Maxillofacial Prosthetic Materials Research Articles

Extra-oral Maxillofacial Prosthetic Materials: Results of the 2020 International Survey.

To report the results of a 2020 international survey of the most commonly used materials and techniques for the fabrication of extraoral maxillofacial prosthetics and to assess the use of 3D technology. A 43-question survey was administered via Qualtrics to the members of the American Academy of Maxillofacial Prosthetics, the International Anaplastology Association, and the International Society of Maxillofacial Rehabilitation. The use of current 3D technology in the fabrication of maxillofacial prostheses, as well as barriers to care such as patient cost and insurance coverage, were also assessed. A total of 134 respondents (13%) completed the survey; 96 (73%) reported that they were currently fabricating maxillofacial prostheses and were thus included in the survey. The majority of respondents reported currently using Silastic MDX4-4210 BioMedical Grade Elastomer (DuPont) with either Silastic Medical Adhesive Silicone Type A or Silastic MDX4-4210 crosslinker. Incorporating the use of current CAD/CAM technology was reported by a majority of respondents (58%; 45/77); however, a small cohort (33%, 15/45) reported they were "still experimenting how best to use technology." A total of 39 clinicians (49%) reported that facial prosthetics were most often paid for by the patient (fee for service), with the fee ranging from $10 to $5,500 USD. The results of this survey indicate that current CAD/CAM technology has been adopted and incorporated into the design and fabrication of maxillofacial prostheses. More research is needed to advance CAD/CAM technology as well as the physical and mechanical properties of materials in maxillofacial prosthetics and anaplastology clinical practice.

Maxillofacial prosthetic materials: current status and recent advances: A comprehensive review

Body abnormalities or defects that compromise form, function and esthetics are sufficient to render an individual incapable of leading a normal life. Maxillofacial disfigurement can be the result of a congenital anomaly, trauma or tumour surgery. Multiple times due to size, location of the defect or because of patient’s medical condition surgical reconstruction may not be possible so prosthetic rehabilitation is indicated in these cases. But the success of prosthetic rehabilitation is largely determined by the physical and mechanical properties of the material used. Materials commonly used these days for fabrication of facial prostheses are acrylic resins, acrylic copolymers, vinyl polymers, polyurethane elastomers and silicone elastomers. There has always been a quest for a maxillofacial prosthetic material that closely matches the defect tissues in appearance and properties. This article focuses on historical background, changing trends and future aspects of various materials used in rehabilitation of maxillofacial defects with their limitations and modifications.

The color stability of maxillofacial silicones: A systematic review and meta analysis.

Aim:This systematic review aims to identify and interpret results of studies that evaluated the changes in the color stability of maxillofacial prosthetic materials due to chemical instability of silicones and pigments and the effect of exposure to environmental conditions and aging factors on the same.Settings and Design:This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA).Materials and Methods:Relevant articles written in English only, before November 15, 2019, were identified using an electronic search in the PubMed/Medline conducted to identify pertinent articles. The relevancy of the articles was verified by screening the title, abstract, and full text, if they met the inclusion criteria. A total of 42 articles satisfied the criteria, from which data were extracted for qualitative synthesis. This review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO registration number CRD42019124562).Statistical Analysis Used:Since considerable data heterogenicity was present in all studies except the ones on incorporation of TiO2 for which meta-analysis using random effects model was performed.Results:The database search resulted in 234 studies, of which 202 articles were excluded due to lack of relevance, duplication, and unavailability of data. The remaining 32 fulltext articles were assessed for eligibility, out of which 2 articles were excluded. Twelve articles were yielded by manual search. A total of 42 studies were included in the present systematic review. Due to heterogeneous data, meta-analysis could be only carried out with the effect of TiO2 nano particle on color stability.Conclusions:Although there has been extensive amount of research in this field, an ideal maxillofacial silicone exhibiting good color stability in various human and environmental aging conditions is yet to be identified. Human and environmental aging conditions have an adverse effect on the color stability and addition of TiO2 nano particle seems to improve the same.

