during this pandemic period. Hence, the aims of this minireview were to discuss the common prosthodontic emergencies in the geriatric population and provide recommendations to manage these issues during the COVID-19 pandemic outbreak.
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Affiliation(s)
- Sami Aldhuwayhi
- Department of Prosthodontics, College of Dentistry, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Saquib Ahmed Shaikh
- Department of Prosthodontics, College of Dentistry, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Amar Ashok Thakare
- Department of Prosthodontics, College of Dentistry, Majmaah University, Al-Majmaah, Saudi Arabia
| | | | - Sreekanth Kumar Mallineni
- Department of Preventive Dental Science, College of Dentistry, Majmaah University, Al-Majmaah, Saudi Arabia.,Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Science, Saveetha University, Chennai, India
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16
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Dholam KP, Parkar SP, Dugad JA, Kharade PP, Shinde AA, Gurav SV. Development of a psychosocial perception scale and comparison of psychosocial perception of patients with extra oral defects before and after facial prosthesis. J Prosthet Dent 2021; 128:1398-1404. [PMID: 33985758 DOI: 10.1016/j.prosdent.2021.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 11/27/2022]
Abstract
STATEMENT OF PROBLEM Loss of facial organs and subsequent rehabilitation affects a patient's psychological status. Understanding the perceived psychosocial aspects of quality of life among patients with missing organs and after prosthetic rehabilitation is essential, but studies that quantify this aspect are lacking. PURPOSE The purpose of this clinical study was to develop and validate a psychosocial perception scale and compare psychosocial perception before and after the prosthetic rehabilitation of a missing facial part. MATERIAL AND METHODS A psychosocial perception scale was developed to quantitatively measure the perceived psychosocial aspects of quality of life among patients with extraoral defects. The instrument was translated in the Hindi and Marathi Indian languages by using a forward and backward translation method. Depending on the responses obtained from the patients in the interview about the interpretation and ease of understanding, the questionnaire was modified and further pilot testing conducted. In the first phase, validation of the questionnaire was carried out with internal consistency, interdomain correlation, and intraclass correlation assessed by using the Cronbach α, Pearson correlation, and test retest reliability. Construct validity was established by the exploratory factor analysis. In the second phase, 32 participants were evaluated for their psychosocial response before and 3 months after prosthetic rehabilitation. Responsiveness and change in the domains scores of the psychosocial perception scale were studied by using the Wilcoxon signed-rank sum test (α=.05). RESULTS The Cronbach α for internal consistency of overall psychosocial perception was .855 and .809 in the pretreatment and post-treatment visits consecutively. Most of the domains in the psychosocial perception scale had a Pearson correlation (r)>0.40. The domain of esthetics had r=0.84(confidence interval: .43-0.95), indicating good intraclass correlation. The domains of esthetics (P<.005), function (P<.005), positive emotions (P<.005), negative emotions (P=.011), and social and personal relationship P=.003) of the psychosocial perception scale showed statistically significant improvement in the scores after prosthetic intervention and had excellent (r>0.90) intraclass correlation. CONCLUSIONS The psychosocial perception scale was a reliable tool to assess the patient response toward the prosthetic rehabilitation of extraoral defects. Positive improvements in the domains score (esthetics, function, positive emotions, and social and personal relationship) contributed to better perception after prosthetic rehabilitation.
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Affiliation(s)
- Kanchan P Dholam
- Professor and Head, Department of Dental and Prosthetic Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Shubhangi P Parkar
- Professor and Head, Department of Psychiatry, GS Medical College, Parel, Mumbai, India
| | - Jinesh A Dugad
- Consultant, Department of Dental & Prosthetics, Asian Cancer Institute, Mumbai, India
| | - Pankaj P Kharade
- Reader, Department of Prosthodontics, Aligarh Muslim University, Aligarh, India
| | - Arti A Shinde
- Dental Technician, Department of Dental and Prosthetic surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Sandeep Vivek Gurav
- Professor Department of Dental and Prosthetic surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
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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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18
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Martel A, Baillif S, Nahon-Esteve S, Gastaud L, Bertolotto C, Lassalle S, Lagier J, Hamedani M, Poissonnet G. Orbital exenteration: an updated review with perspectives. Surv Ophthalmol 2021; 66:856-876. [PMID: 33524457 DOI: 10.1016/j.survophthal.2021.01.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 01/15/2023]
Abstract
Orbital exenteration is a radical and disfiguring surgery mainly performed in specialized tertiary care centers. Orbital exenteration has long been considered the treatment of choice for managing periocular tumors invading the orbit or primary orbital malignancies. Over the past decades, attention has been directed toward reducing the perioperative morbidity by developing new surgical devices and new strategies and promoting cosmetic rehabilitation by providing adequate facial prostheses. Despite these advances, several studies have questioned the role of orbital exenteration in improving overall survival. The last decade has been marked by the emergence of a new paradigm: the "eye-sparing" strategies based on conservative surgery with or without adjuvant radiotherapy and/or targeted therapies and immunotherapies. We summarize the data on orbital exenteration, including epidemiology, etiologies, use of surgical ablative and reconstructive techniques, complications, outcomes, and the related controversies.
