A survey on utilization and barriers of digital removable prostheses in the US dental education.

PURPOSE: Gaining knowledge on the extent of digital technology implementation in dental education and the barriers to it will help inform future directions to promote the use of such technology and will enhance dental education. This study aimed to investigate the utilization of digitally fabricated removable prostheses and the potential obstacles to implementing such technology in US dental schools. METHODS: A survey was developed and distributed to the restorative dentistry department chairs and postdoctoral prosthodontic program directors. The survey delivery protocol included follow-up emails 1 week, 3 weeks, and 4 weeks after the initial email. The collected data were analyzed descriptively. RESULTS: The response rate was 85% and 45% for predoctoral and postdoctoral prosthodontic programs, respectively. The results showed that 88.06% of the predoctoral programs and 95.65% of the postdoctoral prosthodontic programs implement digital complete dentures in the curriculum; however, the digital removable partial dentures implementation rate was recorded at 70.77% in predoctoral programs and 61.9% in postdoctoral prosthodontic programs. CONCLUSIONS: Dental schools are challenged by cost, design software limitations, IT and laboratory support, and faculty training. Multifaceted support is instrumental in further implementing digital removable prosthodontics into dental education.

Dental Findings and Functional Prosthesis use in Child with Hypohidrotic Ectodermal Dysplasia: A Case Report.

Fabrication of maxillary and mandibular esthetic functional prostheses in a 5-year-old female patient with ectodermal dysplasia is reported. This report presents, clinically and radiographically, the orofacial manifestations of a child diagnosed with hypohidrotic ectodermal dysplasia, along with the construction of removable prosthetic devices.

Speech prosthesis in child patient with ectodermal dysplasia. Case report.

Fabrication of several esthetic speech prostheses in a 4-year-old child patient with ectodermal dysplasia is reported. This report details, clinically and radiographically, effects in a child diagnosed with hypohidrotic ectodermal dysplasia, as well as speech device construction.

Facial reconstruction by biosurgery: cell transplantation versus cell homing.

The face distinguishes one human being from another. When the face is disfigured because of trauma, tumor removal, congenital anomalies, or chronic diseases, the patient has a strong desire for functional and esthetic restoration. Current practice of facial reconstruction using autologous grafts, synthetic fillers, and prostheses is frequently below the surgeon's and patient's expectations. Facial reconstruction is yet to take advantage of recent advances in seemingly unrelated fields of stem cell biology, chemical engineering, biomaterials, and tissue engineering. "Biosurgery," a new concept that we propose, will incorporate novel principles and strategies of bioactive cues, biopolymers, and/or cells to restore facial defects. Small facial defects can likely be reconstructed by cell homing and without cell transplantation. A critical advantage of cell homing is that agilely recruited endogenous cells have the potential to harness the host's innate capacity for regeneration, thus accelerating the rate of regulatory and commercialization processes for product development. Large facial defects, however, may not be restorable without cell delivery per our understanding at this time. New breakthrough in biosurgery will likely originate from integrated strategies of cell biology, cytokine biology, chemical engineering, biomaterials, and tissue engineering. Regardless of cell homing or cell delivery approaches, biosurgery not only will minimize surgical trauma and repetitive procedures, but also produce long-lasting results. At the same time, caution must be exercised against the development of products that lack scientific basis or dogmatic combination of cells, biomaterials, and biomolecules. Together, scientifically derived biosurgery will undoubtedly develop into new technologies that offer increasingly natural reconstruction and/or augmentation of the face.

Computer-aided design and rapid manufacture of an orbital prosthesis.

This clinical report presents a novel approach that integrates a new optical digitizing (scanning) technique, a three-dimensional ocular prostheses database, and the Selective Laser Sintering technique to achieve the computer-aided design and manufacture of an orbital prosthesis. An optical-structured light scanner was used to develop a color digital model of the unaffected orbital contour, which was copied and then mirrored to generate the orbital prosthesis contour data. The ocular prostheses database was applied to ascertain the size and position of the eyeball within the orbital prosthesis. Then, a Selective Laser Sintering machine directly manufactured the wax pattern of the definitive orbital prosthesis from the three-dimensional orbital data. This new approach is time and cost-effective and can be considered an alternative to traditional manual techniques of creating facial prostheses.

Osseointegrated implants and auricular defects: a case series study.

PURPOSE: The objective of this study was to report on the survival rate of 16 patients treated with extraoral implants in the auricular region, analyze treatment outcomes, and discuss important clinical variables encountered during treatment. MATERIALS AND METHODS: Sixteen patients who received extraoral dental implants to retain auricular prostheses between 1987 and 2003 were followed retrospectively. The variables recorded were gender, initial diagnosis, number and size of implants, implant placement date, age at implant placement, history of radiation to the treated field, abutment size, design of initial prosthesis, age of initial prosthesis (when a remake was indicated), date of prosthesis delivery, soft tissue response, grafting procedure, date of last follow-up, and complications. All patients were thoroughly evaluated presurgically by the reconstruction team, which consisted of prosthodontists, a facial prosthetist, and an otolaryngologist. Surgical templates were used for all patients. The criteria for success of the prostheses included marginal accuracy, overall stability and function, symmetry/position, texture, color stability, and patient acceptance. RESULTS: Thirty-nine implants were placed in 16 patients. All 16 patients were completely satisfied with their reconstructions. No surgical complications, implant failures, or prosthetic failures were encountered. Therefore, the survival rate was 100%. Three patients (18.75%) had grade 0, seven (43.75%) had grade 1, five (31.25%) had grade 2, and one (6.25%) had grade 3 soft tissue inflammation. The inflammation completely resolved in 7 of the 13 patients (54%) with hygiene reinforcement or soft tissue reduction. CONCLUSIONS: The survival rate for bone-anchored titanium implants and prostheses was 100%. Bone-anchored titanium implants provided the 16 patients in this study with a safe, reliable, adhesive-free method to anchor auricular prostheses with recovery of normal appearance. Under the guidance of an appropriate implant team, proper positioning of implants was optimized to allow prosthodontic rehabilitation using implant-retained prostheses.

Rapid prototyping technique for creating a radiation shield.

Radiation therapy for the treatment of head and neck skin cancer poses challenges because of the inherently uneven tissue topography of the face and the need to protect surrounding unaffected tissues. The use of a customized radiation shield that combines tissue-equivalent bolus material with protective material addresses these issues. This article describes a technique using rapid prototyping to design and fabricate an extraoral radiation shield. This innovative application provides an expedient, standardized approach for delivering radiotherapy to the face, which is not only more comfortable for the patient, but allows more precise treatment delivery.

Immediate nasal prosthetic rehabilitation following cytomegalovirus erosion: a clinical report.

The immediate prosthetic rehabilitation of a patient with erosive cutaneous cytomegalovirus (CMV) is presented. Although CMV is a major cause of morbidity and mortality in immunocompromised patients, skin lesions are rarely discussed in the literature. Recognition of the susceptibility of medically compromised patients to infections that can cause extraoral and intraoral deformity is essential to prevention, early diagnosis, and prompt intervention of a life-threatening destructive debilitation. A method for rapidly fabricating a nasal prosthesis is described, and the importance of prompt esthetic and psychological rehabilitation is reviewed.