Recent Advances in Rehabilitation of Maxillofacial Prosthesis– An Overview

Maxillofacial prosthetic rehabilitation in the UK: a survey of maxillofacial prosthetists’ and technologists’ attitudes and opinions

Aim: This study aimed to review the scientific literature to describe the main care and hygiene protocols for different types of maxillofacial prostheses (MFP). Methods: A bibliographic search on the PubMed / Medline database using the following keywords: [“maxillofacial prosthesis” OR “ocular prostheses” OR “palatal obturators”] AND [“Cleaning” OR “disinfection”] AND [“care”] AND [“color stability”] OR [“denture cleansers” OR “cleansing agents”]. Articles addressing materials, cleaning and disinfection protocols, and care related to MFP were included. The following exclusion criteria were applied: no adequate methodology, incompatibility with the area of interest, and unavailability for reading in full. Results: The papers were grouped into the following topics: facial prostheses, ocular prostheses, maxillofacial intraoral prostheses, and retention systems. Conclusion: Despite the MFP changes over time, its degradation decreases upon following the recommendations and post-adaptation care. The guidelines for cleaning and disinfection must be individualized to guarantee the longevity of the prosthesis and the patient health.

Design and 3D printing of ceramic maxillofacial prosthesis with gradient pores based on Voronoi-Tessellation principle

Introduction: Teeth/maxillofacial deformity is an integral part of oral and physical development with an incredible spectrum of functionality, and their replacement by advanced prosthodontic rehabilitation (dental implants or maxillofacial prostheses) is vital. Aside from chewing, esthetic and physical survival, oral structures also shape the dynamics of phonation, breathing, keeping a patent airway, and serving as a foundation for the vertical dimensions of the face. They can be fixed/removal prostheses, flexible dentures, fenestrated dentures, and by computer-aided design/computer-aided manufacturing fabricated dentures, depending on the conditions. An attempt was made to increase awareness among people and evaluate their opinion regarding dental implants and maxillofacial prostheses. Objective: The purpose of this survey was to determine patients’ preferences and knowledge of dental implants and maxillofacial prostheses. Materials and Methods: A descriptive cross-sectional study among dental patients who attended the dental outpatient department for maxillofacial defects or missing teeth in the past 5–6 months were included in this survey. The level of knowledge, source of information and suitability for the use of dental implants were assessed using standardized and unambiguous questionnaires provided to the patient wishing to correct the defect with an maxillofacial prosthesis or a dental implant. Five hundred patients were selected randomly to be included in this survey. Results: In the present study, among 500 respondents as 260 males and 240 females, 75 participants had knowledge about dental implants and maxillofacial prostheses being costly or not, so 23 answered true these are not costly, 390 answered false that they are costly, whereas 398 said they did not know about the cost. Conclusion: Proper education and motivation among patients should be done regarding dental implants and maxillofacial prostheses. It is high time patients start replacing their missing teeth and missing body parts, if any. Technology is advancing, and many options are available both in removable and fixed prostheses.

Introduction: Maxillofacial prostheses represent a rehabilitative option for patients who underwent head and neck tumor resection. Objective: To describe the epidemiological profile of maxillofacial prostheses rehabilitated patients in an oncology reference center, from 2015 to 2020. Materials and methods: This is a retrospective, descriptive, observational study, based on secondary data. The maxillofacial prostheses were identified through the prosthesis laboratory records. The socio-demographic, clinical, and maxillofacial prosthesis data were collected from medical records and were descriptively analyzed according to the prosthesis types. Results: A total of 202 patients and 282 maxillofacial prostheses were identified. Obturator prostheses (37%) were the most frequent, and 2019 was the year with the largest production (54%). Males (55%), with 45 years, and incomplete primary education (32%) prevailed. Most tumors were carcinomas (43%), in the palate (40%), with 15.5 months of evolution, at stage III (25%) Surgery and surgery associated with radiotherapy were the most commonly used therapeutic modalities (40% each). At the last visit, most patients had complete remission of the disease (67%). Maxillofacial prostheses were mostly in acrylic resin (92%), with 9.5 months of use, and hygiene was considered satisfactory (87%). Most patients reported good adaptation (82%), satisfaction (76%), satisfactory hygiene (87%), and no adverse events (83%) or difficulties (69%) associated with its use. Conclusion: These data highlight the importance of oral and maxillofacial prostheses as an effective and accessible tool in the rehabilitation process and reinforce the need for a multidisciplinary team to work in oncology, with the dentist as an essential player in this context.