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Affiliation(s)
- Arnaud Martel
- Université Côte d'Azur, Ophthalmology department, Centre Hospitalier Universitaire de Nice, Nice, France.
| | - Stephanie Baillif
- Université Côte d'Azur, Ophthalmology department, University Hospital of Nice, Nice, France
| | - Sacha Nahon-Esteve
- Université Côte d'Azur, Ophthalmology department, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Lauris Gastaud
- Oncology department, Antoine Lacassagne Cancer Centre, Nice, France
| | | | - Sandra Lassalle
- Laboratory of Clinical and Experimental Pathology and Biobank BB-0033-00025, Nice, France
| | - Jacques Lagier
- Université Côte d'Azur, Ophthalmology department, University Hospital of Nice, Nice, France
| | - Mehrad Hamedani
- Oculoplastic department, Jules Gonin Eye hospital, Lausanne, Switzerland
| | - Gilles Poissonnet
- Cervico-facial department, Institut Universitaire de la Face et du Cou, Nice, France
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19
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Negreiros WAD, Teixeira RR, Peixoto RF, Regis RR. The challenge of managing oral maxillofacial rehabilitation with quality and cost-benefit. J Prosthet Dent 2020; 127:508-514. [PMID: 33303193 DOI: 10.1016/j.prosdent.2020.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 10/22/2022]
Abstract
Although orofacial cancer leads to substantial functional, esthetic, and psychosocial deficits for patients, reconstructive plastic surgeries may not be indicated for large facial defects. The high costs of prosthetic oral maxillofacial rehabilitation may hamper such treatment, which commonly involves virtual planning, craniofacial implants, and computer-aided design and computer-aided manufactured prostheses. This report shows the treatment of 2 patients with large facial defects from surgical resection of cancerous tissue who were rehabilitated with implant-supported bar-clip overdentures and facial prostheses fabricated by using low-cost straightforward methods.
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Affiliation(s)
- Wagner Araujo de Negreiros
- Associate Professor, Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
| | - Raiza Ricarte Teixeira
- Predoctoral student, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
| | - Raniel Fernandes Peixoto
- Adjunct Professor, Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (UFC), Fortaleza, CE, Brazil.
| | - Rômulo Rocha Regis
- Adjunct Professor, Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
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20
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Matsuo M, Mine Y, Kawahara K, Murayama T. Accuracy Evaluation of a Three-Dimensional Model Generated from Patient-Specific Monocular Video Data for Maxillofacial Prosthetic Rehabilitation: A Pilot Study. J Prosthodont 2020; 29:712-717. [PMID: 32583571 DOI: 10.1111/jopr.13219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate if the combination of a monoscopic photogrammetry technique and smartphone-recorded monocular video data could be appropriately applied to maxillofacial prosthesis fabrication. MATERIALS AND METHODS Smartphone video and laser scanning data were recorded for five healthy volunteers (24.1 ± 0.7 years). Three-dimensional (3D) facial models were generated using photogrammetry software and a laser scanner. Smartphone-recorded video data were used to generate a photogrammetric 3D model. The videos were recorded at two resolutions: 1080 × 1920 (high resolution) and 720 × 1280 pixels (low resolution). The lengths of five nasal component parts (nose height, nasal dorsum length, nasal column length, nasal ala length, and nose breadth) were compared in the photogrammetric 3D models (as the test model) and the laser scanned 3D models (as the validation model) using reverse engineering software. RESULTS There was a significant difference in the nasal dorsum length between the test model and the validation model (high resolution; 95% confidence interval, 2.05-5.07, Low resolution; confidence interval, 2.19-5.69). In contrast to the nasal dorsum length, there were no significant differences in nose height, nose breadth, nasal ala length, and nasal column length. CONCLUSION Using smartphone-recorded video data and a photogrammetry technique may be a promising technique to apply in the maxillofacial prosthetic rehabilitation workflow.
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Affiliation(s)
- Moe Matsuo
- Department of Medical System Engineering, Division of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuichi Mine
- Department of Medical System Engineering, Division of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Translational Research Center, Hiroshima University, Hiroshima, Japan
| | - Kazuko Kawahara
- Department of Oral Biology & Engineering, Division of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takeshi Murayama
- Department of Medical System Engineering, Division of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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21
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Gómez-Pedraza A, González-Cardín V, Díez-Suárez L, Herrera-Villalva M. Maxillofacial Rehabilitation With Zygomatic Implants in an Oncologic Patient: A Case Report. J Oral Maxillofac Surg 2019; 78:547-556. [PMID: 31705866 DOI: 10.1016/j.joms.2019.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/20/2019] [Accepted: 10/05/2019] [Indexed: 11/15/2022]
Abstract
Tumor ablation results in significant sequelae in the appearance, function, and esthetics of a patient with cancer, especially resection for head and neck cancer. Reconstruction with local and microvascular flaps is a workable option; however, the esthetic results will occasionally be unfulfilling and inadequate for the rehabilitation of lost structures. Prosthetic rehabilitation with conventional and zygomatic implants can provide favorable and predictable long-term results. We report the clinical case of a 53-year-old female patient with adenoid cystic carcinoma (ACC). The treatment protocol included radical surgery, radiotherapy, and maxillofacial rehabilitation with conventional and zygomatic implants. Management of an ACC case requires a timely, radical, and multidisciplinary approach. In our patient, rehabilitation of masticatory function was accomplished in the immediate postoperative period and before radiotherapy. The rehabilitation of masticatory function improved the patient's systemic and nutritional status and her speech, with coverage of the esthetic defect. These outcomes reduced the psychological and emotional effects of tumor ablation.
