Extraoral Prosthesis Research Articles

Assessment Of Awareness And Knowledge Of Maxillofacial Prosthesis Among Dental Practitioners And Postgraduates: A Questionnaire Study

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

The rehabilitation of a combined mid-facial defect using a magnetretained intra- and extra-oral prosthesis: a case report

There are several treatment options available to restore function and appearance in patients with combined mid-facial defects. Owing to the size of the defect and the associated size and weight of the prostheses, adequate retention can be challenging to achieve. Retention of a facial prosthesis can be improved using several techniques, such as medical grade adhesives, attachments, or osseo-integrated implants. For patients with a history of radiotherapy, surgical rehabilitation may be less favourable than non-surgical approaches owing to the risk of osteoradionecrosis and a reduced blood supply in the surgical fields. This clinical case report highlights the conservative rehabilitation of a combined mid-facial defect using a magnet-retained intra-oral and extra-oral prosthesis. CPD/Clinical Relevance: A thorough medical and clinical assessment will highlight factors that will influence the treatment planning process when managing a combined mid-facial defect.

Retention systems in extraoral prosthesis

Abstract Prosthodontist plays a very important part in the reconstruction of extraoral defects. Prosthetic rehabilitation of huge maxillofacial defects will be a crucial process for a prosthodontist. The rehabilitation depends on multiple factors such as size, site, etiology, extension of the defect, age of the patient, patient’s comfort, patient’s satisfaction, and treatment cost. The experience, skill, and knowledge of both a surgeon and a prosthodontist help to decide the foremost mode of retention possible for the rehabilitation of maxillofacial prosthesis. Achieving adequate retention for maxillofacial prosthesis is a great challenge. Various conventional methods are there for retention of maxillofacial prosthesis but treatment modalities became advanced with the rise of osseointegrated implants. Periodic evaluation of prosthesis must be carried to determine the retention, stability, function as well as esthetics of the extraoral prosthesis which enhances the well-being and satisfaction of patients. In this review, we collected the articles from PubMed as well as Scopus-indexed journals and limited to research articles published from 1976 to 2020.

Fundamental Properties and Biocompatibility Classification of Extraoral Prosthesis: A Review

This review article discusses on fundamentals of extraoral prosthesis and concerns on the biocompatibility classifications of extraoral prosthesis as medical device. Maxillofacial prosthodontics is a field that seldom being explored. Due to the circumstances, the progression and evolution of research of this area for evidence-based practice are slower comparing to another dental field. Hence, the purpose of this paper is to contribute and provide additional scientific knowledge in related field. Electronic search was done on several databases with keywords ‘maxillofacial prostheses and ‘biocompatibility’. In general, maxillofacial prosthesis can be divided into extraoral prosthesis, intraoral prosthesis, or combination of both depending on the location and function. Ideal properties can be divided into ideal processing characteristics, ideal biologic properties, and ideal physical and mechanical properties of processed extraoral prosthesis materials. Extraoral prosthesis can be classify as Class I or Class II depending on the retentive system according to FDA, and USP Class I and Class III depending on the underlying tissue.

Prosthetic rehabilitation of unilateral congenital microtia with implant-retained auricular prosthesis - a case report

Microtia is a term applied to congenital anomalies of the auricle, ranging from mild structural abnormalities to complete absence of the external ear and auditory canal. Microtia may occur as an isolated condition or in association with other malformations such as facial clefts, cardiac defects, renal abnormalities, anophthalmia, and limb reduction defects. Surgical reconstruction of the absent auricle is difficult, and the results are often unsatisfactory. Prosthetic rehabilitation is indicated where surgical procedures may not provide predictable aesthetic results. In recent years, significant developments in digital dentistry have seen the widespread application of CAD/CAM fabrication techniques in the production of intraoral implant restorations. The use of digital technologies, however, has not permeated the field of maxillofacial prosthetics to the same extent. This report documents the use of existing dental CAD/CAM technology in the fabrication of an extraoral prosthesis and demonstrates the benefits of employing digital technology in the field of maxillofacial prosthetics.