Objective This study aims to assess the knowledge and practice of different types of maxillofacial prosthetic devices among Sudanese dental practitioners. Materials and Methods A descriptive cross-sectional study was conducted in the main governmental dental hospital, Khartoum Dental Teaching Hospital, and the Faculty of Dentistry, University of Khartoum. A self-administered questionnaire consisting of 23 closed questions addressing the participant’s socio-demographic data, knowledge, and practice of maxillofacial prostheses was conducted and distributed. One hundred and eighteen specialists and residents of multidiscipline were enrolled voluntarily, excluding prosthodontists, using the stratified sampling technique and simple randomization within the stratum. The participant's knowledge and practice were calculated as percentages achieved by dividing the number of accurate answers by the total number of questions and hence categorized as good 66.6%–100%, average 33.3%–66.6%, and poor less than 33.3%. The data was collected and analyzed using the IBM Statistical Package. Results The overall knowledge score was average, with a significant association between the different specialties. While the practice score was poor, there was a significant relationship between the participant’s knowledge and their practice (p = 0.001*). The majority of respondents, 80.5% and 68.6%, reported that the lack of knowledge and the multidisciplinary approach in the treatment of maxillofacial patients were the main barriers that prevented the use of the different maxillofacial prostheses. A high percentage (83.1% of respondents) recommended improving awareness and training, and 78% highlighted the application of the multidisciplinary approach and recommended a specialized treatment protocol. Conclusion Although the participants had an average knowledge of the different maxillofacial prostheses, their practice was poor. The lack of knowledge and training and the absence of a multidisciplinary team have been highlighted as the main barriers that prevent the use of the different maxillofacial prostheses. Clinical Significance Maxillofacial prostheses play a crucial role in rehabilitating patients with maxillofacial defects by improving the patient’s aesthetics, phonetics, masticatory efficiency, self-esteem, and quality of life. Hence, dental practitioners' knowledge and practice of the different maxillofacial prostheses are of great importance.

This review presents a classification system for maxillofacial prostheses, while explaining its types. It also aims to describe their origin and development, currently available materials, and techniques, predicts the future requirements, and subsequently discusses its avenues for improvement as a restorative modality. A literature search of the PubMed/Medline database was performed. Articles that discussed the history, types, materials, fabrication techniques, clinical implications, and future expectations related to maxillofacial prostheses and reconstruction were included. Fifty-nine articles were included in this review. Maxillofacial prostheses were classified as restorative or complementary with subclassifications based on the prostheses finality. The origin of maxillofacial prostheses is unclear; however, fabrication techniques and materials have undergone several changes throughout history. Currently, silicones and acrylic resins are the most commonly used materials to fabricate customized prostheses. Maxillofacial prostheses not only restore several types of orofacial defects but also improve the patients' quality of life. Although the current clinical scenario concerning the field of maxillofacial prostheses is promising, improvements in material quality and techniques for maxillofacial prostheses may be expected in the future, to produce better results in the treatment of patients.

Effective rehabilitation of auricular defects with two different prosthetic materials: case reports

Color matching to the surrounding skin is extremely important in patients wearing maxillofacial prostheses. It is of utmost importance to know the different techniques of color matching and coloring in maxillofacial prostheses. The purpose of this study is to review the literature data with regard to color matching in maxillofacial prosthetics. An electronic search of peer review restricted to English language dental literature was conducted to identify the relevant scientific article on color matching and coloring in maxillofacial prostheses. The publication year was up to December 2015 so that the search could include all the articles provided in that particular database. Two independent observers independently read the abstracts and later preselected full-text articles. A full-text review was carried out only for 15 articles. Out of the 15 articles, 7 were related to coloring using tinting, spraying, milling, and use of commercial cosmetics. Three studies were related to shade matching in maxillofacial prostheses. Two studies conducted the measurement of color in maxillofacial prostheses. Only one study had explained color and its relevance in maxillofacial prosthetics. Only one study was done for reproducing silicone shade guide matching Indian skin color. In addition, a single pilot study was done to measure facial skin and lip color in a human population sample stratified by race, gender, and age. Currently, there is no evidence discussing the best technique available for perfectly matching the color for the fabrication of maxillofacial prostheses. However, the latest instruments such as spectrophotometer and colorimeters are believed to have improved efficiency in matching the color.