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Affiliation(s)
- Antonio Gómez-Pedraza
- Surgeon, Head and Neck Surgery Department, National Cancer Institute, Mexico City, Mexico
| | | | - Leandro Díez-Suárez
- Oral and Maxillofacial Surgery Resident, National Cancer Institute and National Autonomous University of Mexico UNAM, Mexico City, Mexico.
| | - María Herrera-Villalva
- Maxillofacial Prosthetics Resident, National Cancer Institute and National Autonomous University of Mexico UNAM, Mexico City, Mexico
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22
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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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23
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Farber SJ, Latham KP, Kantar RS, Perkins JN, Rodriguez ED. Reconstructing the Face of War. Mil Med 2019; 184:e236-e246. [DOI: 10.1093/milmed/usz103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/18/2019] [Indexed: 11/14/2022] Open
Abstract
AbstractIntroductionOngoing combat operations in Iraq, Afghanistan, and other theaters have led to an increase in high energy craniomaxillofacial (CMF) wounds. These challenging injuries are typically associated with complex tissue deficiencies, evolving areas of necrosis, and bony comminution with bone and ballistic fragment sequestrum. Restoring form and function in these combat-sustained CMF injuries is challenging, and frequently requires local and distant tissue transfers. War injuries are different than the isolated trauma seen in the civilian sector. Donor sites are limited on patients with blast injuries and they may have preferences or functional reasons for the decisions to choose flaps from the available donor sites.MethodsA case series of patients who sustained severe combat-related CMF injury and were treated at Walter Reed National Military Medical Center (WRNMMC) is presented. Our study was exempt from Institutional Review Board review, and appropriate written consent was obtained from all patients included in the study for the use of representative clinical images.ResultsFour patients treated by the CMF team at Walter Reed National Military Medical Center are presented. In this study, we highlight their surgical management by the CMF team at WRNMMC, detail their postoperative course, and illustrate the outcomes achieved using representative patient clinical images. We also supplement this case series demonstrating military approaches to complex CMF injuries with CMF reconstructive algorithms utilized by the senior author (EDR) in the management of civilian complex avulsive injuries of the upper, mid, and lower face are thoroughly reviewed.ConclusionWhile the epidemiology and characteristics of military CMF injuries have been well described, their management remains poorly defined and creates an opportunity for reconstructive principles proven in the civilian sector to be applied in the care of severely wounded service members. The War on Terror marks the first time that microsurgery has been used extensively to reconstruct combat sustained wounds of the CMF region. Our manuscript reviews various options to reconstruct these devastating CMF injuries and emphasizes the need for steady communication between the civilian and military surgical communities to establish the best care for these complex patients.
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Affiliation(s)
- Scott J Farber
- University of Texas Health Science Center San Antonio, Texas, Division of Plastic and Reconstructive Surgery, 7703 Floyd Curl Drive, MC 7844, San Antonio, TX
| | - Kerry P Latham
- Walter Reed National Military Medical Center Bethesda, MD, Division of Plastic Surgery, 4494 North Palmer Road, Bethesda, MD
| | - Rami S Kantar
- NYU Langone Health New York, NY, Hansjorg Wyss Department of Plastic Surgery, 307 E 33rd Street, New York, NY
| | - Jonathan N Perkins
- Walter Reed National Military Medical Center Bethesda, MD, Department of Otolaryngology-Head & Neck Surgery, 4494 North Palmer Road, Bethesda, MD
| | - Eduardo D Rodriguez
- NYU Langone Health New York, NY, Hansjorg Wyss Department of Plastic Surgery, 307 E 33rd Street, New York, NY
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Unsal GS, Turkyilmaz I. Improved reconstruction of an implant-retained auricular prosthesis using CAD/CAM technology. J Dent Sci 2019; 14:328-329. [PMID: 31528263 PMCID: PMC6739256 DOI: 10.1016/j.jds.2019.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/12/2019] [Indexed: 11/26/2022] Open
Affiliation(s)
- Gokce Soganci Unsal
- Yildirim Beyazit University, Faculty of Dentistry, Department of Prosthodontics, Ankara, Turkey.,New York University College of Dentistry, Department of Prosthodontics, New York, NY, USA
| | - Ilser Turkyilmaz
- New York University College of Dentistry, Department of Prosthodontics, New York, NY, USA
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Dings JPJ, Merkx MAW, de Clonie Maclennan-Naphausen MTP, van de Pol P, Maal TJJ, Meijer GJ. Maxillofacial prosthetic rehabilitation: A survey on the quality of life. J Prosthet Dent 2019; 120:780-786. [PMID: 30414646 DOI: 10.1016/j.prosdent.2018.03.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 03/18/2018] [Accepted: 03/19/2018] [Indexed: 11/30/2022]
