Effect of in vivo aging on the surface and electrochemical properties of magnetic attachments used in facial prostheses: A retrieval analysis study.

STATEMENT OF PROBLEM: Reasons associated with the failure of facial prosthesis are of major concern and may be associated with deterioration of both elastomeric materials and magnetic attachments. However, the extent of deterioration of these components is unclear. PURPOSE: The purpose of this in vitro study was to evaluate selected retrieved facial prostheses and provide information regarding the electrochemical characterization of the recovered magnetic attachments. MATERIAL AND METHODS: Five facial prostheses (RP1, RP2, RP3, RP4, RP5) fabricated at the University of Texas, M.D. Anderson Cancer Center were retrieved following clinical use. The intaglio and external surfaces of the prostheses along with the incorporated magnetic attachments were photographed. The areas with the detected failures on the retrieved prostheses, as well as the recovered magnetic attachments, were evaluated under a reflected light stereomicroscope at ×16 nominal magnification and photographed with a digital camera. Five magnetic attachments recovered from the prostheses (retrieved group RT) were evaluated for degradation of their corrosion resistance after electrochemical testing in artificial sweat solution and were compared with 5 unused magnetic attachments (control group, CT). To identify the elemental composition of the intact magnet surface, 1 specimen from the control group was investigated by X-ray energy dispersive spectroscopy (EDS). Means and standard deviations of the open circuit potential (EOCP), the zero-circuit potential (Ecorr), and Icorr were calculated and statistically analyzed by a t test (α=.05 for all tests). RESULTS: The main reasons of failure were discoloration, degradation and rupture of the silicone elastomer, marginal misfit, and delamination of the polyurethane sheet. Additional findings were tarnish and discoloration of the magnetic attachments accompanied by considerable smear build-up. EDS results verified the Ni plating of tested magnets. Electrochemical testing revealed that retrieved magnets showed significantly lower OCP (P<.001) and Ecorr (P<.001) but similar Icorr (P=0.083) while the pseudopassivity region of unused magnets vanished in the retrieved group, denoting a degradation of electrochemical properties after clinical use. CONCLUSIONS: In vivo aging exerts extended degradation on the elastomer part of facial prostheses as well as deterioration of their surface integrity and electrochemical properties.

Incorporation of the Altered Cast Technique in the Fabrication Workflow of an Implant-Assisted Removable Partial Denture (IARPD) for an Elderly Patient.

Implants are currently used to serve as abutments for implant-assisted removable partial dentures (IARPDs) to facilitate retention and support of the prosthesis. Implants are proposed in cases of posterior edentulous areas to convert Kennedy Class I or II to Class III or when the preparation of existing teeth to serve as abutments is contraindicated. The purpose of this report is to describe the protocol applied to fabricate an IARPD to restore a Kennedy Class II mandible of an elderly patient by incorporating traditional methods, such as the altered cast technique. Each step of the clinical procedure is thoroughly illustrated to document the selected appointment sequence. The patient was satisfied with the delivered prosthesis that demanded no additional implants to be placed but exploitation of an existing one. IARPDs are a viable and cost-effective solution substantiated by numerous reports with positive effects on patient satisfaction.

Effect of spatial arrangement and clinical service lifetime simulation on the retention of magnetic units used in implant-anchored orbital prostheses.

