Simultaneous Implant Placement in a Mandibular Defect Reconstructed With a Free Fibula Graft and Fabrication of a Fixed Metal Porcelain Prosthesis.

This clinical report presents the multidisciplinary treatment approach for a 23-year-old male patient who underwent a total mandibular reconstruction due to trauma in the past and experienced postoperative complications. For his retreatment, exposed fixation plate was removed and infected bone was debrided and then a free fibula graft augmentation with simultaneous implant placement procedure was performed. After an osseointegration period of 6 months, a screw-retained porcelain fused to metal fixed prosthesis was fabricated and delivered.

Quality of life assessment of implant-retained overdentures and fixed metal-acrylic resin prostheses in patients with marginal mandibulectomy.

STATEMENT OF PROBLEM: Several factors affect the prosthetic outcome of patients with mandibular defects. However, it is questionable whether fixed or removable implant-supported prostheses meet the expectations and satisfaction of the patients. The perspectives of these patients are important in managing the prosthetic treatment strategies. PURPOSE: The purpose of this prospective clinical study was to evaluate the satisfaction and oral health-related quality of life of patients with marginal mandibulectomies with implant-retained overdentures and fixed metal-acrylic resin prostheses. MATERIAL AND METHODS: Twenty-two participants with marginal mandibulectomies were included in the study. They completed an oral health impact profile questionnaire designed for patients with edentulism (OHIP-Edent) for the assessment of quality of life and visual analog scales (VASs) to validate their general satisfaction before treatment. Ten participants received 4 implant-retained fixed metal-acrylic resin prostheses, whereas 12 participants were treated with 2 implant-supported overdentures. Six months after delivery of their prostheses, the participants completed the OHIP-Edent questionnaire and VAS again. For the statistical analyses, Student t tests together with descriptive statistics (mean, standard deviation, frequency) were used in the 2 intergroup parameter comparisons that showed normal distribution. The Mann-Whitney U test and Kruskal-Wallis test were used for intergroup comparisons, and the Wilcoxon signed rank test was used for intragroup comparisons. RESULTS: Compared with pretreatment mean values, a statistically significant (P<.05) decrease in mean scores of all OHIP-Edent values and an increase in VAS scores were found in both groups. After patients were treated, their OHIP-Edent values in the group with an overdenture prosthesis were higher than those in the group with a fixed metal-acrylic resin prosthesis (P<.05). CONCLUSIONS: These results demonstrate that implant-retained overdentures and fixed metal-acrylic resin prostheses provide better function and, thus, oral health-related quality of life for patients with marginal mandibulectomies.

Fabrication of an Orbital Prosthesis Combined With Eyebrow Transplantation.

Fabrication of an orbital prosthesis is considered as a challenging procedure as compared to the other facial prosthesis due to the presence of inactive eye movements and the need of artificial hair in order to mimic eyelashes and eyebrows. Generally these structures are sewed or bonded in the silicone. However, deformation or hair loss is observed within time. This deformation is visible especially in the eyebrow. This clinical report represents a patient with an implant supported orbital prosthesis. Patient was not satisfied with the nature of her eyebrow that was sewed in the silicone. Therefore, an alternative approach of eyebrow transplantation was used for the patient. The patient expressed her better satisfaction of this definitive prosthesis supported with eyebrow transplantation.

Assessment of implant stability of patients with and without radiotherapy using resonance frequency analysis.

The purpose of this study was to clinically monitor the stability of dental implants in patients with and without a history of radiotherapy, using resonance frequency analysis over 1 year. The stability of patients with 80 implants was monitored with resonance frequency analysis (Osstell Mentor) over 1 year. Data were assessed with Mann-Whitney U test and correlation analysis. Irradiated maxillary implants showed statistically lower values than the mandibular implants at a significant level (P < .05).

Utilization of a modified bite guard for preventing traumatic macroglossia.

This clinical report describes the treatment of a patient having traumatic macroglossia due to schwannoma in the craniocervical region. Enlarged tongue or macroglossia may compromise vital functions of the patient. To avoid a chronic tongue bite trauma, a bite guard that was inspired from a habit breaker was fabricated. Tongue injury has significantly healed with the use of this appliance, and the patient was able to masticate without biting on his tongue.

Treatment outcome of extraoral implants in the craniofacial region.

Extraoral implants for the retention of facial prosthesis have been used for better support, stability, and retention. Other than the clinical experiences, treatment outcomes of these prostheses should be evaluated for predicting the long-term success. The aim of this study was to evaluate the survival rates and soft tissue responses of extraoral implants. In total, 52 patients were examined, including 16 with auricular defects, 16 with orbital defects, 13 with nasal defects, and 7 with midfacial defects. Data on implant length and location, radiation-treatment history, systemic diseases, and alcohol and cigarette use were collected and assessed, and data on the health of periimplant soft tissue were recorded for all of the defects. Statistical analyses were performed with t and chi2 tests and correlation and regression analyses for the determination of the survival rate. According to results, the defect area has a significant effect on success rate. The overall success rate was found highest in the auricular area and least in the midfacial area. The presence of diabetes, alcohol use, and age were found as significant factors for implant loss, whereas smoking and radiotherapy were found as insignificant.

Fabrication of an auricular prosthesis using computed tomography and rapid prototyping technique.

This article describes the use of computed tomography and rapid prototyping method to produce a wax pattern of a missing ear. Computed tomographic scans were obtained from the patient, and a three-dimensional digital image was produced using a computer-aided design software. Then, the image of the present ear was extracted, and its mirror image was obtained with the software. The pattern of the inverted three-dimensional cast was produced using a rapid prototyping machine. The cast was duplicated in wax of identical dimensions and shape of the opposing ear, and the auricular prosthesis was fabricated with traditional methods.