Abstract
STATEMENT OF PROBLEM Maxillofacial prostheses, especially those supported by endosseous implants, are regarded as a viable, secure treatment for the reconstruction of facial defects to restore quality of life. The long-term quality of life of patients treated with facial prostheses with different retentive systems is unclear. PURPOSE The purpose of this clinical study was to assess the long-term quality of life of patients treated with facial prostheses with different retentive systems over a 14-year period at a Dutch oral and maxillofacial surgery unit. MATERIAL AND METHODS A total of 66 patients with facial prostheses were inventoried and categorized based on anatomic location and type of retention. A 62-item questionnaire was designed to survey the daily prosthetic use, care, quality, durability, longevity, and reliability of retention. Furthermore, issues relating to general satisfaction, self-image, and socialization frequency were addressed. RESULTS Completed validated questionnaires were returned by 52 patients. Of the prosthetic replacements, 23% (n=12) were orbital, 33% (n=17) nasal, and 44% (n=23) auricular prostheses. The survey showed that a prosthetic reconstruction led to high satisfaction scores with regard to wearing comfort, anatomic fit, color, and anatomic form. A significant difference was shown for implant-retained facial prostheses, which provided enhanced retention and increased ease of placement and removal (Fisher exact test P=.01 and P=.04). Patients with nasal prostheses were less satisfied with the junction of their prostheses to the surrounding soft tissue and more aware of others noticing their prosthetic rehabilitation. Patients with auricular defects were less embarrassed (P=.01) by their prostheses. Although auricular prostheses were less frequently cleaned (P=.01), no significant difference was found in minor soft tissue complications between different anatomic locations and the various retentive systems. CONCLUSIONS Implant-retained prostheses have advantages over adhesive-retained prostheses in terms of ease of handling. However, improvements in prosthetic material properties, including color stability and durability, are needed to increase the longevity of facial prostheses.
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Affiliation(s)
- Jeroen P J Dings
- Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
| | - Matthias A W Merkx
- Professor, Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | | | - Pascal van de Pol
- Maxillofacial Prosthodontist, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Thomas J J Maal
- Coordinator 3D Laboratory, Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Gert J Meijer
- Professor, Department of Implantology and Periodontology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Color stability of maxillofacial prosthetic silicone functionalized with oxide nanocoating. J Prosthet Dent 2019; 121:538-543. [DOI: 10.1016/j.prosdent.2018.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 06/14/2018] [Accepted: 06/14/2018] [Indexed: 11/22/2022]
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Karakoca Nemli S, Bankoğlu Güngör M, Bağkur M, Turhan Bal B, Kasko Arıcı Y. In vitro evaluation of color and translucency reproduction of maxillofacial prostheses using a computerized system. J Adv Prosthodont 2018; 10:422-429. [PMID: 30584471 PMCID: PMC6302083 DOI: 10.4047/jap.2018.10.6.422] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/10/2018] [Accepted: 11/18/2018] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Accurate color matching of maxillofacial prostheses to skin is important for esthetics. A computerized color matching system specific to human skin has recently been developed. The purpose of this study was to evaluate the accuracy in color and translucency matching of the computerized color matching system across different skin colors. MATERIALS AND METHODS The silicone was colored to simulate 28 different skin colors (n=5) to serve as “target skin colors”. Using a spectrocolorometer (e-skin), color codes were determined for “replicate skin color” fabrication. CIELAB Delta-E between target skin color-replicate skin color pairs and translucency parameter were calculated. CIELAB Delta-E values were compared with one-way ANOVA and Tukey multiple-comparison. The agreement between L*, a*, b* and translucency parameter of target skin colors and replicate skin color were calculated by a two-way mixed average measures intraclass correlation coefficient. Translucency parameter of target skin color-replicate skin color pairs were compared with Paired t-test (α=.05). RESULTS The mean CIELAB Delta-E value was 3.83 and significant differences were found among colors. The intraclass correlation coefficient showed excellent reliability for L*, a*, b* and good reliability for translucency parameter (P<.001). The mean translucency parameter of replicate skin colors was significantly higher than that of translucency parameter. CONCLUSION The computerized color matching system specific to human skin was found to be reliable in terms of color and translucency between target skin colors and replicate skin color.
