Implant-retained Auricular Prosthesis Research Articles

Improved Fabrication of Implant Retained Auricular Prosthesis with Digital Technologies.

A 28-year-old male patient came to the prosthodontics department seeking replacement for his congenital defect left ear. With the use of digital technology, a silicone implant supported bar retained auricular prosthesis that is an exact match in size, shape, and orientation to the existing contralateral ear was made.

Description of the Surgical and Prosthetic Workflow of a Patient Rehabilitated with Implant-Retained Auricular Prosthesis

Facial tissue loss is acquired as a result of congenital anomalies or acquisitional misshapen like tumoral lesions or accidents. These defects result in functional problems, esthetic concerns, and also psychosocial troubles and could be repaired by plastic surgery or reconstructed using facial prostheses. Conventional tissue-supported auricular prostheses meet lots of challenges due to dependence on tissue undercut or adhesive for retention. Implant-retained auricular prostheses lessen the complications related to adhesive-retained prostheses and alleviate the need for invasive plastic surgery. Implant-retained auricular prostheses provide patients with secure retention and avoid prosthesis disengagement caused by movable surrounding soft tissue. The impact of prostheses with secured retention and satisfactory esthetics on the self-confidence of patients with facial defects is promising. This paper aimed to describe the surgical and prosthetic workflow of a patient with acquired ear deformity due to basal cell carcinoma (BCC) which was rehabilitated with implant retained auricular prosthesis.

Repositioning an Implant-retained Auricular Prosthesis using a Custom Acrylic Base: A Case Report

Prosthetic rehabilitation offers an alternative to surgical procedures for repositioning implant-retained auricular prosthesis. This report illustrates a prosthetic rehabilitation of a 15-year- old male with a unilateral microtia who presented with an unfavorable implant-retained left auricular prosthesis. The implants placed seven years ago were drifted posterosuperior away from the ideal ear canal position. The fabrication of a new prosthesis on the existing bar-clip attachment using a custom acrylic base was planned to correct the location. A skin-colour perforated custom acrylic base was fabricated and designed to extend anteriorly, therefore, shifting the prosthesis forwards into a more natural location. The custom base was able to relocate the prosthesis’ position without compromising its retention whilst engaging the existing implant attachment. This in turn enhanced prosthesis acceptability and improved the patient’s confidence. The custom acrylic base serves as a viable option to reposition the prosthesis influenced by age related growth and development.

Fully digital workflow for ear defect rehabilitation with an immediate implant-retained auricular prosthesis

The fully digital workflow for an immediate implant-retained auricular prosthesis procedure included computer-aided treatment planning, flapless surgery, and the prefabricated auricular prosthesis rehabilitation. This technique also encompassed the presurgery fabrication of the substructure of the implants and the definitive auricular prosthesis to ensure the smooth insertion of the ear prosthesis.

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.

An implant-retained auricular prosthesis complicated by a modified temporal bone resection

A patient underwent a modified temporal bone resection and total auriculectomy to remove a sebaceous carcinoma arising from the tragus of the right auricle that extended into the external auditory meatus. Because the tumor extended into the temporal bone, the osseous sites originally selected for immediate placement of the craniofacial implants were resected and no longer available. Subsequently, after an appropriate period of healing, implants were placed into the residual temporal bone, considerably more superior and posterior to the external auditory meatus such that they emerged through hair-bearing skin. The purpose of this report was to describe the fabrication of an implant-retained auricular prosthesis with implants in suboptimal positions. Challenges included optimization of the stability and retention of the prosthesis, effectively managing the prosthetic space without compromising the esthetic outcome, providing adequate hygiene access for the implant connecting bar, and maintaining the health of the peri-implant tissues when the implant emerged through hair-bearing skin.

A combined digital technique to fabricate an implant-retained auricular prosthesis for rehabilitation of hemifacial microsomia

Implant-retained auricular prostheses provide an excellent treatment option with better retention and stability than a conventionally retained prosthesis. This article presents a technique for auricular reconstruction for a patient with misplaced implants. The scanning process combined the use of an intraoral scanner and a facial scanner to enhance accuracy in space management for different parts of the auricular prosthesis and to reduce sculpting time.