Prosthetic Rehabilitation of a Hemimandibulectomy Case by Non-Surgical Approach- A Case Report

Hemimandibulectomy can have several consequences such as disoriented masticatory cycle, eccentric occlusion, distorted speech and facial disfigurement depending on the severity of the defect. It is challenging for the prosthodontist to rehabilitate the patients in whom osseous reconstruction has not been carried out. This clinical report describes the Prosthetic management of a patient who had undergone hemimandibulectomy due to moderately differentiated squamous cell carcinoma involving left buccal mucosa, gingivobuccal sulcus and retromolar trigone. A non- surgical approach was carried out to rehabilitate this patient, which included the fabrication of a maxillary guide flange prosthesis for correction of the frontal plane rotation and a twin occlusion prosthesis for ease of mastication. The appearance of the patient was improved drastically by the fabrication of an extraoral prosthesis.

English

Prosthodontists usually stick to the dictum by MM Devan, “preservation of what remains than meticulous replacement of what has been lost.1” “Microtia” is a term used to describe congenital anomaly of the external ear. It is a combination of the words “micro” and “otia” each of the term denoting small and ear respectively. It includes a range of deformities which may consist of presence of a rudimentary ear, a grossly normal or smaller ear or complete absence of the entire external ear. These deformities usually account for 3 in every ten thousand births, with less than 10 % of all the cases showing bilaterally missing ears.2-4 Facial deformities are common for the microtia patient as the auricle develops from tissues of the branchial arches. Figure 1 describes the patient having congenitally missing unilateral ear. Maxillofacial prosthodontics deals with prosthetic rehabilitation of disfigured or missing parts of head and neck. Prosthetic replacement of the exterior part (Epithesis) can be related to as old as civilization. References to it are available in Indian, Greek, Roman, Egyptian Civilizations.5 Ambroise Pare is credited with making various contributions to the materials and techniques in facial prosthetics. Fabrication of an extra-oral prosthesis is probably more of an art than science. Throughout the recorded history, humans have attempted to restore missing parts of the body by using various artificial materials. MPF materials have evolved since centuries right from metals, ivory, porcelain, waxes, natural rubber, gelatin, and latex to modern day materials such as methacrylate or acrylic resins, polyurethane elastomers, and silicone elastomers each having their own set of advantages and disadvantages. But silicone is most commonly used because of its assorted benefits over other MFP materials. This case report describes an auricular prosthesis for the patient with congenital ear deformity using an acrylic template for colour depiction and room temperature volcanizing (RTV) silicone.6

Are Nano TiO2 Inclusions Improving Biocompatibility of Photocurable Polydimethylsiloxane for Maxillofacial Prosthesis Manufacturing?

(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.

Fabrication of a silicone partial nasal prosthesis

Fabricating a partial extraoral prosthesis is challenging, especially partial nasal prosthesis. An extraoral prosthesis can be successful when patients can socialize without fear of being noticed with an abnormal facial defect. Homogeneity, subtle textures, and color match are essential to fabricate successful extraoral prosthesis. In this case report, a 69-year-old Caucasian female patient presented with a partial nasal defect. A silicone partial nasal prosthesis was fabricated to replicate the missing structures.

Nasal prosthesis with magnetically secured intranasal framework for a patient with partial rhinectomy and intra-oral defects: a case report

Partial rhinectomy is a challenge for most maxillofacial prosthodontists, as retention of the prosthesis is a major issue to overcome. The scenario becomes even more difficult when there is an intraoral defect. This article describes the fabrication of a removable silicone nasal prosthesis and removable PMMA intraoral obturator prosthesis to rehabilitate a patient following partial rhinectomy with associated loss of premaxilla. The retention of removable intraoral and extraoral prosthesis was achieved partially from anatomical undercuts and further enhanced by rare earth magnets placed between both prostheses. An acrylic framework was fabricated and placed inside to provide rigidity to the nasal part of the prosthesis. A customized method of making impressions using a modified syringe tube to mold the inner surface of the nasal defect is described. The obturator function scale (OFS) questionnaire was used to measure the patient's satisfaction with the obturator. After insertion of the prosthesis, there was an overall improvement in the OFS of the patient.This case report documents the rehabilitation of a patient following partial rhinectomy and associated loss of premaxilla with customized intraoral obturator prosthesis and a removable silicone nasal prosthesis. The successful outcome of this case shows that for people with similar orofacial defects, these prostheses are a good option to achieve acceptable esthetics, speech, and function.