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Affiliation(s)
- Seçil Karakoca Nemli
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | | | - Meral Bağkur
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Bilge Turhan Bal
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Yeliz Kasko Arıcı
- Biostatistics and Medical Informatics Department, Faculty of Medicine, Ordu University, Ordu, Turkey
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Nuseir A, Hatamleh MM, Alnazzawi A, Al-Rabab'ah M, Kamel B, Jaradat E. Direct 3D Printing of Flexible Nasal Prosthesis: Optimized Digital Workflow from Scan to Fit. J Prosthodont 2018; 28:10-14. [PMID: 30461125 DOI: 10.1111/jopr.13001] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2018] [Indexed: 01/28/2023] Open
Abstract
A maxillofacial prosthesis is a successful treatment modality to restore missing facial parts. Digital technologies and 3D printing are employed in constructing facial prostheses such as ears; however, their application is still partial, and final prostheses are usually manufactured conventionally using stone molds. This report aims to introduce a complete digital workflow to construct a nasal prosthesis and compare it to the conventional workflow of a patient requiring a nasal prosthesis. A computer tomography scan showing the defect was exported to specialized software to create 3D reconstructions of the patient's face and underlying bone. The nose was digitally designed restoring facial esthetics, anatomy, shape, and skin color. Different skin tones were digitally matched to skin tissues adjacent to the defect area using the Spectromatch system. The design was 3D printed in flexible and colorful material at 16 μm resolution using a 3D printer. External color pigmentations were applied to the nose for optimum esthetics, and the prosthetic nose was sealed in silicone and left to heat polymerize for 15 minutes. The prosthetic nose was retained in place using biomedical adhesive, and the patient was pleased with it. This report proposes a complete digital workflow to directly design and fabricate a prosthetic nose of acceptable esthetics. Such a workflow can lead to enhanced prosthesis reproducibility and acceptability and may become an effective treatment option for treatment of patients with facial defects.
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Affiliation(s)
- Amjad Nuseir
- Faculty of Medicine, Jordan University of Science and Technology, King Abdullah University Hospital, Irbid, Jordan
| | - Muhanad Moh'd Hatamleh
- Oral and Maxillofacial Surgery Department, King's College Hospital NHS Foundation Trust, London, UK.,Luminous Technical University College, Amman, Jordan
| | - Ahmad Alnazzawi
- Department of Substitutive Dental Science, Faculty of Dentistry, Taibah University, Madinah, Saudi Arabia
| | - Mohammad Al-Rabab'ah
- University of Jordan, School of Dentistry, Amman, Jordan.,University of Liverpool, School of Dentistry, Liverpool, UK
| | - Belal Kamel
- Plastic Surgery Specialist, Nour Clinic, Cairo, Egypt
| | - Esraa Jaradat
- Department of Allied Dental Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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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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Management of High-energy Avulsive Ballistic Facial Injury: A Review of the Literature and Algorithmic Approach. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1693. [PMID: 29707453 PMCID: PMC5908512 DOI: 10.1097/gox.0000000000001693] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 01/12/2018] [Indexed: 01/13/2023]
Abstract
Background: High-energy avulsive ballistic facial injuries pose one of the most significant reconstructive challenges. We conducted a systematic review of the literature to evaluate management trends and outcomes for the treatment of devastating ballistic facial trauma. Furthermore, we describe the senior author’s early and definitive staged reconstructive approach to these challenging patients. Methods: A Medline search was conducted to include studies that described timing of treatment, interventions, complications, and/or aesthetic outcomes. Results: Initial query revealed 41 articles, of which 17 articles met inclusion criteria. A single comparative study revealed that early versus delayed management resulted in a decreased incidence of soft-tissue contracture, required fewer total procedures, and resulted in shorter hospitalizations (level 3 evidence). Seven of the 9 studies (78%) that advocated delayed reconstruction were from the Middle East, whereas 5 of the 6 studies (83%) advocating immediate or early definitive reconstruction were from the United States. No study compared debridement timing directly in a head-to-head fashion, nor described flap selection based on defect characteristics. Conclusions: Existing literature suggests that early and aggressive intervention improves outcomes following avulsive ballistic injuries. Further comparative studies are needed; however, although evidence is limited, the senior author presents a 3-stage reconstructive algorithm advocating early and definitive reconstruction with aesthetic free tissue transfer in an attempt to optimize reconstructive outcomes of these complex injuries.
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31
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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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Ozdemir-Karatas M, Balik A, Evlioglu G, Uysal Ö, Peker K. Predictors of obturator functioning and satisfaction in Turkish patients using an obturator prosthesis after maxillectomy. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 125:e76-e82. [PMID: 29273193 DOI: 10.1016/j.oooo.2017.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/24/2017] [Accepted: 11/04/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to determine the sociodemographic, behavioral, and clinical factors affecting obturator function and satisfaction using the obturator functioning scale (OFS) in maxillectomy patients rehabilitated with obturator prostheses. STUDY DESIGN The study sample consisted of 41 maxillectomy patients. The OFS was translated into Turkish and adapted for assessing obturator functioning and patient satisfaction among Turkish patients. Data were collected from patients' medical records and self-completed questionnaires, including the Turkish version of the OFS, sociodemographic and behavioral characteristics. Descriptive statistics, Mann-Whitney U test, Spearman's correlation coefficient, and backward stepwise multiple linear regression were used for data analysis. RESULTS Internal consistency (Cronbach's alpha = 0.85) and test-retest reliability (intraclass correlation coefficient = 0.86) were acceptable for the OFS. The most frequently reported problem was "difficulty chewing." Bivariate analysis revealed significant differences in total OFS scores in terms of surgery type, defect size, and education level, except for the other clinical and sociodemographic characteristics and behavioral factors. Education level and surgery type were found to be the most important predictors of patient satisfaction and functioning of the obturator. CONCLUSIONS The Turkish version of the OFS might be a useful tool for clinicians to identify patients who are at risk for poor functioning of the obturator, lack of satisfaction, and unmet needs.
