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Swanepoel HF, Matthews HS, Claes P, Vandermeulen D, Oettlé AC. A statistical shape model for estimating missing soft tissues of the face in a black South African population. J Prosthodont 2024; 33:565-573. [PMID: 37589169 DOI: 10.1111/jopr.13746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 07/30/2023] [Accepted: 08/11/2023] [Indexed: 08/18/2023] Open
Abstract
PURPOSE Facial disfigurement may affect the quality of life of many patients. Facial prostheses are often used as an adjuvant to surgical intervention and may sometimes be the only viable treatment option. Traditional methods for designing soft-tissue facial prostheses are time-consuming and subjective, while existing digital techniques are based on mirroring of contralateral features of the patient, or the use of existing feature templates/models that may not be readily available. We aim to support the objective and semi-automated design of facial prostheses with primary application to midline or bilateral defect restoration where no contralateral features are present. Specifically, we developed and validated a statistical shape model (SSM) for estimating the shape of missing facial soft tissue segments, from any intact parts of the face. MATERIALS AND METHODS An SSM of 3D facial variations was built from meshes extracted from computed tomography and cone beam computed tomography images of a black South African sample (n = 235) without facial disfigurement. Various types of facial defects were simulated, and the missing parts were estimated automatically by a weighted fit of each mesh to the SSM. The estimated regions were compared to the original regions using color maps and root-mean-square (RMS) distances. RESULTS Root mean square errors (RMSE) for defect estimations of one orbit, partial nose, cheek, and lip were all below 1.71 mm. Errors for the full nose, bi-orbital defects, as well as small and large composite defects were between 2.10 and 2.58 mm. Statistically significant associations of age and type of defect with RMSE were observed, but not with sex or imaging modality. CONCLUSION This method can support the objective and semi-automated design of facial prostheses, specifically for defects in the midline, crossing the midline or bilateral defects, by facilitating time-consuming and skill-dependent aspects of prosthesis design.
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Affiliation(s)
| | - Harold S Matthews
- Laboratory for Imaging Genetics, Department of Human Genetics, Katholieke Universiteit, Leuven, Belgium
- Medical Imaging Research Center, Universitair Ziekenhuis, Leuven, Belgium
- Facial Sciences, Murdoch Children's Research Institute, Parkville, Australia
| | - Peter Claes
- Laboratory for Imaging Genetics, Department of Human Genetics, Katholieke Universiteit, Leuven, Belgium
- Medical Imaging Research Center, Universitair Ziekenhuis, Leuven, Belgium
- Facial Sciences, Murdoch Children's Research Institute, Parkville, Australia
- Department of Electrical Engineering, Katholieke Universiteit, Leuven, Belgium
| | - Dirk Vandermeulen
- Medical Imaging Research Center, Universitair Ziekenhuis, Leuven, Belgium
- Department of Electrical Engineering, Katholieke Universiteit, Leuven, Belgium
| | - Anna C Oettlé
- Department of Anatomy, University of Pretoria, Pretoria, South Africa
- Anatomy and Histology Department, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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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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Baghani MT, Neshati A, Sadafi M, Shidfar S. Evaluation of the accuracy of digital and conventional implant-level impression techniques for maxillofacial prosthesis. J Family Med Prim Care 2023; 12:446-451. [PMID: 37122657 PMCID: PMC10131967 DOI: 10.4103/jfmpc.jfmpc_1324_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/29/2022] [Accepted: 08/27/2022] [Indexed: 05/02/2023] Open
Abstract
Objectives This study aims to evaluate the accuracy of digital impression making based on trueness and precision measurements of dental implants placed in maxillofacial lesions to produce Maxillofacial prosthesis substructures. Methods Two intra-oral scanners (Trios 3 and CS 3700) and one Desktop scanner (open technology) were examined in this study. A Model of a patient with a lesion in the ear region was created as a reference. The reference model was scanned by each scanner 10 times. Standard Tessellation Language files were provided from each scanner and were examined in terms of Trueness and Precision aspects. Results In Distance 1, in the one-way analysis of variance test, there was a significant difference between the three scanners. The Trios group has less deviation than the Open Technology group (P = 0.015) compared with the CareStream (CS) group that showed more deviation (P < 0.000). There is a statistically significant difference in distance 2 among scanners. The Trios group showed more deviation as compared with the Open Technology group (P < 0.000). While this deviation is not statistically significant compared with the CS group (P = 0.0907). Open Technology Group compared with the CS group also has less deviation in distance 2, which has been statistically significant (P < 0.000). The preparation of a precise model of maxillofacial lesions is still difficult for some Intraoral scanners. Conclusion There were significant statistical differences in Trueness and Precision among scanners. Used scanners can be applied as an alternative to conventional impression methods.
