Implant-retained Nasal Prostheses Research Articles

Facial rehabilitation with implant-retained nasal prosthesis of acrylic resin: a case report

ABSTRACT The objective of this study was to report a clinical case of facial rehabilitation with an acrylic implant-retained nasal prosthesis after partial rhinectomy resulting from the resection of a basal cell carcinoma in the patient, a 53-year-old Caucasian, normosystemic, professional cowboy. After clinical examination and in possession of computed tomography images, surgery was performed for the placement of conventional dental implants in the premaxillary region (left side). After the surgery, a three-month period of waiting was observed to allow osseointegration of the implants. Later, the nasal prosthesis was prepared, and at the end of treatment, this presented satisfactory peripheral adaptation, retention and esthetics. The patient has returned for follow-up every 6 months, regarding analysis of the prosthesis color, peri-implant health, hygiene, and exchange of the magnets and relays when necessary. The authors concluded that this therapy may be well indicated in patients with partial and total nasal defects, provided that there is correct planning and execution of the surgical, clinical and laboratory phases.

Integration of digital technology in the workflow for an osseointegrated implant-retained nasal prosthesis: A clinical report

This clinical report describes the integration of digital technology into the treatment of a patient with an osseointegrated implant-retained nasal prosthesis. The surgery was planned digitally to determine the optimal implant positions. Implant placement surgical guides were digitally designed and additively manufactured. Prosthetic components, including the nasal form and substructure, were simulated digitally. Based on this simulated prosthetic model, patient-specific abutments were digitally designed and copy-milled. Prototypes for the substructure and prosthesis were 3D printed. Spectrophotometry and computerized color formulation were used to generate the silicone base color of the prosthesis, and characterization was performed by eye. The integration of digital technology allowed for optimized prosthetic retention, predictable esthetic outcomes, and reduced patient appointment time.

Rehabilitation of Nose following Chemical Burn Using CAD/CAM Made Substructure for Implant Retained Nasal Prosthesis: A Clinical Report

Insufficient knowledge of medical chemicals and their improper use have destructive effects. Accidental exposure to chemicals on facial tissue may result in large facial defect. For ages the tradition of piercing nose is common but improper use of unknown chemical for piercing has deleterious effect. Mostly rhinectomy defects are acquired caused by trauma or malignant diseases. Prosthetic rehabilitation is the preferred treatment of choice for any large rhinectomy defects as medical and surgical interventions are ineffective in developing esthetics. Main concern with the prosthesis for such defects is retention. This article describes rehabilitation of a patient with large size nasal defect created by chemical burn in childhood during piercing. Implant retained customized silicone nasal prosthesis was fabricated using simple O-ring attachments and innovative modified polyamide acrylic resin substructure acting as skeleton.

Recommendations for implant-retained nasal prostheses after ablative tumor surgery: Minimal surgical aftercare, high implant survival, and satisfied patients.

Nasal defects resulting from tumor resection are preferably rehabilitated with implant-retained nasal prostheses. Aftercare, clinical outcome of the implants, and patients' satisfaction with implant-retained nasal prostheses were assessed. Twenty-eight consecutive patients needing total rhinectomy because of tumor resection between 1998 and 2013 were treated according to a standardized protocol with 2 implants in the nasal floor. Surgical and prosthetic aftercare was scored using patient records. Finally in 2014, skin reaction, peri-implant bone loss, and patients' satisfaction were assessed in all 13 still living patients. In total, 56 implants were inserted (median follow-up, 35.1 months; interquartile range [IQR], 8.9-63.3). Implant survival was 96.4%. Implant survival was independent of radiotherapy. Peri-implant skin was healthy and patients' satisfaction high. Longevity of the prostheses was limited. Rehabilitation of nasal defects resulting from total rhinectomy with implant-retained nasal prostheses, according to our protocol, resulted in high patient satisfaction and favorable treatment outcome. © 2015 Wiley Periodicals, Inc. Head Neck 38: E-E, 2016.