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Affiliation(s)
- Meltem Ozdemir-Karatas
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, Istanbul, Turkey.
| | - Ali Balik
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, Istanbul, Turkey
| | - Gülümser Evlioglu
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Capa, Istanbul, Turkey
| | - Ömer Uysal
- Department of Medical Statistics and Informatics, Medical School, Bezmialem Vakif University, Fatih, Istanbul, Turkey
| | - Kadriye Peker
- Department of Dental Public Health, Faculty of Dentistry, Istanbul University, Capa, Istanbul, Turkey
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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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Elhelow KM, Al-Thobaiti YE, Gomawi AA. The prosthetic rehabilitation of a patient with a lateral postsurgical defect using a 2-piece magnet-retained facial prosthesis: A clinical report. J Prosthet Dent 2017; 119:848-851. [PMID: 28918299 DOI: 10.1016/j.prosdent.2017.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 05/25/2017] [Accepted: 05/25/2017] [Indexed: 10/18/2022]
Abstract
Nonsurgical prosthetic interventions are often proposed after repeated grafts have failed to restore irradiated facial defects. This report describes a facial prosthetic reconstruction following ablative surgery for a sizable facial tumor by using a novel custom-made magnet-bearing substructure, which connected with an exposed part of the mandibular reconstruction plate. The defect involved the entire left lower part of the face and angle of the mentum. This reconstructive technique, together with an added surface texture with hair-like silicone strands, effectively addressed the cosmetic needs of the patient. Magnetic anchorage to an exposed reconstruction plate could be considered an option for retaining facial prostheses. The biomechanical aspects of loading and retention should be addressed before considering this prosthetic option.
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Affiliation(s)
- Kariem M Elhelow
- Consultant, Maxillofacial and Implant Prosthodontics, Department of Dental and Maxillofacial Surgery, King Abdullah Medical City, Makkah, Saudi Arabia.
| | - Yasser E Al-Thobaiti
- Consultant, Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Abdurabu A Gomawi
- Senior Anaplastologist and Head, Dental Laboratory Division, Department of Dental and Maxillofacial Surgery, King Abdullah Medical City, Makkah, Saudi Arabia
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35
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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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36
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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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Visser A, Vechiato Filho AJ, Raghoebar GM, Brandão TB. A Simple Technique for Placing Extraoral Implants at an Optimal Position in Orbital Defects. J Prosthodont 2016; 27:784-785. [PMID: 27880027 DOI: 10.1111/jopr.12572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2016] [Indexed: 11/28/2022] Open
Abstract
Translucent acrylic templates have been used to indicate implant positions for implant-retained extraoral prostheses; however, this procedure can be challenging, as the acrylic templates have to be positioned onto reflected skin flaps. The fabrication of an acrylic-based colorless template or duplicating an existing prosthesis can facilitate the location of extraoral implants. Spots can be created on templates to indicate the optimal position of the implants. Afterward, punching the skin to the bone with a very thick sharp needle or a small sharp bur will mark the desired implant position on the bone before reflecting the skin.
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Affiliation(s)
- Anita Visser
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Aljomar José Vechiato Filho
- Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Thais Bianca Brandão
- Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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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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Salazar-Gamarra R, Seelaus R, da Silva JVL, da Silva AM, Dib LL. Monoscopic photogrammetry to obtain 3D models by a mobile device: a method for making facial prostheses. J Otolaryngol Head Neck Surg 2016; 45:33. [PMID: 27225795 PMCID: PMC4881215 DOI: 10.1186/s40463-016-0145-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 05/05/2016] [Indexed: 11/30/2022] Open
Abstract
Purpose The aim of this study is to present the development of a new technique to obtain 3D models using photogrammetry by a mobile device and free software, as a method for making digital facial impressions of patients with maxillofacial defects for the final purpose of 3D printing of facial prostheses. Methods With the use of a mobile device, free software and a photo capture protocol, 2D captures of the anatomy of a patient with a facial defect were transformed into a 3D model. The resultant digital models were evaluated for visual and technical integrity. The technical process and resultant models were described and analyzed for technical and clinical usability. Results Generating 3D models to make digital face impressions was possible by the use of photogrammetry with photos taken by a mobile device. The facial anatomy of the patient was reproduced by a *.3dp and a *.stl file with no major irregularities. 3D printing was possible. Conclusions An alternative method for capturing facial anatomy is possible using a mobile device for the purpose of obtaining and designing 3D models for facial rehabilitation. Further studies must be realized to compare 3D modeling among different techniques and systems. Clinical implication Free software and low cost equipment could be a feasible solution to obtain 3D models for making digital face impressions for maxillofacial prostheses, improving access for clinical centers that do not have high cost technology considered as a prior acquisition.