Evaluation Outcome of Physical Properties of Maxillofacial Prosthetic Materials: A Systematic Review and Meta-Analysis

Evaluation Outcome of Physical Properties of Maxillofacial Prosthetic Materials: A Systematic Review and Meta-Analysis

EFFECT OF EXTRAORAL AGING CONDITIONS ON MECHANICAL PROPERTIES OF FACIAL SILICONE ELASTOMER REINFORCED WITH TITANIUM-OXIDE NANOPARTICLES (IN VITRO STUDY)

Introduction: Investigators have been searching for ideal maxillofacial prosthetic materials in order to gain patient acceptance and can be fabricated easily in the dental setting. Objectives: To evaluate the influence of adding different concentrations of titanium oxide nanoparticles (TiO2 NPs) on the mechanical properties of facial silicone elastomer (SE) after different extra-oral aging methods. Materials and methods: TiO2 nanoparticles were mixed with MED-4210 maxillofacial silicone elastomer at 1.5 %, 2% and 2.5 % weight percentage (w/w). Unmodified silicone was served as control group. Each of the above groups were evaluated to mechanical properties before aging conditions. Control & 2.5% nano-TiO2 silicone elastomers groups were subjected to six equal aging conditions groups as follow. Dry storage in dark for 6 months, storage in simulated sebum solution for 6 months, storage in simulated acidic perspiration for 6 months, accelerated artificial daylight weathering for 360 hours, storage in antimicrobial silicone-cleaning solution for 30 hours and mixed aging of sebum under UV light for 360 hours. After aging exposures, they were evaluated to the mechanical properties. Data were analyzed using the Kolmogorov-Smirnov test, F-test (ANOVA) and Post-hoc pair-wise test. Results:TiO2 nanoparticles addition improved the mechanical properties in terms of tensile strength and percentage elongation, tear strength and shore A hardness of MED-4210 maxillofacial silicon elastomer before and after extra-oral aging conditions (P < 0.05). Pair-wise comparison between control group and 2.5% nano-TiO2 silicone elastomers composite exhibited significant differences according to the mechanical properties after aging. Conclusions: Reinforcement of MED-4210 maxillofacial silicon elastomer with TiO2 nanoparticles introduces a favorable material with physical and anti-ageing properties in our in vitro study.

The Effects of Nano Alumina On Mechanical Properties of Room Temperature Vulcanized Maxillofacial Silicone (Pilot Study)

Background: Facial disfigurement can be the result of a congenital anomaly, trauma or tumor surgery, in many cases the prosthetic rehabilitation is indicated. Maxillofacial prosthetic materials should have desirable and ideal physical, aesthetic, and biological properties and those properties should be kept for long period of time in order to reach patient acceptance. Silicone elastomer are the most commonly used material for facial restoration because of its favorable properties mechanically and physically as the biocompatibility and good elasticity. Aim of this study: This study aimed to evaluate the effect of addition of Aluminum oxide (Al2O3) Nano fillers in different concentrations on tear strength and hardness of VST 50F room temperature vulcanized maxillofacial silicone. Methods: The Nano Al2O3 was added in a concentrations of 0.5, 1, 1.5 and 2 by weight to the VST 50F RTV maxillofacial silicone, the samples were tested for tear strength (ISO 34 -1) and shore A hardness (ISO 7619), the FTIR was used to analyze the interaction of the Nano Al2O3 with the silicone. The data were analyzed using descriptive and inferential statistics. One-way ANOVA test was used to test the changing significance. Results: There was no interaction between the Nano-Al2O3 and the silicone in the FTIR. The results showed highly significant increase in tear strength and shore A hardness for the 1 and 1.5 concentration groups when Compared to control group. Conclusion: The reinforcement of VST 50F maxillofacial silicone with 1 and 1.5 concentrations of Nano Al2O3 improved some of the mechanical properties of the room temperature vulcanized silicone.

PREVELANCE OF ORAL AND RESPIRATORY MICROORGANISMS ON THE CAD-CAM VERSUS PRESS FORM OF POLY-ETHER-ETHER KETONE MATERIAL FOR ORAL AND MAXILLOFACIAL PROSTHESIS

INTRODUCTION: Biofilm formation differs in accordance to material type and processing technique, which has a crucial impact on maxillofacial prosthetic materials’ practicability. OBJECTIVES: to compare the prevalence of the upper respiratory tract and oral microbial flora colonization on the two commercially available forms of polyetheretherketone (modified PEEK); the conventional press form and the CAD-CAM form. MATERIALS AND METHODS: : forty eight circular discs, were processed forming four groups: Group I: twelve BioHPP discs were prepared with CAD-CAM form, Group II: twelve BioHPP discs with conventional press form, Group III: twelve heat polymerized poly methyl meth acrylate (PMMA) to mimic the polished surface Group IV: twelve heat cured PMMA to mimic the fitting surface. Microbiological procedures were performed including microbiological sampling, isolation, purification and identification, biofilm formation and assessment of the normal oral and respiratory flora on modified PEEK and PMMA discs. RESULTS: Acrylic resin fitting surface group had the highest biofilm formation when compared with the three other groups. No statistical significant difference was found between each pair of the three remaining groups, CAD-CAM BioHPP group showed the lowest biofilm formation of all groups according to mathematical data, but it didn’t approach the level of being statistically significant. CONCLUSIONS: Both BioHPP processing techniques were positive for biofilm formation, though BioHPP CAD-CAM showed a rougher surface than pressed BioHPP, it showed the least biofilm formation of all groups. Fitting surface of acrylic resin group showed the worst results for biofilm formation