STATEMENT OF PROBLEM: Evidence for the optimal spatial arrangement of magnetic attachments in implant-supported orbital prostheses is lacking. PURPOSE: The purpose of this in vitro study was to assess the effect of 6 different spatial arrangements on the retentive force of magnetic attachments following the in vitro simulation of clinical service by insertion-removal test cycles and the contribution of artificial aging to the morphological alterations induced on the magnetic surfaces. MATERIAL AND METHODS: Ni-Cu-Ni plated disk-shaped neodymium (Nd) magnetic units (d=5 mm, h=1.6 mm) were secured on leveled (50×50×5 mm, n=3) and angled (40×45×40 mm, interior angle=90 degrees, n=3) pairs of test panels in 6 different spatial arrangements: triangular_leveled (TL), triangular_angled (TA), square_leveled (SL), square_angled (SA), circular_leveled (CL), and circular_angled (CA) generating corresponding test assemblies (N=6). TL and TA arrangements included 3 magnetic units (3-magnet groups) and SL, SA, CL, and CA 4 (4-magnet groups). The retentive force (N) was measured at a mean crosshead speed of 10 mm/min (n=10). Each test assembly was subjected to insertion-removal test cycles with a 9-mm amplitude, ν=0.1 Hz, and n=10 consequent retentive force measurements at a crosshead speed of 10 mm/min at 540, 1080, 1620, and 2160 test cycles. Surface roughness alterations following the 2160 test cycles were measured by calculating the Sa, Sz, Sq, Sdr, Sc, and Sv parameters with an optical interferometric profiler with 5 new magnetic units used as a control group. Data were analyzed with 1-way ANOVA and Tukey HSD post hoc tests (α=.05). RESULTS: The 4-magnet groups had statistically significantly higher retentive force than the 3-magnet ones at baseline and following the 2160 test cycles (P<.05). In the 4-magnet group, the ranking at baseline was SA.05). CONCLUSIONS: Four magnetic attachments placed on an SL spatial arrangement resulted in the highest retention force but presented with the highest force reduction following the in vitro simulation of clinical service by insertion-removal test cycles.

Prosthodontic restoration of a COVID-19 associated mucormycosis defect: A clinical report.

INTRODUCTION: Coronavirus Disease 2019 (COVID-19) pandemic brought the clinical practice of dentistry and prosthodontics at the threshold of a new era, due to the increasing prevalence of a relative rare condition normally affecting the immunocompromised patients. AIM: The aim of this clinical case report is to briefly describe the etiopathogenesis, the surgical and prosthodontic management of this evolving medical condition emphasizing the emerging role of the maxillofacial prosthodontist in restoring the patients' well-being. METHODS AND RESULTS: The surgical and prosthodontic rehabilitation of a COVID-19 infected patient with a mucormycotic lesion of the maxilla will be presented. CONCLUSION: The role of the maxillofacial prosthodontist is important in alleviating this severe COVID-19 associated morbidity.

Chairside transformation of a removable partial denture to a transitional complete denture to alleviate an impaired stroke patient: A case report.

BACKGROUND: The purpose of this clinical report is to present a technique for transformation of an existing removable partial denture (RPD) into a transitional complete denture (CD) for an impaired stroke patient. CASE PRESENTATION: A 67-year-old male who underwent an ischemic stroke 12 months ago presented in the Postgraduate Clinic of the National and Kapodistrian University of Athens, requiring treatment of his remaining teeth and repair of his existing RPD which lacked retention and stability. The treatment plan included placement of amalgam plugs on the remaining teeth which were decoronated due to poor prognosis and modification of the existing RPD to a transitional CD. The procedure included one alginate impression and chairside alteration of the prosthesis with simple means. The new prosthesis managed to improve patient's masticatory ability and reduce the risk for aspiration pneumonia. CONCLUSION: In the present case report a technique for modifying an existing RPD into a transitional CD for an impaired, stroke patient is described. Reduced treatment time, costs and patient's inconvenience while embracing the benefits provided by the utilization of an existing prosthesis regarding adaptation of the neuromuscular system are among the advantages of the described technique.

Effectiveness of prosthetic rehabilitation and quality of life of older edentulous head and neck cancer survivors following resection of the maxilla: a cross-sectional study.