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Affiliation(s)
- Rodrigo Salazar-Gamarra
- UNIP Postgraduate Dental School, Universidade Paulista, Rua Afonso Braz, 525 - Cj. 81 Vila Nova Conceição, São Paulo, CEP 04511-011, SP, Brazil.
| | - Rosemary Seelaus
- The Craniofacial Center, University of Illinois at Chicago, 811 S Paulina St, Chicago, IL, 60612, USA
| | - Jorge Vicente Lopes da Silva
- Division of the Centro Tecnológico da Informação Renato Archer, Rodovia Dom Pedro I, Km 143, 6 - Amarais, Campinas, SP, 13069-901, Brazil
| | - Airton Moreira da Silva
- Centro Tecnológico da Informação Renato Archer Campinas, Rodovia Dom Pedro I, Km 143, 6 - Amarais, Campinas, SP, 13069-901, Brazil
| | - Luciano Lauria Dib
- UNIP Postgraduate Dental School, Universidade Paulista, Rua Afonso Braz, 525 - Cj. 81 Vila Nova Conceição, São Paulo, CEP 04511-011, SP, Brazil.,Oncology Center, Hospital Alemão Oswaldo Cruz, Rua Afonso Braz, 525 - Cj. 81 Vila Nova Conceição, São Paulo, CEP 04511-011, SP, Brazil
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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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Wei LA, Brown JJ, Hosek DK, Burkat CN. Osseointegrated implants for orbito-facial prostheses: Preoperative planning tips and intraoperative pearls. Orbit 2016; 35:55-61. [PMID: 26817410 DOI: 10.3109/01676830.2015.1099699] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Implant-retained facial prostheses are becoming increasingly sophisticated. We describe our experience with successful implant placement. METHODS Retrospective case series. Patients with severe unilateral orbital deformity who underwent socket reconstruction with placement of orbital implants were identified. Data on patient age, gender, mechanism of eye, soft tissue, and bone loss, prior reconstructive surgeries and radiation, and orbital imaging were collected and analyzed. RESULTS Four patients (9 implants) between 2010 and 2014, who had osseointegrated implants placed for orbito-facial prostheses were identified. Three were male, one female. Average age was 59 years (range 34-86). Reason for eye loss was trauma in two patients, exenteration for recurrent rhabdomyosarcoma in one patient, and enucleation for retinoblastoma in one patient. All patients had Vistafix® (Gothenburg, Sweden) osseointegrated titanium implants (4 mm) placed in a 2-stage procedure over a span of 3-6 months with subsequent successful prosthesis fitting. CONCLUSION Implant-retained orbito-facial prostheses are safe, easy, and reliable. The ideal socket has minimal dead space, robust bone, and soft tissue 4-5 mm in depth. Preoperative planning should consist of: 1) orbit CT; 2) careful clinical exam of the orbital deformity; and, 3) analysis of socket topography. Operative tips for successful implant placement include: 1) 2-3 points of fixation; 2) placement of implants in bone of adequate thickness; and 3) implant placement as a 2-stage rather than 1-stage procedure. There appears to be no difference in outcome in irradiated and non-irradiated sockets in this series, but should be a consideration and discussed with the patient.
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Affiliation(s)
- Leslie A Wei
- a Department of Ophthalmology, Oculoplastic, Facial Cosmetic and Orbital Surgery Service , University of Wisconsin-Madison , Madison , Wisconsin , USA
| | - Julie J Brown
- b Medical Art Resources, Inc ., Milwaukee , Wisconsin , USA
| | - Dori K Hosek
- c Global Prosthetics, Inc ., Madison , Wisconsin , USA
| | - Cat N Burkat
- a Department of Ophthalmology, Oculoplastic, Facial Cosmetic and Orbital Surgery Service , University of Wisconsin-Madison , Madison , Wisconsin , USA
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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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Littlefield PD, Tolisano AM, Sabol JV, Herberg ME, Coppit GL. Total Auricular Rehabilitation: Combined Cosmetic and Functional Lateral Temporal Bone Reconstruction. J Craniofac Surg 2015; 26:1467-70. [PMID: 26114506 DOI: 10.1097/scs.0000000000001770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of the study was to describe 3 cases of total auricular rehabilitation, including the novel use of iliac crest bone grafts to support bone-anchored auricular prostheses. STUDY DESIGN This study is a retrospective case series from a single institution. RESULTS Three cases with large lateral temporal bone and soft tissue defects were successfully treated with total auricular rehabilitation. Rehabilitation included the following: soft tissue coverage with an anterolateral thigh microvascular free flap, iliac crest-free bone graft with staged placement of a bone-anchored auricular prosthesis into the bone graft, and audiologic rehabilitation with a bone-anchored hearing aid (BAHA). All of the cases with grafts and flaps survived and were without significant donor site morbidity. Bone-anchored hearing aid abutment skin overgrowth was seen in 2 cases and was revised under local anesthesia. All of the patients had expected functional recovery on postoperative audiologic testing. Each patient continues to consistently wear his/her auricular prosthesis and BAHA during 3 years of follow-up. CONCLUSIONS Total auricular rehabilitation is a complex task involving reconstruction of extensive soft tissue defects, bony defects, and the hearing apparatus. Acceptable cosmetic and functional outcomes and high patient satisfaction is possible in committed patients.