Evaluation of Some Mechanical Properties of a Maxillofacial Silicon Elastomer Reinforced with Polyester Powder

Maxillofacial silicone elastomers are used to replace and reconstruct missing facial parts for patients with trauma or a certain disease. Although commonly favorable silicone elastomers are not ideal in properties, many studies have been carried out to improve their mechanical properties and to come out with ideal maxillofacial prosthetic materials, so as to render patients with the best maxillofacial prostheses. The aim of the current study is to evaluate the effect of addition of different concentrations of polyester powder on hardness, tear strength, surface roughness, and tensile strength of maxillofacial A-2186 RTV silicone elastomers. Polyester powder was added to the silicone elastomer in the concentrations of 1%, 3% and 5% by using an electronic digital balance, compared with the control group of 0% polyester filler. The shore A hardness test was done according to ASTM D 2240 standards. The tear test was done according to ASTM D624 type C standards. The tensile test was done according to ISO specification number 37:2011. The surface roughness test was performed according to ISO 7619-1 2010 specifications. The data collected were then analyzed using one-way analysis of variance (ANOVA) and post hoc and Fisher’s LSD tests. All three groups showed a highly significant increase in tear strength, tensile strength, hardness, and roughness, compared to the control group. Reinforcement of A-2186 Platinum RTV Silicone Elastomer with 5% polyester significantly improved the mechanical properties tested in this study.

Effect of Aging and Weathering on the Physical Properties of Maxillofacial Silicone Elastomers: A Systematic Review and Meta-Analysis.

This systematic review aims to identify and interpret results of studies that evaluated the changes in the physical properties of maxillofacial prosthetic materials (1) without aging, (2) after natural or artificial accelerated aging, and (3) after outdoor weathering. Relevant articles written in English only, before January 15, 2017, were identified using an electronic search in the PubMed, Scopus, and Google Scholar databases. Furthermore, a manual search of the related major journals was also conducted to identify more pertinent articles. The relevancy of the articles was verified by screening the title, abstract, and full text if they met the inclusion criteria. A total of 37 articles satisfied the criteria, from which data were extracted for qualitative synthesis. Among the 37 included articles, 14 were without aging, 15 were natural or artificial accelerated aging, 7 were outdoor weathering, and 1 contained both artificial aging and outdoor weathering. Only 4 studies out of the 14 without aging had significant observations; whereas 9 articles with natural or artificial aging published significant results, and 3 out of 7 outdoor weathering articles showed significant changes in the evaluated silicone elastomers. Despite the varying research, it seems that the single "ideal" maxillofacial prosthetic material that can provide sufficient resistance against different aging conditions is yet to be identified. Therefore, it is imperative for standardization organizations, the scientific community, and academia to develop modified prosthetic silicones possessing improved physical properties and color stability, limiting the clinical problems regarding degradation of maxillofacial prostheses.

Mechanical Properties and Simulated Aging of Silicone Maxillofacial Elastomers: Advancements in the Past 45 Years.

To identify and discuss the findings of publications on mechanical behavior of maxillofacial prosthetic materials published since 1969. Original experimental articles reporting on mechanical properties of maxillofacial prosthetic materials were included. A two-stage search of the literature, electronic and hand search, identified relevant published studies up to May 2015. An extensive electronic search was conducted of databases including PubMed, Embase, Scopus, and Google Scholar. Included primary studies (n = 63) reported on tensile strength, tear strength, and hardness of maxillofacial prosthetic materials at baseline and after aging. The search revealed 63 papers, with more than 28 papers being published in the past 10 years, which shows an increased number of publications when compared to only 6 papers published in the 1970s. The increase is linear with significant correlation (r = 0.85). Such an increase reflects great awareness and continued developments and warrants more research in the field of maxillofacial prosthetic materials properties; however, it is difficult to directly compare results, as studies varied in maxillofacial prosthetic materials tested with various silicone elastomers being heavily investigated, standards followed in preparing test specimens, experimental testing protocols, and parameters used in setting simulated aging conditionings. It is imperative to overcome the existing variability by establishing unified national or international standards/specifications for maxillofacial prosthetic materials. Standardization organizations or bodies, the scientific community, and academia need to be coordinated to achieve this goal. In the meantime and despite all of these theoretically significant alternatives, clinical practice still faces problems with serviceability of maxillofacial prostheses.