This study aims to assess the antimicrobial efficacy and impact on color stability of Thymus (T.) vulgaris solution compared to conventional disinfectants on maxillofacial silicones. Various solutions were evaluated, including T. vulgaris solutions at 5 and 10%, saline (control), chlorhexidine (4%), and soap water. The substrates were MDX4-4210 silicone elastomers, and the microorganisms tested were Candida (C.) albicans and Staphylococcus (S.) aureus. The viability of microorganisms was determined through an 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) reduction assay, and color stability was measured using a spectrophotometer with X-Rite Europe software. Statistical analysis was performed using the Kruskal-Wallis test, Mann-Whitney U post hoc test, and Wilcoxon Signed Rank test. Soap water demonstrated superior disinfectant action against both microorganisms, while T. vulgaris solutions at 5 and 10% exhibited comparable antimicrobial efficacy. Chlorhexidine and 10% T. vulgaris solution showed minimal color changes in the silicone material. In contrast, soap water and the 5% T. vulgaris solution resulted in clinically unacceptable color alterations. This study underscores the potential of T. vulgaris as an herbal disinfectant for combating microbial biofilms on maxillofacial silicones, particularly at concentrations of 5 and 10%. The importance of maintaining color stability is emphasized, with Chlorhexidine and the 10% T. vulgaris solution demonstrating effective preservation of esthetics. These findings suggest the viability of considering T. vulgaris as an alternative disinfectant in clinical settings for maxillofacial silicone prostheses. Maxillofacial silicones are vital in restoring aesthetic features for individuals with facial trauma, congenital deformities, or post-surgical interventions. Yet, biofilm-related infections jeopardize their durability and visual integrity. Clinically, T. vulgaris signifies a potential advance in prosthodontic care, offering valuable insights for improving antimicrobial performance and aesthetic durability in maxillofacial prostheses. How to cite this article: Peter M, Kanathila H, Bembalagi M, et al. An In Vitro Comparative Evaluation of Conventional and Novel Thymus vulgaris Derived Herbal Disinfectant Solutions against Pathogenic Biofilm on Maxillofacial Silicones and Its Impact on Color Stability. J Contemp Dent Pract 2023;24(12):967-973.

(1) Background: The development of a biocompatible material for direct additive manufacturing of maxillofacial extraoral prosthesis is still a challenging task. The aim of the present study was to obtain a photocurable PDMS, with nano TiO2 inclusions, for directly 3D printing of extraoral, maxillofacial prosthesis. The biocompatibility of the newly obtained nanocomposite was also investigated; (2) Methods: 2.5% (m/m) titania nanoparticles (TiO2) oxide anatase and a photoinitiator, benzophenone (BF) 4.5% were added to commercially available PDMS for maxillofacial soft prostheses manufacturing. The three different samples (PDMS, PDMS-BF and PDMS-BF-TiO2) were assessed by dielectric curing analysis (DEA) based on their viscosities and curing times. In vitro micronucleus test (MNvit) was performed for genotoxicity assessment and three concentrations of each compounds (2 mg/L, 4 mg/L and 8 mg/L) were tested in duplicate and compared to a control; (3) Results: The nanocomposite PDMS-BP-TiO2 was fully reticulated within a few minutes under UV radiation, according to the dielectric analysis. PDMS-BF-TiO2 nanocomposite showed the lowest degree of cyto- and genotoxicity; (4) Conclusions: In the limits of the present study, the proposed ex situ preparation of a PDMS-BP-TiO2 offers an easy, simple, and promising technique that could be successfully used for 3D printing medical applications.

Background: Maxillofacial silicone prostheses are prone to microbial colonization due to their long-term use and exposure to the oral and facial environment, especially in immunocompromised patients. Effective disinfection is essential to maintain hygiene without compromising the material’s physical and esthetic properties. This review aims to evaluate the effect of plant-based and chemical disinfectants on the physical properties and antimicrobial performance of silicone elastomers used in maxillofacial prostheses. Methods: An extensive search was conducted across electronic databases, including Google Scholar, ScienceDirect, and PubMed, as well as journals related to maxillofacial surgery and prosthodontics. The search covered literature up to February 2025. All relevant English-language in vitro studies published up to February 2025 were considered, with no time restrictions applied. A total of 14 studies were included based on pre-established inclusion and exclusion criteria. Results: The findings indicate that both chemical and plant-based disinfectants demonstrated antimicrobial efficacy against commonly colonizing organisms. However, many chemical agents, such as sodium hypochlorite and chlorhexidine, were associated with changes in surface roughness, hardness, and color degradation of silicone elastomers. In contrast, plant-based agents such as neem extract, tea tree oil, and Thymus vulgaris extract showed comparable antimicrobial performance with fewer adverse effects on material properties. Conclusions: Overall, the need for biocompatible and non-damaging disinfection methods, especially for patients with compromised immunity, plant-based disinfectants offer a promising and safer alternative for maintaining prosthesis hygiene. Their efficacy, combined with lower cytotoxicity and better material compatibility, supports their consideration in clinical cleaning protocols for maxillofacial prostheses.