Magnetically retained extra oral prosthesis and maxillary interim obturator

Rehabilitation of patients with acquired defects of the maxilla is a challenge in terms of re-establishing oro-nasal separation. In most patients, these goals are met by means of prosthetic rehabilitation with an obturator prosthesis. Prosthetic rehabilitation can be achieved satisfactorily if all facets of treatment planning and design consideration are taken into account prior to the rehabilitation process. In many cases, effective obturation is achieved, but, in the relative majority, the prosthesis is usually rejected by the patient as being non-retentive and the outcome is a failure. Therefore, making the prosthesis hollow and incorporation of retentive features in effective way can have a dramatic effect on the stability and retention of the obturator prosthesis in partially dentulous maxillectomy patients. This clinical report describes prosthetic rehabilitation of acquired maxillofacial defect with magnetically retained maxillary interim obturator with extra-oral prosthesis. Extra-oral prosthesis was retained with closed-field magnet system. Defect was developed following post-maxillectomy due to olfactory neuroblastoma and surgical obturator.

Prosthetic rehabilitation of a patient with facial mucormycosis

Facial mucormycosis is a known complication in patients with immunological or metabolic compromise. Mainstay of treatment includes reversal of the compromised state, systemic antifungals and repeated radical debridements. The resultant deformity following debridement causes gross morbidity and psycho-social embarrassment. Surgical reconstruction is difficult on account of co-morbid diseases. Nonsurgical prosthetic rehabilitation gives fairly accurate correction in these patients. We report a case of a 62-year-old male diabetic with facial mucormycosis where debridement resulted in a gross morbid defect. However, effective rehabilitation was achieved using extraoral prosthesis.

Prosthetic management of mid-facial defect with magnet-retained silicone prosthesis

Mid-facial defect is one of the most disfiguring and impairing defects. A design of prosthesis that is aesthetic and stable can be precious to a patient who has lost part of his face due to surgical excision. Prosthesis can restore the patients' self-esteem and confidence, which affects the patients and their life style. The aim of this case report is to describe a technique of mid-facial silicone prosthesis fabrication. To provide an aesthetic and stable facial prosthesis, the extra-oral prosthesis was fabricated using silicone material, while the intra-oral defect was restored with obturator prosthesis, and then both prostheses were connected and attached to each other using magnets. This clinical report describes the rehabilitation of a large mid-facial defect with a two-piece prosthesis. The silicone facial prosthesis was made hollow and lighter by using an acrylic framework. Two acrylic channels were included within the facial prosthesis to provide the patient with clean and patent airways. A sectional mid-facial prosthesis was made and retained in place by using magnets, which resulted in a significant improvement in the aesthetical and functional outcome without the need for plastic surgery. Silicone prostheses are reliable alternatives to surgery and should be considered in selected cases.

Rehabilitation of a mandibular segmental defect with magnet retained maxillofacial prosthesis

Resection or loss of a portion of the mandible can result in a variety of functional, cosmetic and psychological deficits that are dependent on the extent of the defect, the concomitant therapy and the timing of rehabilitative efforts. These impairments greatly affect the patient's Quality of life (QOL). The thrust in cancer care is not simply on survival but on rehabilitation, which aims to improve multiple impairments and QOL. This article describes a case of a 58-year-old female with segmental resection of the anterior mandible, extending to lower lip, resulting in a large intraoral as well extra oral defect. Prosthodontics rehabilitation was done using a two-piece intra oral and extra oral prosthesis oriented to each other using magnets. Use of magnets for retaining the extra oral prosthesis simplifies the clinical and laboratory phase enhancing patient's comfort and psychological morale.