ÇENE YÜZ PROTEZLERİNDE KULLANILAN MATERYALLER VE BU KONUDAKİ GELİŞMELER

Maxillofacial prostheses rehabilitation of both congenital defects and acquired defects related to cancer or trauma. Materials used in maxillofacial prosthetics should have some ideal properties such as mechanical and physical strength. Silicone elastomers have been widely used for constructing maxillofacial and other prosthetic devices. This article presents a literature review for maxillofacial prosthetic materials especially for silicone elastomers and latest advances in this topic

Surface Coating of Gypsum-Based Molds for Maxillofacial Prosthetic Silicone Elastomeric Material: The Surface Topography.

This study aimed to compare the surface roughness of maxillofacial silicone elastomers fabricated in noncoated and coated gypsum materials. This study was also conducted to characterize the silicone elastomer specimens after surfaces were modified. A gypsum mold was coated with clear acrylic spray. The coated mold was then used to produce modified silicone experimental specimens (n = 35). The surface roughness of the modified silicone elastomers was compared with that of the control specimens, which were prepared by conventional flasking methods (n = 35). An atomic force microscope (AFM) was used for surface roughness measurement of silicone elastomer (unmodified and modified), and a scanning electron microscope (SEM) was used to evaluate the topographic conditions of coated and noncoated gypsum and silicone elastomer specimens (unmodified and modified) groups. After the gypsum molds were characterized, the fabricated silicone elastomers molded on noncoated and coated gypsum materials were evaluated further. Energy-dispersive X-ray spectroscopy (EDX) analysis of gypsum materials (noncoated and coated) and silicone elastomer specimens (unmodified and modified) was performed to evaluate the elemental changes after coating was conducted. Independent t test was used to analyze the differences in the surface roughness of unmodified and modified silicone at a significance level of p < 0.05. Roughness was significantly reduced in the silicone elastomers processed against coated gypsum materials (p < 0.001). The AFM and SEM analysis results showed evident differences in surface smoothness. EDX data further revealed the presence of the desired chemical components on the surface layer of unmodified and modified silicone elastomers. Silicone elastomers with lower surface roughness of maxillofacial prostheses can be obtained simply by coating a gypsum mold.

Maxillofacial Prosthetic Materials -An Update

Body abnormalities or defects that compromise appearance, function may make an individual, incapable of leading a relatively normal life. Faci al disfigurement can be the result of a congenital anomaly, trauma or tumour surgery. Surgical reconstruction may not be possible owing to size or location of the defect. The patient's medical condi tion or personal desires may also preclude reconstructive surgery. In such cases, prosthetic r ehabilitation is indicated. A facial prosthesis res tores normal anatomy and appearance, protects the tissues of a defect, and provides great psychological benefits to the patient. A number of materials are available and have been used for fabrication of maxillofacial prosthesis; the aim of this article i s to provide some insight about the currently used maxillofacial prosthetic materials.

Maxillofacial prosthetic materials- an inclination towards silicones.

There have been constant searches and researches which are taking place in the field of dental materials to best suit the ideal selection criteria to satisfy the functionality, biocompatibility, aesthetics as well as the durability as a maxillofacial material. Among all the different materials, Silicone is the most popularly used, but still studies are carried out to overcome their weaknesses and to come out with a material which can be labeled as the "ideal maxillofacial prosthetic material". This article comprises the materials which were and are in use and the reason for their unpopularity. It also gives us a scope to understand the major fields where the materials lack and thus needs improvement to render an individual with the best maxillo-facial prosthesis.

Shade Selection: Blending of Conventional and Digital Methods - An Updated Review

ABSTRACT Major challenges in cosmetic dentistry are to accomplish appropriate and satisfactory reproduction of natural shade of teeth. The procedure of choosing a shade can be performed using visual method or by an instrument. The kind of shade guide, individual ability to choose shades and conditions the choice is made under, all have influence on reliability and accuracy of the procedure. Therefore, it is necessary to introduce instrumental color determination in everyday work. They include RGB devices, colorimeters, spectrophotometers. The impact of the color science can be seen on various restorative materials ranging from ceramics to maxillofacial prosthetic materials. Good communication between the dental team of all these details is paramount to a successful aesthetic result.