Prevention of peri-implant skin inflammation using an acrylic resin housing with a tunnel design for an implant-retained auricular prosthesis

Implant-retained auricular prostheses offer better retention than conventional adhesive retentive methods. Peri-implant skin inflammation, which results from improper substructure design, poor hygiene, skin thickness, and the hot and moist environment around abutments, however, is a common complication of craniofacial implants. This article describes a technique for fabricating an acrylic resin housing design with an extended arm to improve ventilation around implants and to reduce the risk of the silicone prosthesis tearing away from the acrylic resin housing.

Implant-retained auricular prostheses: a clinical challenge

Microtia, malformation, deformity, and partial or complete loss of the pinna may be due to various congenital or acquired factors. In adult patients, surgical reconstruction of the missing pinna is difficult and the results are often far from satisfactory. An implant-retained auricular prosthesis is a suitable alternative. A retrospective study of eight patients treated with implant-retained auricular prostheses was performed. For each missing pinna, three titanium implants were placed in the temporal bone. After 6 months of osseointegration, the implants were loaded. Four cases were rehabilitated with a magnet-retained prosthesis and the remaining four with a bar and clip retained prosthesis. There were six male and two female patients with an average age of 30.62 years. Seven patients had unilateral absence of the pinna and one had bilateral absence. The loss was due to trauma in four patients and to burn in one patient, and three had congenital absence. A total 27 implants were placed, 12 on the right side and 15 on the left. The average post-rehabilitation follow-up was 21 months. Peri-implant tissue reactions were observed at two sites. The implant-retained auricular prosthesis is an alternative treatment approach with good retention and patient satisfaction. Long-term follow-up is required to assess delayed complications.

Yanık Hastalarının İmplant Destekli Maksillofasial Protezlerle Rekonstrüksiyonu: İki Olgu Sunumu

Surgical reconstruction of facial structures of burned patients remains one of the most difficult areas of plastic surgery, and the esthetic results are not always acceptable. Implant-retained maxillofacial prostheses are an alternative treatment to surgical reconstruction for patients who lost facial structures from burn. This article describes fabrication of an implant-retained auricular prosthesis and a nasal prosthesis for two burned patients and represents treatment outcomes. Extraoral implants were placed in the defect sites. After a 3-month osseointegration period, abutments were connected to the implants at stage 2 surgery. Retention was obtained with bar-clips attachment for auricular prosthesis and magnetic attachment for nasal prosthesis. The prostheses were fabricated from silicone. After prosthetic reconstruction, clinical follow-ups were performed every six months. The implant-retained prosthetic rehabilitation of the burned patients discussed in this article resulted in acceptable functional and cosmetic results.

A different wax sculpture technique for implant-retained auricular prosthesis

Replacement of missing ears is a challenging task in which extensive array of materials and techniques have been employed. This article describes a different and simplified procedure for fabricating auricular prostheses very similar to the intact left ear of the patient. A 65-year-old male patient was referred to the Department of Prosthodontics with the loss of the right ear. In this case, the impression was made using hydrocolloid material (alginate) from the both defected and the opposite side. After hardening of the stone casts, a custom-made transparent splint plate was designed for the left auricular side. The splint was reversed and a cast model of the right auricular side was obtained as pouring the dental stone into transparent orthodontic splint. After getting the impression from cast model, conventional wax pattern and try on process was done. Finally, silicone elastomer was polymerized and the retention of the prosthesis acquired with the magnetic attachments. The technique described is economical, conventional, and time-saving. Furthermore, the prosthesis imitates the patient's intact auricular tissue.

Prosthesis-guided implant restoration of an auricular defect using computed tomography and 3-dimensional photographic imaging technologies: A clinical report

The concept of prosthesis-guided implantation has been widely accepted for intraoral implant placement, although clinicians do not fully appreciate its use for facial defect restoration. In this clinical report, multiple digital technologies were used to restore a facial defect with prosthesis-guided implantation. A simulation surgery was performed to remove the residual auricular tissue and to ensure the correct position of the mirrored contralateral ear model. The combined application of computed tomography and 3-dimensional photography preserved the position of the mirrored model and facilitated the definitive implant-retained auricular prosthesis.