This study aimed to develop an adhesive for silicone maxillofacial prostheses and compared the properties with the Daro adhesive hydrobond (Factor II, Inc, Lakeside, AZ, USA). Two adhesives were developed from non-vulcanized natural rubber-based adhesives (Adhesive A) and deproteinized natural rubber latex (DNRL) products (Adhesive B) and stored at 4 °C. The Control group was the commercial Daro adhesive hydrobond (Factor II, Inc, Lakeside, AZ, USA). The physical properties (appearance, viscosity, spreadability, color, and pH) of the adhesives were measured and every week for 12 weeks after storing at 4 °C. The adhesives were characterized under scanning electron microscopy. Mechanical testing done were peel bond strength and biocompatibility testing was done using MTT assay. Physical, surface, and mechanical properties were compared with the commercial adhesive. Data analysis was done using SPSS version 24. Both adhesives were physically and chemically stable at temperature 4 °C and had suitable peel bond strength adhesives as the commercial adhesive. Hence, the adhesives can be used to adhere to the maxillofacial silicone prostheses.

Maxillofacial prosthetics is a specialized branch of prosthodontics that involves the rehabilitation of patients with defects or disabilities due to disease, trauma, or congenital conditions affecting the head and neck region. The primary goal is to restore the form and function of affected areas, improving the patient's quality of life. Aim: To assess the knowledge and awareness of maxillofacial prosthesis among dental practitioners and dental postgraduate students. Materials and Methods: cross-sectional questionnaire based online survey was undertaken at C.S.M.S.S. Dental College and Hospital, Chhatrapati Sambhajinagar, Maharashtra, India between March 2024 and September 2024 amongst dental postgraduate students and dental practitioners across India. The questionnaire consisted of 14 questions which evaluated their awareness towards maxillofacial prosthetic dentistry. The Chisquare test was used for statistical analysis. Results: A total 102 responses were obtained in this study, out of which 64 (62.7%) were dental postgraduates students, 9(8.8%) dental practictioners and 20 (19.6%) were dental practitioners and teaching faculty 12% were undergraduate student.92(91.1%) participants were know about maxillofacial prosthesis. 92(91.1%) were aware about maxillofacial prosthesis. 9(8.9%) were unaware about maxillofacial prosthesis. (Fig.2) 85(83.3%) responded both (extraoral and intraoral prosthesis ) are there. 4(3.9%) responded only intraoral prosthesis are there.11(10.8%) responded only extraoral prosthesis are there. While 6(5.9%) are not aware about the maxillofacial prosthesis. (Fig.3) 73%(73.7) responded silicone is commonly used for maxillofacial prosthesis. 27% responded acrylic resin is commonly used while 6% responded polyurethane is used. 8% responded other materials are used.(Fig. 4).92% responded they vare using the new technologies(CAD CAM ) while remaining 8% responded they are not using any recent technology. Conclusion: The majority of the participants were aware of digital technology, which yields good results.Overall, while the current level of awareness and knowledge among dental postgraduate students is commendable, there is a clear need for enhancements in training, resources, and curriculum to fully prepare future dental professionals in the field of maxillofacial prosthetics

In this study, analytic models were used to simulate marginal resection in the area of the second premolar to the second molar region, and the mechanical effects on the mandible of residual bone mass, a maxillofacial prosthesis, and a reconstruction plate were evaluated by three-dimensional finite element analysis. As residual bone mass decreased, maximum principal stress increased near the anterior ramus of the mandible, and maximum shear stress increased at the anterior buccal region of the resected area. In the mandible with a maxillofacial prosthesis, the maximum principal stress distribution at the anterior ramus was lower, and the distribution of maximum shear stress at the anterior buccal region of the resected area was higher. When a reconstruction plate was used, maximum principal stress and maximum shear stress were lower. Thus, lower residual bone mass was associated with increased mandible deflection and torsion. In addition, presence of a maxillofacial prosthesis decreased deflection but increased torsion, and presence of a reconstruction plate decreased deflection and greatly decreased torsion. These findings suggest that decreased residual bone mass and maxillofacial prostheses increase fracture risk; however, presence of a reconstruction plate was effective in decreasing torsional stress, thereby reducing fracture risk in the mandible.