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Affiliation(s)
- Mohammad Taghi Baghani
- Department of Prosthodontics, Faculty of Dentistry, Aja University of Medical Sciences, Tehran, Iran
| | - Ammar Neshati
- Department of Prosthodontics, Faculty of Dentistry, Aja University of Medical Sciences, Tehran, Iran
- Address for correspondence: Dr. Ammar Neshati, Department of Prosthodontics, Faculty of Dentistry, Aja University of Medical Sciences, Tehran, Iran. E-mail:
| | - Mehdi Sadafi
- Department of Prosthodontics, Faculty of Dentistry, Aja University of Medical Sciences, Tehran, Iran
| | - Shireen Shidfar
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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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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Aulia RK, Beatty MW, Simetich B. Effect of Superhydrophobic Coating and Nanofiller Loading on Facial Elastomer Physical Properties. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7343. [PMID: 36295406 PMCID: PMC9610099 DOI: 10.3390/ma15207343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/11/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Facial prosthetics are currently constructed of materials that are far from optimal; superior materials with a “skin-like” feel are required. In this study, the property changes brought about by the consecutive additions of hydrophobic- and uncoated nano-SiO2 to polydimethylsiloxane (PDMS) are assessed, and the alterations are compared with those observed for conventional submicron SiO2-filled materials. In sequence, 0%, 0.5%, 5%, 10%, and 15% by weight of each filler type were successively added to vinyl-terminated PDMS. Tensile, tear, Durometer hardness, translucency, and viscoelastic properties were assessed, and hardness and translucency were further measured after 3000 h of outdoor weathering. The results showed that 15% coated nano- SiO2-filled PDMS materials given the highest tensile strength, elastic modulus, storage modulus, loss modulus, tear strength, and durometer hardness (p < 0.05), whereas 15% submicron coated SiO2-filled materials displayed the highest failure strain and translucency parameter (p < 0.05). Only 10%- and 15%-filled submicron SiO2 PDMS materials were altered by outdoor weathering; nevertheless, the increases were assessed to be too small to be clinically perceptible. As increased filler levels provided protection against solar radiation, heat, and moisture, only unfilled and 0.5%-filled PDMS formulations discolored from weathering. 15%-filled superhydrophobic-coated nano- SiO2-filled PDMS was found to produce the strongest, most tear-resistant, and least translucent materials, but it also produced materials with limited stretchability and high hardness, which were regarded to be downsides for creating a “skin-like” feel.