Evaluation of two different reinforcing materials used with silicone auricular prostheses

ObjectiveClinical and laboratory evaluation of the effect of addition of polyurethane sheets or polypropylene fibers as reinforcing materials to silicone that was used in auricular prostheses. Materials and methodsFifteen patients with a history of acquired auricular defects were divided into three equal groups. Group I patients received silicone prostheses (control group), Group II patients received silicone prostheses lined with polyurethane sheets, and Group III patients received silicone prostheses reinforced with polypropylene fibers. The final prostheses were made from medical grade silicone rubber (RTV, MDX4-4210). The basic principles for construction of successful auricular prosthesis were followed. ResultsClinical evaluation of this study revealed an acceptable and well tolerated use of modified silicone ear prostheses either silicone lined with polyurethane sheets or silicone reinforced with polypropylene fibers. ConclusionNone of the tested prostheses showed any clinically detrimental effects on the underlying tissues. Reinforcing silicone with polyurethane sheets and polypropylene fibers improved the tear strength, tensile strength and modulus of elasticity thus providing better marginal integrity and durability of prostheses. Addition for modifying the silicone as a famous maxillofacial prosthetic material seems to be an active area for further researches.

The Effect of Different Storage Conditions on the Physical Properties of Pigmented Medical Grade I Silicone Maxillofacial Material

Objective. This study aimed to evaluate the effect of different storage solutions that simulate acidic, alkaline, and sebum conditiions on the physical properties of pigmented (colorant elastomer) cosmesil M511 maxillofacial prosthetic material. Materials and Methods. Sixty specimens were prepared according to the manufacturer's instructions and were tested before and after immersion of different storage conditions for six months at 37 °C. The following tests were performed: color changes (group I), solution absorption (group II), surface roughness (group III), and scanning electron microscopy (group IV). Results. There were no significant changes observed in the color and solution absorption tests while surface roughness revealed significant difference between control group and other testing storage medium groups, and this result was supported by SEM analysis that revealed limited surface changes. Conclusions. Cosmaseil material is an acceptable cross-linked formulation that withstands storage in different solutions with variable pH. The addition of pigment cannot vary the physical properties of these materials. Surface roughness test as well as SEM microscopic study showed moderate changes indicating a limited effect on the surface of the material.

Light weight prosthesis for a patient with bilateral orbital exenteration—A clinical report

PatientThis article describes a case report of a patient with history of bilateral orbital exenteration due to squamous cell carcinoma. Spectacle retained acrylic prosthesis was considered to be the best possible option in this case due to total lack of vision and related manual dexterity. DiscussionMain challenge in fabrication of spectacle retained prosthesis is to maintain its adaptation with the tissues during attachment of the screws. So, method of attachment of prostheses with the frame has been discussed in detail. The other concern was the increased weight of the prosthesis and associated discomfort to the patient, as both artificial eyes had to be attached to one frame. Therefore, procedure to reduce the weight of the prosthesis is also discussed. ConclusionSuccessful prosthodontic rehabilitation is based on the selection of most suitable maxillofacial prosthetic material and appropriate retentive aid for each patient. Though spectacle retained acrylic prosthesis is a conventional method, it was a user friendly and economical option for this patient.

Role of colors in prosthodontics: Application of color science in restorative dentistry

Shade selection procedure depends on various factors including translucency, contour and surface texture. Tooth shade selection using a conventional means involves a high degree of subjectivity. Traditional shade guides are available that use several methods for quantifying shade. Technology-based systems provide with an advantage of natural looking restorations. They include RGB devices, colorimeters, spectrophotometers. The impact of the color science can be seen on various restorative materials ranging from ceramics to maxillofacial prosthetic materials.

Measuring the Color of Maxillofacial Prosthetic Material

Color information from different color-measuring systems varies during color matching in maxillofacial prosthetics. We studied the hypothesis that a non-contact measuring system and 4 contact color-measuring instruments perform comparably in accuracy and precision on measurements of pigmented maxillofacial elastomer specimens having human skin colors. Measurement comparisons in accuracy on opaque standard color patches were made in Phase I. In Phase II, the system with the best accuracy was used as the reference instrument, and comparisons in accuracy and precision on elastomer specimens were made. The CIEDE2000 color difference formula was used. Repeated-measures ANOVA with Tukey testing and linear regression analysis for CIELAB and color differences among the instruments were performed. The contact measuring systems perform differently in accuracy, possibly due to edge loss and other factors, but performed comparably in precision with the non-contact measuring instrument. This non-contact system is recommended for color measurement of maxillofacial prosthetic materials.