Extraoral Implants Research Articles

CUSTOMIZED THERMOPLAST RETENTIVE AID FOR PARTIAL AURICULAR PROSTHESIS-A CASE REPORT

Auricular prostheses were traditionally retained using chemical adhesives ,mechanical retentive aids or natural undercuts at retention sites.These methods have the limitation of frequent loss of retention, skin reactions to adhesives, or unnatural movements of the prosthesis. Osseo integrated implants which has superior advantages over others have disadvantages for patients with financial constraints and/or who are apprehensive of surgery.Also, extraoral implants require adequate thickness of bone, which may be deficient in certain cases. In this case report,we have described about a new technique of fabricating and incoporating a customized thermoplastic auricular retentive aid thus utilizing both anatomic and mechanical retention.

A Case Report on the Rehabilitation of an Ear Deformity using an Implant Supported Auricular Prosthesis

Extraoral implant retained prostheses have been shown to be a reliable therapy choice for maxillofacial rehabilitation. The clinical and laboratory steps for creating an auricular prosthesis are described in this case report. A 27-year-old male patient met with a road traffic accident, lost his left ear, and developed an ear deformity. The patient then sought out rehabilitation. Extraoral implants and Hader bar-and-clip retention were used to ensure that the auricular prosthesis was properly connected to the implant. The patient was satisfied with the prosthesis remarkable support, retention, and aesthetic abilities. Treatment success depends on factors like patient acceptability, aesthetics, compatibility, durability, and prosthetic considerations like material availability, processing ease, and ease of duplication that make the prosthesis look natural and give the patient social confidence.

Oculofacial Prosthetic Rehabilitation Complemented With Temporary Fillers and Neurotoxin.

Surgical treatment of head and neck cancer causes severe tissue loss, therefore, deformities and psychosocial consequences. In cases involving orbit exenteration, satisfactory reconstruction can only be achieved with prosthetic replacement, despite successful reconstructive plastic surgery. Extraoral implants, 3D scanning, and prototyping technologies have contributed to increase satisfactory aesthetic results of oculofacial prosthesis. However, to achieve prosthetic rehabilitation refinement, patients' biological tissues have been treated with injectable cosmetic adjuncts methods as complements to results. This study aimed to describe the use of botulinum toxin type A, hyaluronic acid, and calcium hydroxyapatite previously to oculofacial prostheses manufacturing, in 5 oncologic patients of a rehabilitation unit. Outcomes produced by additional cosmetic methods on tissues, prostheses planning, and overall facial rehabilitation were observed and registered by photographs. Botulinum toxin type A, hyaluronic acid, and calcium hydroxyapatite has shown to be useful in improving asymmetries, volumizing surgical depressions and dissembling atrophic scars. Presenting an additional resource to improve overall results, enabling the manufacturing of smaller, thinner, and better-fitting oculofacial prostheses. Limitations as chronic infection and necrosis episodes, related to filler injection into previously irradiated sites, were described. The temporary effect of the materials used generates a need for reapplications but increases the safety of such procedures and enables patients' cancer treatment follow-up.

CHOICE OF OSTEOFIXATION OF EPITHESIS IN TOTAL DEFECT OF THE MAXILLOFACIAL REGION

RETRACTED ARTICLE Relevance. Surgical treatment of neoplasms, various genetic disorders and facial trauma often contribute to a violation of the general aesthetic perception of a person and the development of dysfunctions [1]. The main difficulty of reconstructive treatment in the maxillofacial area is a clear understanding of the anatomical and topographic landmarks and three-dimensional relationships of organs and tissues from each other. Purpose. Development of an algorithm for the use of various types of extraoral implants for various total facial defects. Materials and methods. The collection and analysis of clinical material was carried out in the Department of Maxillofacial Surgery on the basis of the Samara Regional Clinical Hospital named after V.I. V.D. Seredavina. From 2015 to the present, we have installed 104 extraoral implants of various designs for the rehabilitation rehabilitation of fifty patients suffering from total facial defects of various lengths. Conclusions. The analysis of our study showed that the use of extraoral implants of various designs for total facial defects of various lengths, taking into account individual anatomical and topographic features, the etiology of the total defect, has demonstrated its clinical effectiveness.