Implant-retained nasal prosthesis for reconstruction of large rhinectomy defects: the Salisbury experience

The authors report their experience with 34 patients who had large full thickness nasal defects reconstructed with an implant-retained prosthesis. Their technique of modifying post-rhinectomy defects is described and factors influencing implant success are evaluated. 111 implants were placed to retain a nasal prosthesis. Age, sex and tumour histology did not affect the outcome. Smoking, extent of rhinectomy, use of radiotherapy (pre- and post-implant), hyperbaric oxygen, length and location of the implant and type of retention (bar/magnets) influenced implant success. The overall success rate was 89% (99/111); 94% in patients who did not receive radiotherapy and 86% in those who did. The prosthesis was in place in all patients (100%) at the time of last follow up. Post-rhinectomy defect modification enables adequate access for safe placement of long implants with good primary stability and helps the maintenance of good hygiene (further enhanced by the use of skin grafts). The authors think implant-retained prosthesis is a reliable option for reconstructing large full thickness rhinectomy defects. They suggest their technique of modifying the defect, use of long implants and magnets for retention is responsible for the high success rate of implants used to retain a nasal prosthesis.

Peri-implant skin graft for a craniofacial prosthesis

Patients who sustain avulsive craniofacial injuries are sometimes better reconstructed esthetically and functionally with prosthetic devices rather than regional or distant flaps and grafts. 1 Sugar A Beumer 3rd, J Reconstructive prosthetic methods for facial defects. Oral Maxillofac Surg Clin North Am. 1994; 7: 755-764 Google Scholar , 2 Flood TR Russell K Reconstruction of nasal defects with implant-retained nasal prostheses. Br J Oral Maxillofac Surg. 1998; 36: 341-345 Abstract Full Text PDF PubMed Scopus (55) Google Scholar , 3 Tjellstrom A Hakannson B Linstrom J Brånemark PI Hallen O Rosenhall U et al. Analysis of the mechanical impedance of bone anchored hearing aids. Acta Otolaryngol. 1980; 89: 85-92 Crossref PubMed Scopus (84) Google Scholar Unfortunately, available bone for placement of craniofacial implants is often limited. The overlying soft tissues are thick and mobile, which requires the use of longer transcutaneous attachments. However, these attachments may compromise the stability of the implants and lead to implant loss. The facial prosthesis also must be of sufficient thickness to provide for adequate camouflage of the underlying structures, strength, and insertion of different retaining attachments. This should not be accomplished at the expense of, or compromise, the surface architecture of the facial prosthesis. To accommodate these requirements, bone recontouring, skin and subcutaneous debulking, and split thickness skin grafts are performed.

Reconstruction of nasal defects with implant-retained nasal prostheses

Predictable biomechanical retention of nasal prostheses can now be achieved using Brånemark osseointegrated implants. These prostheses are tissue compatible, simple in design and easy to place, can be worn independently of spectacles and can in the majority of cases be provided soon after surgical excision. We have treated 14 patients (30 implants) 8 of whom had the implants placed at the time of surgical excision of the tumour. The longest survival so far has been 62 months (mean 38 months). Craniofacial osseointegration changes patients' perceptions of a nasal prosthesis and improves quality of life. Initial reconstructioe surgery after radical nasal excision should be limited to reconstruction of the upper lip and preparation of the surgical defect for an implant-retained prosthesis.

Nasal defects and osseointegrated implants: UCLA experience

A clinical study of 23 craniofacial implants placed in 11 nasal defects was conducted over a 7-year period. Implant-retained nasal prostheses were fabricated, implant success rate was determined, and the soft tissue responses were recorded at 6-month intervals. No data were gathered on two implants because of patient death. The implant success rate was 71.4% ( 15 21 ) but varied significantly by anatomic site. The implant success rate in the glabella was 0% ( 0 4 ), whereas the success rate in the anterior nasal floor was 88.1% ( 15 17 ). All implant failures occurred within the first year of loading. A five-point scale was used to record the health of the peri-implant soft tissues, and the patients were followed up from 6 to 74 months. The unit of measure was a visit/site, and a unit was assigned for each instance an implant site was evaluated. Evaluations were conducted at 6-month intervals for a total of 76 visit/sites for the study period. The results revealed that 85.5% ( 65 76 ) of the visit/sites demonstrated an absence of inflammation; 10.5% ( 8 76 ) of the visit/sites demonstrated slight redness; 1.3% ( 1 76 ) demonstrated peri-implant red and moist tissues; 2.6% ( 2 76 ) demonstrated granulation tissue associated with the implants; and 0% ( 0 76 ) demonstrated infection of the peri-implant soft tissues. Severe soft tissue reactions around implants placed in the anterior nasal floor are rare.