Quality of Life in Children Fitted With a Bone-Anchored Hearing Aid

To evaluate the self-rated quality of life and benefits associated with the use of a Bone-Anchored Hearing Aid (BAHA). To assess any change in health status after a BAHA. This was a retrospective postal questionnaire study. The Glasgow Children's Benefit Inventory was the validated tool used.Children with a BAHA on the Birmingham pediatric Bone-Anchored Hearing Aid Programme from February 1992 to February 2007 were included. One hundred fifteen children were sent a postal questionnaire. Eighty-four were returned, giving a response rate of 73%. All children had worn their BAHA for more than 6 months. Children with an implant-retained auricular prosthesis were excluded from the study, as were children who were older than 16 years at the time of the questionnaire. Patients with bilateral BAHA were advised to answer the questionnaire with reference to their first BAHA. The BAHA was a success in the pediatric population. All 84 children reported a positive benefit with their BAHA. The median benefit score was +54. No child demonstrated deterioration in health status after their BAHA. The use of a BAHA significantly enhanced general well-being, improved patient state of health (quality of life), and finally, was considered a success by patients and their families. This study demonstrates a significant benefit from BAHA as measured by the Glasgow Children's Benefit Inventory.

Locking retentive attachment for an implant-retained auricular prosthesis

This article describes the use of the Slant-Lock retention system with an implant-retained auricular prosthesis. (J Prosthet Dent 2002;87:336-8.)

Assisted retention of a hearing device in an implant-retained auricular prosthesis

The use of bone-anchored hearing aids is not possible for all patients who wear an implant-retained auricular prosthesis. For some patients, the external ear canal cannot be occluded with a conventional hearing device. Currently manufactured hearing aids may not readily fit the contours of an implant-retained auricular prosthesis. This article describes a technique that allows a modular hearing aid device to be inserted into a custom “sleeve.” With this device, the patient can take advantage of binaural cues. (J Prosthet Dent 2001;86:386-9.)

Hemifacial microsomia and treatment options for auricular replacement: A review of the literature

Statement of problem. Although surgical reconstruction is the treatment of choice for auricular deformities that result from hemifacial microsomia, the implant-retained auricular prosthesis must be considered when surgical reconstruction is not possible. The competent and successful practitioner should be knowledgeable of the nature of this congenital disease. Purpose. This article reviewed the first and second branchial syndrome, treatment approaches, and potential advances in surgical and prosthetic rehabilitation for patients with hemifacial microsomia. Conclusion. Advantages and disadvantages of autogenous and alloplastic ear reconstructions are discussed. New research initiatives, such as tissue engineering and fabrication of auricular prosthesis by CAD/CAM, offer the potential for improved treatment for the future treatment of hemifacial microsomia. (J Prosthet Dent 1999;82:197-204.)

Presurgical confirmation of craniofacial implant locations in children requiring implant-retained auricular prosthesis

Early prosthetic treatment is believed to be psychologically beneficial to children who have an ear defect resulting from congenital malformation. Lack of soft tissue landmarks and minimal bone thickness in deformed auricular areas are sometimes problematic for craniofacial implant placement in these children. This article describes procedures to confirm locations of craniofacial auricular implants by using computed tomographic scan information and a surgical stent. The procedures can also be applied to children and adults to identify locations for auricular implant placement. This method ensures precise locations for implant placement and it also provides a better prosthodontic prognosis for auricular defect patients.

An impression and cast construction technique for implant-retained auricular prostheses

Implant-retained auricular prostheses present a challenge with regard to the esthetic placement of the margins of the prosthesis. A technique for the impression and master cast fabrication to produce an implant-retained auricular prosthesis is described. This technique allows control of the esthetic margin, fabrication of a durable master cast with planned blockout, and inclusion of a replica of the retentive bar, which allows processing duplicate prostheses without returning the retentive bar to the mold.