CHOICE OF OSTEOFIXATION OF EPITHESIS IN TOTAL DEFECT OF THE MAXILLOFACIAL REGION

RETRACTED ARTICLE Relevance. Surgical treatment of neoplasms, various genetic disorders and facial trauma often contribute to a violation of the general aesthetic perception of a person and the development of dysfunctions [1]. The main difficulty of reconstructive treatment in the maxillofacial area is a clear understanding of the anatomical and topographic landmarks and three-dimensional relationships of organs and tissues from each other. Purpose. Development of an algorithm for the use of various types of extraoral implants for various total facial defects. Materials and methods. The collection and analysis of clinical material was carried out in the Department of Maxillofacial Surgery on the basis of the Samara Regional Clinical Hospital named after V.I. V.D. Seredavina. From 2015 to the present, we have installed 104 extraoral implants of various designs for the rehabilitation rehabilitation of fifty patients suffering from total facial defects of various lengths. Conclusions. The analysis of our study showed that the use of extraoral implants of various designs for total facial defects of various lengths, taking into account individual anatomical and topographic features, the etiology of the total defect, has demonstrated its clinical effectiveness.

Survival rate of disk and screw-type implants used for the retention of extraoral prostheses

Statement of problemImplant-supported and implant-retained extraoral prostheses are reliable treatment options for patients with craniofacial defects. They provide stable retention and therefore enhance the patient's appearance and quality of life. Despite studies on survival rates of extraoral implants, little attention has been paid to the design of the implants used to support and retain extraoral prostheses. PurposeThe purpose of this longitudinal clinical study was to assess the long-term survival rate (1 to 12 years, mean 6 years) of 2 different designs of implants (disk: single, double, and triple and screw-type) used for extraoral epithesis anchorage. Material and methodsTwenty-six participants with orbital and nasal defects, 10 of whom had had radiation treatment, were included in the study. Disk implants and extraoral (EO) screw implants were used and placed in the periorbital (15 participants) and perinasal regions (11 participants). Data were analyzed by using the Chi-square test and the Fisher Exact test for qualitative variables and the Mann-Whitney U test for comparison of quantitative variables. Implant survival rates were calculated by Kaplan-Meier analysis. ResultsThe overall 12-year survival rate of all implants was 90.3% (mean=79 months), with 92.9% for nasal (mean=84 months) and 88.2% for orbital (mean=75 months) implants. Related to the implant design, survival rates were as follows: for single-disk implants, 90.2%; for double disks, 94.6%; for triple disks, 88.3%; and for screw implants, 83.3%. In nonradiated participants, the implant survival rate was 97.6%, and for radiated participants, 76.1%. ConclusionsSurvival rates for implant-retained craniofacial prostheses are limited. The nasal site seems to be a more predictable implant site than the orbital site, with a higher overall survival rate. Also, implants inserted in radiated tissues have lower survival rates for both anatomic sites, with statistically significantly lower results in the orbital region. The most reliable type of implant among the disk implants used was the double disk in the orbital site and the single disk in the nasal site, which may indicate the advantages of some designs in specific areas.

Artigo plagiado.

O artigo "Implantologia nas deformidades oculopalpebrais em pacientes com câncer." é na verdade um plágio do artigo original 'CURI, Marcos Martins et al. Extraoral implants in the rehabilitation of craniofacial defects: implant and prosthesis survival rates and peri-implant soft tissue evaluation. Journal of oral and maxillofacial surgery, v. 70, n. 7, p. 1551-1557, 2012." disponivel em: https://pubmed.ncbi.nlm.nih.gov/22698291/ .
 Os pesquisadores que aparecem como autores neste "trabalho" nada tem a ver com este plágio e foram vitimas da ex editora convidada Dra. Lauane Gentil.
 Existe um editorial de retratação onde são dadas maiores explicações, disponiel em: https://doi.org/10.36557/2674-8169.2020v2n4p06-09 .