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Affiliation(s)
- Philip D Littlefield
- *Department of Otolaryngology, Tripler Army Medical Center, Honolulu, HI †Department of Otolaryngology ‡Department of Maxillofacial Prosthetics, Walter Reed National Military Medical Center, Bethesda, MD
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Hatamleh MM, Watson J, Srinivasan D. Closed-eye orbital prosthesis: A clinical report. J Prosthet Dent 2015; 113:246-9. [DOI: 10.1016/j.prosdent.2014.07.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 07/29/2014] [Accepted: 07/29/2014] [Indexed: 11/16/2022]
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Cifter ED, Ozdemir-Karatas M, Sancakli E, Balik A. A surface roughening technique for maxillofacial prostheses. J Prosthet Dent 2014; 113:250-2. [PMID: 25444281 DOI: 10.1016/j.prosdent.2014.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 09/01/2014] [Accepted: 09/02/2014] [Indexed: 11/30/2022]
Abstract
Giving a natural surface texture to the maxillofacial prostheses is one of the major goals for the maxillofacial prosthodontists. This article describes a technique for application of an antiskid epoxy resin to the surface of the definitive mold before pouring the maxillofacial silicone elastomer. This technique produces evenly distributed and same-size pores that are more similar to the natural appearance of human skin.
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Affiliation(s)
- Ebru D Cifter
- Research assistant, Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
| | - Meltem Ozdemir-Karatas
- Research assistant, Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Erkan Sancakli
- Research assistant, Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Ali Balik
- Research assistant, Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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Peker K, Ozdemir-Karatas M, Balık A, Kürklü E, Uysal O, Rogers SN. Validation of the Turkish version of the Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3) in prosthetically rehabilitated patients with head and neck cancer. BMC Oral Health 2014; 14:129. [PMID: 25339520 PMCID: PMC4216844 DOI: 10.1186/1472-6831-14-129] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 10/13/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3) is a measure assessing the impact of oral rehabilitation on patients' health-related quality of life (HRQOL).The aims of the study were to adapt culturally the LORQv3 for Turkish-speaking head and neck cancer patients who had undergone prosthetic rehabilitation and to undertake an initial investigation of its psychometric properties. METHODS The Turkish version of the LORQv3 was translated and culturally adapted into Turkish, and tested on a sample of 46 head and neck cancer patients who had undergone prosthetic rehabilitation at a university clinic. Patients were categorized into three groups: Patients with maxillary obturator prostheses treated by surgery alone (n = 15); Patients with maxillary obturator prostheses treated by surgery plus radiotherapy, with or without chemotherapy (n = 23); and, Nasopharyngeal cancer patients without maxillary defects wearing conventional dental prostheses who had been treated by radiotherapy with or without chemotherapy (n = 8). Data were collected through clinical examinations and self-reported questionnaires, including socio-demographic characteristics, the LORQv3, and the University of Washington Quality of Life questionnaire version 4 (UW-QOLv4). The psychometric evaluation included validity (content, face, construct, and criterion) and reliability (internal consistency and test-retest). RESULTS All sections of the LORQv3 showed satisfactory internal consistency, with Cronbach's alpha between 0.71 to 0.82. Kappa statistics showed moderate to perfect test-retest reliability for the 33 LORQv3 items. We found significant negative correlations between the LORQv3 and the UW-QOL v4 for some related items. The LORQv3 also identified differences in responses among patient groups, supporting its construct and criterion validity. CONCLUSIONS This study provides initial evidence in support of the validity and reliability of the Turkish version of LORQv3 in prosthetically rehabilitated patients with head and neck cancer; it could be used in clinical practice in Turkey.
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Affiliation(s)
- Kadriye Peker
- Department of Dental Public Health, Faculty of Dentistry, Istanbul University, Çapa, Istanbul, Turkey.
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Gonçalves LM, Gonçalves TMSV, Rodrigues AHC, Lanza MD, do Nascimento PRG, Girundi FMDS. Intra- and extraoral prostheses retained by zygoma implants following resection of the upper lip and nose. J Prosthodont 2014; 24:172-7. [PMID: 24981971 DOI: 10.1111/jopr.12178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2013] [Indexed: 11/29/2022] Open
Abstract
Upper lip cancers are infrequent lesions, being aggressive unless diagnosed and treated early. After the surgical resection, maxillofacial defects require special care in rehabilitation. This article describes the maxillofacial rehabilitation of an edentulous patient diagnosed with upper lip squamous cell carcinoma. The treatment consisted of a large amount of upper lip and nose tissue resection, followed by chemoradiotherapy. After the first surgical healing, zygoma implants were inserted in a two-step procedure. The maxillary and nasal prostheses were installed and fixed by a titanium framework. After 6 years follow-up, no recurrences were observed, and the patient did not develop metastases. Tissues around implants were in good health, and the prostheses remained well-fitted. The use of implant-retained prostheses improved the quality of life, and the patient was extremely satisfied with the final result. The implant-retained prostheses are well accepted by the patient, improving comfort and safety during function while recovering her esthetic apperance.
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Affiliation(s)
- Letícia Machado Gonçalves
- Graduate and Post Graduate Program in Dentistry, Ceuma University-UniCEUMA, São Luís, Maranhão, Brazil
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