A custom positioning aid for an auricular prosthesis: A clinical report.

This report describes the treatment of a 68-year-old man with basosquamous cell carcinoma of the left auricular area. His oncologic treatment resulted in the loss of his left ear and much of the left temporal bone. The loss of a significant portion of the temporal bone precluded the use of extraoral implants. Owing to the lack of anatomic landmarks after his surgical treatment, positioning his auricular prosthesis proved challenging. The fabrication of his prosthesis and a custom positioning aid are described.

A technique to orient a stone cast in the fabrication of a nasal prosthesis.

Obtaining the correct orientation of the stone cast in the fabrication of a nasal prosthesis is a challenging task. The current technique involves repeated trials of the waxed nasal prosthesis on the patient's face to establish its correct position. This article proposes a simplified technique to aid in establishing the proper orientation of the stone cast in an effort to decrease the number of error corrections related to midline discrepancies during the wax sculpting stage.

Extraoral Maxillofacial Prosthetic Materials: Results of the 2020 International Survey.

PURPOSE: 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. MATERIALS AND METHODS: A 43-question survey was administered via Qualtrics to the members of the American Academy of Maxillofacial Prosthetics (AAMP), the International Anaplastology Association (IAA), and the International Society of Maxillofacial Rehabilitation (ISMR). 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. RESULTS: In total, 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 fees ranging from $10 to $5,500 USD. CONCLUSIONS: 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. Int J Prosthodont 2023;36:570-580.

Maxillofacial rehabilitation of a microstomic patient after resection of nose, lip, and maxilla.

Few published reports have addressed the issues related to upper lip reconstruction. The present clinical report describes the maxillofacial rehabilitation of an edentulous patient who had been diagnosed with squamous cell carcinoma of the nasal septum and contiguous structures. The patient underwent total rhinectomy, anterior maxillectomy, and maxillary lip resection. Her maxillary lip was reconstructed with a bilateral cheek advancement flap, which allowed primary closure of the lip and aided in maintaining function of the orbicularis oris muscle. Microstomia was anticipated and was a consequence of this procedure. During primary resection, and before chemoradiotherapy, dental implants were successfully placed in the maxilla. These implants helped to retain a maxillary obturator prosthesis, which, in turn, helped to retain a silicone nasal prosthesis that restored the nasal defect. An intranasal acrylic resin framework with magnets aided in connecting the extraoral prosthesis with the intraoral prosthesis. The surgical and prosthodontic advantages of a cheek advancement flap and the treatment challenges in a microstomic patient are discussed.

Survey of currently used materials for fabrication of extraoral maxillofacial prostheses in North America, Europe, Asia, and Australia.

PURPOSE: The purpose of this survey was to review the extraoral maxillofacial materials currently used as well as the advantages and disadvantages of the materials in the fabrication of facial prostheses. Results of this survey will enhance scientific knowledge, generate research study ideas, and possibly lead to production of alternative or new maxillofacial materials. MATERIAL AND METHODS: A 47-question survey was delivered via e-mail to all members (combined total of 260 members) of the American Anaplastology Association (AAA) and American Academy of Maxillofacial Prosthetics (AAMP) for evaluation of personal preference involving maxillofacial prosthetic materials (intrinsic/extrinsic silicone elastomers and pigments/colorants used, polymerization/curing process, advantages and disadvantages of the most often used materials, most important characteristic of material/technique used). RESULTS: The views of 43 (16%) respondents indicated that the majority surveyed were using room temperature-vulcanized (RTV) silicone products. Silicone pigments for intrinsic and silicone pastes for extrinsic coloring were favored over artist's oil colors and dry earth pigments. The polymerization process and/or curing times and temperatures for the same silicone material varied between users. The top five advantages of most often used materials were good esthetics, ease of coloring, easy manipulation, thin margins possible, and adhesive compatibility. The top five disadvantages were discoloration over time, technique-sensitivity, lack of repairability, extrinsic colors peel/fade, and lack of longevity. Nontoxic/nonallergenic materials with high edge strength and color stability were the most important features when choosing a maxillofacial prosthetic material/technique. CONCLUSIONS: The responses to this survey indicate that the majority of AAA and AAMP members are using or have used a variety of RTV silicones, pigments, and colorants in the quest to provide the best possible facial prosthetic service. Further research is needed to further refine and improve extraoral maxillofacial materials/techniques based on the results of this study.

Digital imaging in the fabrication of ocular prostheses.

Several ocular and orbital disorders require surgical intervention that may result in ocular defects. The associated psychological effect of these defects on the patient requires immediate management and rehabilitation intervention by a team of specialists. The role of the maxillofacial prosthodontist in fabricating an ocular prosthesis with acceptable esthetics to restore facial symmetry and normal appearance for the anophthalmic patient becomes essential. This article presents a technique for fabricating ocular prostheses using the advantages of digital photography.