In Vitro Analysis of the Implant-Abutment Interface Connection and Bacterial Infiltration in Two Extraoral Implant Models.

To compare the connection microgaps and the bacterial infiltration of implant-abutment interfaces of two extraoral implant models. Two implant models were used: the inner connection and the flush connection types. The implant-abutment microgaps of five sets of each extraoral implant were evaluated with scanning electron microscopy. Eleven additional sets of each model design were immersed in Staphylococcus aureus cultures for 24 hours, and samples were obtained from the external surface and from the implant's internal chamber to quantify the colony-forming units. Scanning electron microscopy analysis showed that microgaps of the flush connection were smaller compared with the inner connection (P < .0001), and that bacterial counts were higher at the inner connection compared with the flush connection (P < .0001). Within the limitations of this experimental study, it can be concluded that the flush connection model presented a smaller microgap and fewer bacterial colonies compared with the inner connection model.

Frontal sinus augmentation: Preliminary results of a new approach in prosthetic orbital reconstruction

PurposeReliable application of endosseous implants for prosthetic facial reconstruction depends on the bone volume available at the defect site. Regarding the orbit, sufficient bone presentation in the medial superior orbital rim is limited due to the frontal sinus. The aim of this article is to report for the first time on the augmentation of the frontal sinus for gaining bone volume for supraorbital implant placement. Materials and methodsBetween 2007 and 2014, five patients with orbital exenteration were treated by frontal sinus augmentation using autogenous cancellous bone graft from the ilium. Extraoral implants for prosthetic orbit reconstruction were placed 4–7 months later. In advance, cadaver surgery was performed to prove the feasibility of the method. Surgical technique is described, and intraoperative images are provided. ResultsThe frontal sinus was successfully augmented in all five patients. No major complications related to the procedure were observed. A total of nine orbital implants were inserted in the augmented bone, thereof one sleeping implant. Six implants were restored prosthetically, two implants were lost at exposure. The observation period ranged from 6 to 97 months (mean: 52.8 months). Mean time for patient rehabilitation was 13 months. High patient satisfaction was achieved with the implant-retained orbital prosthesis. ConclusionThe augmentation of the frontal sinus allows implant placement by providing sufficient bone volume in the medial supraorbital rim. Considering the surgical success of this method and patient satisfaction, this new approach is concluded to be a viable option in a unique subset of patients.

Progressive facial hemiatrophy (Parry-Romberg syndrome): short case report

Introduction: The Parry Romberg syndrome (PRS) is a mosaic disease of unknown aetiology which mostly affects women. The facial hemiatrophy generally begins during the early childhood. It has a great impact on social life, and aesthetic rehabilitation is a major challenge. Observation: A 38 years-old-female patient presented with an enucleation of the left eye, due to multiple hamartomas and progressive facial hemiatrophy. The placement of 2 extraoral implants was proposed to bear an ocular epithesis. Comments: PRS develops between the 2nd and 20th year of life, and stabilizes at the adult age. Its main characteristic is a progressive facial hemiatrophy, which involves skin, fat tissues, muscles and osteocartilaginous tissues. 20% of patients have neurological symptoms, and epilepsy is often described as a side effect of the disease. Conclusion: Diagnosis of localized scleroderma has to be eliminated, as these 2 entities are very similar. Major facial reconstructive surgery is often proposed to restore aesthetics.

Long-term results of endosseous implants as retention elements of orbital epitheses, reconstruction techniques, and aftercare after radical tumor resection.