Cytotoxic Evaluation of a Colored Maxillofacial Silicone Elastomer

Copyright: © 2013 Atay A. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. One of the issues in the prosthetic rehabilitation of a maxillofacial defect is, to help the patient regain the normal facial appearance, to protect the region that has undergone surgical operation, to help raise self-confidence and to return to normal life in the best possible way. Therefore, the prosthetic rehabilitation should have the optimum aesthetic and functional properties and maintain them throughout its service time.Beside the defect and the incapacity of the materials used, an extra oral prosthesis can still be judged as good or bad mostly due to the harmony of its color with the surrounding tissue.Therefore, a maxillofacial prosthesis’ material must accept and retain the coloration in the best way to achieve success. There are many materials and techniques used in the coloring of facial prosthesis, and scientific studies regarding their harmony with the adjoining tissues.

Reconstruction of a midfacial defect using an intraoral-extraoral combination prosthesis employing magnets: a clinical report

Radical maxillectomy frequently leads to extended defects in hard and soft tissues that result in a connection between the oral cavities and orbit. If the defect cannot be surgically reconstructed, a combination prosthesis may be necessary to remedy dysfunction in patient function, comfort, esthetics. For minor defects, enlargement of the base of the intra oral prosthesis is generally sufficient. Resections that affect more than one third of the maxilla usually require an intra oral and an extra oral prosthesis that could be assembled and retained in the patient. This clinical report describes a technique of prosthetic rehabilitation of midfacial defect with a silicone orbital prosthesis and intra oral obturator that are retained by magnets. Key words:Combination Prosthesis, Silicone Prosthesis, Magnets, obturators.

Manufacturing Implant Supported Auricular Prostheses by Rapid Prototyping Techniques

Maxillofacial prostheses are usually fabricated on the models obtained following the impression procedures. Disadvantages of conventional impression techniques used in production of facial prosthesis are deformation of soft tissues caused by impression material and disturbance of the patient due to. Additionally production of prosthesis by conventional methods takes longer time. Recently, rapid prototyping techniques have been developed for extraoral prosthesis in order to reduce these disadvantages of conventional methods. Rapid prototyping technique has the potential to simplify the procedure and decrease the laboratory work required. It eliminates the need for measurement impression procedures and preparation of wax model to be performed by prosthodontists themselves In the near future this technology will become a standard for fabricating maxillofacial prostheses.

An extra oral prosthesis for extensive maxillofacial defect :A clinical report

An extra oral prosthesis for extensive maxillofacial defect :A clinical report

Maxillofacial Rehabilitation of a Microstomic Patient After Resection of Nose, Lip, and Maxilla

Few published reports have addressed the issues related to upper lip reconstruction. The present clinical report describes the maxillofacial rehabilitation of an edentulous patient who had been diagnosed with squamous cell carcinoma of the nasal septum and contiguous structures. The patient underwent total rhinectomy, anterior maxillectomy, and maxillary lip resection. Her maxillary lip was reconstructed with a bilateral cheek advancement flap, which allowed primary closure of the lip and aided in maintaining function of the orbicularis oris muscle. Microstomia was anticipated and was a consequence of this procedure. During primary resection, and before chemoradiotherapy, dental implants were successfully placed in the maxilla. These implants helped to retain a maxillary obturator prosthesis, which, in turn, helped to retain a silicone nasal prosthesis that restored the nasal defect. An intranasal acrylic resin framework with magnets aided in connecting the extraoral prosthesis with the intraoral prosthesis. The surgical and prosthodontic advantages of a cheek advancement flap and the treatment challenges in a microstomic patient are discussed.

An interim extraoral prosthesis used for the rehabilitation of a patient treated for osteoradionecrosis of the mandible: A clinical report

In patients with tumors of the head and neck, ionizing radiation delivered in dosages that will kill cancer cells induces unavoidable changes in normal tissue. Bone cells and vascularity may be irreversibly injured, leaving devitalized bone susceptible to the development of osteoradionecrosis. This clinical report describes the fabrication of an acrylic/rubber prosthesis retained by an orthodontic headgear. The prosthesis was used to improve the mastication, speech, and saliva control of a patient treated for osteoradionecrosis of the mandible. (J Prosthet Dent 2001;86:130-4.)