PURPOSE: To evaluate the effectiveness of prosthetic rehabilitation, as well as the quality of life (QOL) of older edentulous maxillectomy patients. METHODS: Effectiveness of the complete denture obturator prosthesis and QOL of N = 44 older edentulous patients who had resection of the maxilla and were restored with a definitive prosthesis that was in use for a minimum of 1 year was assessed using three instruments: European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30), Head and Neck Cancer Module (QLQ-HN35), and Obturator Functioning Scale (OFS). Data analysis was performed by one-way analysis of variance (ANOVA) on ranks, Spearman rank-order correlation, and hierarchical multivariable rank regression at α = .05 level of significance. RESULTS: Participants' gender (P < .001), adjuvant treatment (P = .016), surgical approach (P = .017), size of the maxillary defect (P = .028), participants' prosthetic history (P = .047), and dental status of the mandible (P = .038) were significantly related to the self-reported effectiveness of the complete denture obturator prosthesis. Perceived functioning of the prosthesis (P = .001), participants' gender (P = .002), the American Society of Anesthesiologists (ASA) physical status (P = .027), and surgical approach (P = .039) were significant predictors of QOL. CONCLUSION: Restoration of the edentulous maxillectomy defect is challenging. An effective definitive complete denture obturator appeared to be the strongest predictor for advanced quality of life in older maxillectomy patients. The physical status of the older participants significantly affected the overall QOL, but did not influence the self-reported functioning of the complete denture obturator prosthesis.

Quality of life in patients with soft palate resection: The relationship between reported functional prosthetic outcomes and the patient's psychological adjustment.

STATEMENT OF PROBLEM: Tumors of the soft palate and the adjacent tissues often create considerable soft palate defects that are challenging for the maxillofacial prosthodontist. Soft palate obturator prostheses can usually address functional and esthetic concerns; however, the effectiveness of the prosthetic rehabilitation in improving the patient's well-being and overall quality of life (QOL) has not been extensively researched. PURPOSE: The purpose of the present research was to evaluate the function of the prosthesis, to review the interrelation between sociodemographic, medical, and treatment (SMT) characteristics, QOL, and prosthesis functioning, and to analyze the role of the prosthesis in how the patient represents the illness and the psychological coping response. MATERIAL AND METHODS: Thirty-three patients who underwent resection of the soft palate and had been using a technically successful soft palate obturator prosthesis for at least 1 year were interviewed by means of 5 questionnaires: European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30), Head and Neck Cancer Module (QLQ-HN35), Obturator Functioning Scale (OFS), Illness Perceptions Questionnaire (IPQ-R), and Mental Adjustment to Cancer Scale (MAC). Data analysis was performed at α=.01. RESULTS: The QOL (r=-0.53, P=.001), personal control (r=-0.53, P=.001), negative adjustment to cancer (r=0.47, P=.005), treatment control (r=-0.55, P=.001), consequences (r=0.62, P<.001), and emotional representations (r=0.30, P=.009) were significantly related to prosthesis functioning. Better QOL was significantly related to prosthesis functioning (P=.006), age (P=.001), sex (P=.011), and type of soft palate defect (P=.009). The most important predictors of favorable soft palate obturator functioning were age (P<.001) and type of soft palate defect (P=.01). CONCLUSIONS: A patient-perceived effective soft palate obturator prosthesis was a significant predictor for advanced QOL, better adjustment to illness and illness-related disabilities, as well as the overall coping response to cancer.

Effects of sociodemographic, treatment variables, and medical characteristics on quality of life of patients with maxillectomy restored with obturator prostheses.