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Affiliation(s)
- Rahmi Khairani Aulia
- College of Dentistry, University of Nebraska Medical Center, Lincoln, NE 68583-0740, USA
- Faculty of Dentistry, Andalas University, Padang 25175, West Sumatera, Indonesia
| | - Mark W. Beatty
- College of Dentistry, University of Nebraska Medical Center, Lincoln, NE 68583-0740, USA
- Veteran Affairs Nebraska-Western Iowa Healthcare System, Omaha, NE 68105-1850, USA
| | - Bobby Simetich
- College of Dentistry, University of Nebraska Medical Center, Lincoln, NE 68583-0740, USA
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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,Correspondence: Rodrigo Salazar-Gamarra
| | - 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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Salazar-Gamarra R, Cárdenas-Bocanegra A, Masch U, Da Costa Moraes CA, Seelaus R, Lopes Da Silva JV, Lauria Dib L. Color translation from monoscopic photogrammetry +ID Methodology into a Polyjet final 3D printed facial prosthesis. F1000Res 2022; 11:582. [PMID: 38434006 PMCID: PMC10904947 DOI: 10.12688/f1000research.111196.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 03/05/2024] Open
Abstract
Background: The artistic techniques necessary to fabricate facial prostheses mainly depend on individual skill and are not a resource easily reproduced. Digital technology has contributed to improved outcomes, often combining analog and new digital techniques in the same workflow. Methods: This article aims to present an innovative workflow to produce a final colored 3D printed and facial prosthesis by UV-map color translation into colored resin 3D printing. A modified +ID Methodology was used to obtain 3D models with the calibrated 3D printable patient's skin color. No hands-on physical molding, manual sculpture, or intrinsic silicone coloration was used. Results: The outcome resulted in acceptable aesthetics, adaptation, and an approximate color match after extrinsic coloration. The patient reported good comfort and acceptance. Conclusions: A direct resin 3D printed prosthesis may be a viable alternative, especially for rapid delivery as an immediate prosthesis or an option when there is no experienced anaplastogist to manufacture a conventional prosthesis.
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Affiliation(s)
- Rodrigo Salazar-Gamarra
- Norbert Wiener University - Digital Transformation Research Centre, Lima, 15046, Peru
- Plus Identity (+ID) Institute, São Paulo, 04057-000, Brazil
| | | | | | | | - Rosemary Seelaus
- The Craniofacial Center, Department of Surgery, University of Illinois at Chicago, Chicago, 60612, USA
| | | | - Luciano Lauria Dib
- Plus Identity (+ID) Institute, São Paulo, 04057-000, Brazil
- Paulista University, São Paulo, 04057-000, Brazil
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Spintzyk S, Brinkmeier S, Huettig F, Unkovskiy A. Bonding strength of 3D printed silicone and titanium retention magnets for maxillofacial prosthetics application. J Prosthodont Res 2021; 66:422-430. [PMID: 34545007 DOI: 10.2186/jpr.jpr_d_21_00019] [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] [Indexed: 11/06/2022]
Abstract
PURPOSE To assess the bonding between conventional and additively manufactured silicone elastomers and cylindrical retention titanium magnets for anchorage of facial prostheses. METHODS The customized titanium retention magnets were embedded in conventional and additively produced silicone blocks without primer application (n = 20) and with two commercially available primers G611 (n = 20) and A304 (n = 20) applied onto the magnet surface. The pull out test was performed in the universal testing machine using 45° and 90° angulation and the pull out strength was measured for each group. Additionally the SEM images of the pulled out magnets' surface were obtained and the amount of residual silicone onto the magnet surface was quantified. RESULTS Significantly higher pull out strength values (p < 0.05) were revealed for 90° specimens (0.11 - 0.17 ± 0.01 N/mm2) compared to the 45° group (0.03 ± 0.02 N/mm2). The pull out test with primer revealed no significant differences between the G 611 and A 304 primers in the additive group. However, significantly (p < 0,05) higher values were observed for conventional specimens in the A304 group (1.10 ± 0.21 N/mm2) compared to the G611 group (0.59 ± 0.27 N/mm2). CONCLUSION The application of both used primers may be an acceptable technical option for the anchorage of retention titanium magnets in silicone facial prostheses, produced additively in a fully digital workflow.
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Affiliation(s)
- Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tuebingen University Hospital, Tuebingen, Germany
| | - Sophia Brinkmeier
- Section Medical Materials Science and Technology, Tuebingen University Hospital, Tuebingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
| | - Alexey Unkovskiy
- Department of Prosthodontics, Geriartric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin, Berlin, Germany.,Department of Dental Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
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