The aim of this study was to examine the long-term results of implants in orbital reconstruction after exenteration. From 1998 to 2012, patients undergoing implant-supported rehabilitation after subtotal or total exenteration due to a tumor were included in a retrospective study. All the patients were evaluated for soft tissue reconstruction, irradiation, complications, abutments, hygiene index, implant mobility, and long-term success. Forty-eight patients (aged between 27 and 81 years) were selected. A total of 187 implants were inserted. All the patients were supplied with epitheses after implantation in the long term. Of the 187 implants, nine implants placed on five patients were lost. The mean follow-up period was 34 months (ranging from 6 to 144 months). The 5-year survival rate was 88%. On the basis of this retrospective study of 48 patients with 187 implants, the following observations were made: (1) The 5-year survival of implants in nonradiated bone was 92%, and (2) the 5-year survival of implants in radiated bone was 86%. Extraoral implants should be presented as an option in orbital rehabilitation after exenteration.

A custom positioning aid for an auricular prosthesis: A clinical report

This report describes the treatment of a 68-year-old man with basosquamous cell carcinoma of the left auricular area. His oncologic treatment resulted in the loss of his left ear and much of the left temporal bone. The loss of a significant portion of the temporal bone precluded the use of extraoral implants. Owing to the lack of anatomic landmarks after his surgical treatment, positioning his auricular prosthesis proved challenging. The fabrication of his prosthesis and a custom positioning aid are described.

ВЫБОР ЭКСТРАОРАЛЬНОГО ИМПЛАНТАТА ПРИ ТОТАЛЬНОМ ДЕФЕКТЕ ЛИЦА

Subject. Despite upgrading of methods of surgical recovery of total face defects it’s hard to achieve esthetic results. Thanks to implementation of extra-oral implants and production of individual silicone prostheses of external ear, orbit, nose and their compilations it became possible to achieve high esthetic results and firm prosthesis fixation. In the article there is an algorithm showing the choices of extra-oral implants at total face defects keeping in mind the origin of the defect (innate, acquired posttraumatic, postresection) local beam-therapy, which is carried out during the illness and the expected lifetime of the patient. The goal of the research is working out an algorithm of application various implants for innate or acquired total face defects. Methodology. The experience of various extra-oral implants that were used for 50 patients with total defects of external ear, orbit, nose and compilation of those defects was analyzed. Results. The analysis showed that with beamed orbit (total radiation dose higher than 46gr) the implant’s success was 92.5%(25 implants). 2 times implants did not receive osseointegration and during the step of placing the healing cap were removed. With patients with the defect of external ear the frequency of successful osseointegration was 96.2%. 2 times due to cicatricial deformity of skin and periosteal coverage in the zone of defect acquired during thermic burn implants were not integrated. 1 time during the application of covered osseofixated magnet implant in orbit of a 10 year old child a decubital gangrene was formed. Conclusions. Application of extra-oral implants of various types for total face defects proved to its clinical efficiency by differentiated approach considering individual anatomical conditions, cause of the defect and the expected lifetime of the patient.

EXTRAORAL IMPLANTS IN THE REHABILITATION OF AURICULAR DEFECTS

The objective of this study was to evaluate implant and prosthesis survival rates and the soft tissue reactions around the extraoral implants used to support auricular defects. Following the favorable decision of Ethical Committee, a retrospective study was performed of patients who received implants for craniofacial rehabilitation from 2003 to 2015. Two outcome variables were considered: implant and prosthetic success. A statistical model was used to estimate survival rates and associated confidence intervals. Data were analyzed using the Kaplan-Meier method and log-rank test to compare survival curves. A total of 39 titanium implants were placed in 17 patients. The 2-year overall implant survival rates were 94.1% and the 2-year overall prosthesis survival rates were 100%. From this study, it was concluded that craniofacial rehabilitation with extraoral implants is a safe, reliable, and predictable method to restore the patient's normal appearance.

Implantes extraorales usados para la rehabilitación de deformidades oculopalpebrales en pacientes oncológicos. Estudio retrospectivo con 14 casos

ObjectivesTo evaluate the success rate of the implants and the survival rate of the eyelid prosthesis, as well as the quality of the peri-implant soft tissue.Material and method A retrospective study was conducted, after approval of the Ethics Committee, using the medical records of all cancer patients with orbital deformities, and who received implants for rehabilitation with eyelid prosthesis, between the period 2003 to 2015. Two outcome variables were considered for the study: the success rate of the implants and the survival rate of the eyelid prosthesis. Data were analysed using the Kaplan-Meier test. ResultsA total of 33 extra-oral implants were installed in 14 patients. The success rate of the implants was 96.9%, and the survival rate of the eyelid prosthesis was 92.3% at 2 years. ConclusionsThe rehabilitation of the orbital region with extra-oral implants is a safe, reliable and predictable technique to restore the facial aesthetics of the patient and improve their quality of life.