STATEMENT OF PROBLEM: Restoration of maxillary defects resulting from tumor ablative surgery presents a difficult challenge, with both functional and esthetic issues. Whether rehabilitation with an obturator prosthesis could significantly contribute to improved quality of life in patients with maxillary resection has been scarcely studied, with relatively small study samples. PURPOSE: The purpose of this survey study was to assess the overall functioning of the obturator prosthesis and the effect of specific sociodemographic, medical, and treatment variables on obturator functioning and quality of life in patients with maxillectomy. MATERIAL AND METHODS: Global quality of life (QOL) and satisfaction with the obturator prosthesis of 57 patients who underwent maxillectomy and prosthetic rehabilitation at the National and Kapodistrian University of Athens were assessed using 3 questionnaires: European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30), the EORTC QLQ-HN35, and the obturator functioning scale. The data were analyzed using the Kruskal-Wallis 1-way ANOVA on ranks, hierarchical multiple regression analysis, and the Spearman rank order correlation (α=.05). RESULTS: Satisfactory functioning of the obturator prosthesis was the most significant predictor of improved QOL (P<.05). QOL was significantly related to additional treatments (P<.05), the size of the primary tumor (P<.05), and the size of the maxillectomy defect (P<.05). The most significant predictors of good obturator functioning were additional treatments (P<.01), age at the time of surgery (P<.05), presence of mandibular teeth (P<.05), and previous maxillary removable prosthetic experience (P<.05). Obturator functioning scale appearance and insertion subscales (r=0.47, P<.01), followed by speech (r=0.42, P<.01), were significantly related to better QOL. CONCLUSIONS: A well-functioning obturator prosthesis was the most significant determinant for improved QOL in patients with maxillary resection. Age at the time of surgery, adjuvant treatments, presence of mandibular teeth, and previous maxillary removable prosthetic experience were the most significant predictors for better obturator functioning, whereas the size of the maxillectomy defect had a significant effect on QOL but did not influence the functional outcome.

Prosthodontic Management and Treatment Considerations for an HIV-Positive Patient with a Nonhealing Lesion of the Maxilla: A Clinical Case History Report.

Osteonecrosis of the jaws has recently been associated with HIV infection and requires surgical and prosthetic intervention. The prosthetic management of an HIV patient with a maxillary lesion, as well as medical status-related treatment considerations, are discussed in this article.

Porosity of maxillofacial silicone elastomers and microleakage pattern of the commercially pure Ti-silicone elastomer interface after hydrothermal cycling.

STATEMENT OF PROBLEM: Delamination of the maxillofacial silicone elastomer away from the commercially pure titanium (cpTi)-encapsulated magnets affects the long-term performance of the facial restoration. PURPOSE: The purposes of this in vitro study were to investigate the interfacial microleakage patterns of 2 maxillofacial silicone elastomers with cpTi when 3 different primers were used and to evaluate the porosity of the 2 elastomers tested. MATERIAL AND METHODS: To test the interfacial microleakage patterns of the 2 elastomers MDX4-4210 (EL1) and A-2006 (EL2) with cpTi when 3 metal primers, A-304 (PR1), A-320 bonding enhancer (PR2), Super-Bond C&B monomer (PR3), and ethyl-cyanoacrylate (Super Glue) were used, the bonded interfaces were observed using reflected light microscopy, and the percentage of the linear extent of leakage along the interface (%microleakage) was measured. High-resolution x-ray computed microtomography scanning was used to investigate the percentage of void volume fraction (%VF) for both silicone EL1 and EL2. The data were analyzed with 2-way ANOVA and post hoc tests (α=.05). RESULTS: No statistically significant differences were found among the percentages of PR1, PR2, and PR3 microleakage, whereas ethyl-cyanoacrylate showed a statistically significant higher percentage of microleakage than either of the silicone elastomers (P<.001). EL1 medical grade elastomer groups have always had a statistically significantly higher percentage of microleakage than the EL2 platinum silicone elastomer groups (P<.001). For both elastomers, no statistically significant differences were found in %VF (P=.056). CONCLUSIONS: Differences in mechanical properties, chemical composition, and manipulations during handling of the maxillofacial silicone elastomers can affect the linear microleakage along the cpTi-silicone elastomer bonding interface and the porosity of the silicone elastomer.

Modified PEEK Resin Bonded Fixed Dental Prosthesis for a Young Cleft Lip and Palate Patient.