Extra-oral implants for prosthetic rehabilitation of craniofacial defects at University Hospitals Birmingham 2005-2015

Extra-oral implants for prosthetic rehabilitation of craniofacial defects at University Hospitals Birmingham 2005-2015

A Simple Technique for Placing Extraoral Implants at an Optimal Position in Orbital Defects.

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.

Implant-retained skull prosthesis to cover a large defect of the hairy skull resulting from treatment of a basal cell carcinoma: A clinical report

Skin carcinoma, particularly basal cell carcinoma, and its treatment can result in large defects of the hairy skull. A 53-year-old man is described who was surgically treated for a large basal cell carcinoma invading the skin and underlying tissue at the top of the hairy skull. Treatment consisted of resecting the tumor and external part of the skull bone. To protect the brain and to cover the defect of the hairy skull, an acrylic resin skull prosthesis with hair was designed to mask the defect. The skull prosthesis was retained on 8 extraoral implants placed at the margins of the defect in the skull bone. The patient was satisfied with the treatment outcome.

Extraoral Implants for Anchoring Facial Prostheses: Evaluation of Success and Survival Rates in Three Anatomical Regions.

The aim of this study was to evaluate the success and survival rates of extraoral implants for the fixation of facial prostheses in three anatomical regions. Subjects were consecutive patients with facial defects who underwent implant placement by the same surgeon in the orbital, nasal, and auricular regions between 2003 and 2012. After a minimum of 4 months of osseointegration, prostheses were anchored to the implants, and the patients were monitored for 11 to 111 months. Success rate, implant survival time, and occurrence of previous radiotherapy were evaluated. Rate of implant survival was estimated as a function of the anatomical region of the three groups (orbital, nasal, or auricular), and confidence intervals were calculated using Kaplan-Meier analysis with α = .05. In the 68 patients' 138 fixed implants, 48 showed defects in the orbital, 9 in the nasal, and 11 in the auricular region. The success rates and survival times were 95.9% and 8.6 years for the orbital, 92.9% and 2.8 years for the nasal, and 92% and 9.0 years for the auricular region, respectively. The success rate of implants in previously irradiated regions was 90.3% for the orbital and 100% for the auricular region. None of the patients was irradiated in the nasal region. No significant differences in implant success or survival were observed with regard to anatomical region or previous irradiation.

Osseointegration and implant stability of extraoral implants in Göttingen minipigs after irradiation.

The aim of this study was to compare the influence of implant surface treatment and irradiation dose on implant stability and osseointegration of 144 extraoral implants in irradiated frontal bone of minipigs. 144 implants with 3 different surface treatments (machined, etched and HAVD-coated) were implanted in the frontal bone of 16Göttingen minipigs. Three groups of four pigs received radiation with equivalent doses of 25, 50 and 70Gy, and one group served as control. Resonance frequency analysis (RFA) was performed recording Implant Stability Quotients (ISQ) at implant placement and 3 months thereafter. Removal torque was measured whilst removing specific implants after 3 months. In addition, the bone-to-implant contact (BIC) was analyzed. Evaluation of ISQ, BIC-values showed no significant difference between the different surface treatments in irradiated and non-irradiated bone. Removal torque revealed statistically significant differences between machined and HAVD-coated implants in the irradiated bone. Implant stability and osseointegration, based on Removal Torque showed significant higher results for the HAVD-coated implants. No significant difference was observed between the irradiated and non-irradiated animals. This study shows that HAVD-coated extraoral implants can potentially be used for craniofacial rehabilitation in non-irradiated and irradiated bone.