OBJECTIVE: This clinical report presents the use of a modified poly ether-ether ketone material as an alternative material for the fabrication of resin-bonded fixed dental prosthesis (RBFDP) framework. This new material can be used for patients allergic to metals, maintaining the same high esthetic demand of ceramics, presenting light weightness and a flexibility similar to bone as a distinct advantage over ceramic materials. CONCLUSIONS: The use of a BioHPP RBFDP framework could be considered as an alternative restoration for the replacement of missing lateral incisors in young patients with cleft palate defects. CLINICAL SIGNIFICANCE: This modified PEEK material known as BioHPP, is a biocompatible, non allergic, rigid material with good mechanical properties, wear resistance, chemical stability, high polishing and low absorption properties. BioHPP frameworks can be manufactured either via CAD/CAM or via the conventional lost wax technique. The low modulus of elasticity, combined with the use of indirect composite resin as a veneering material, provide a distinct advantage over ceramics or metal ceramics on dampening the occlusal forces, reducing the risk of debonding. (J Esthet Restor Dent 28:201-207, 2016).

Prosthetic Rehabilitation of a Complex Maxillofacial Defect as an Alternative to Surgical Reconstruction: A Case History Report.

Free tissue transfers are used to restore maxillofacial resected tissues during tumor ablative surgery. The maxillofacial prosthodontist remains an integral member of the therapeutic team, since conventional retained facial prostheses are in certain cases the most practical, trouble-free, cost-efficient, and successful means of rehabilitation.

Peel strength and interfacial characterization of maxillofacial silicone elastomers bonded to titanium.

OBJECTIVES: To investigate the effect of three adhesive primers on the morphology, chemistry and peel bond strength of two maxillofacial silicone elastomers with commercially pure titanium (cpTi). METHODS: The effect of three primers (PR2:A-304 Primer/A-320 Bonding Enhancer, PR3:Super Bond, and PR4:Super Glue) on cpTi morphology and chemistry were studied by reflected light polarized microscopy (RPOLM) and reflection Fourier-transform infrared microspectroscopy (RFTIRM). For testing the bond strength between two elastomers (EL1:MDX4-4210, EL2:A-2006) and primed cpTi surfaces, a 90° T peel test was performed (PBS), using as reference EL1, EL2 specimens bonded to heat-cured poly(methyl methacrylate) resin (PMMA) primed with A-330G primer (PR1). Failure modes were analyzed under a stereomicroscope, and the percentage of remaining silicone (RS%) on cpTi and PMMA were calculated by image analysis. Scanning electron microscopy/energy dispersive X-ray spectrometry (SEM/EDX) was used to investigate representative failure patterns on cpTi. Data were analyzed with Weibull analysis, ANOVA plus post hoc tests, and Pearson correlation coefficient (a=0.05). RESULTS: Thick-irregular (PR2), thin-smooth (PR3), and uniform-porous (PR4) films were identified on cpTi by RPOLM. RFTIRM revealed: a strong peak of Si-O-Si with a distribution following the outline of the image (PR2); COO-M groups developed, but unevenly distributed (PR3); and reduction in CC groups due to in situ polymerization (PR4). Following PBS, the ranking of the statistical significant differences in Weibull scale parameter (σ0) of the EL1 group was PMMA_PR1>cpTi_PR2,cpTi_PR3>cpTi_PR4, whereas for the EL2 group cpTi_PR2>PMMA_PR1>cpTi_PR4,cpTi_PR3. For RS%, the ranking in the EL1 group was: PMMA_PR1>cpTi_PR2>cpTi_PR3>cpTi_PR4, and in the EL2 cpTi_PR2>cpTi_PR3>cpTi_PR4,PMMA_PR1. There was no statistically significant correlation between PBS and RS%, with the exception of EL1_PMMA_PR1. In all groups mixed failure modes were found by SEM/EDX. SIGNIFICANCE: Although there is evidence of bonding with cpTi, there are important differences among the primer/elastomer combination that may affect the clinical performance of these materials.

In vitro staining effects of stannous fluoride and sodium fluoride on ceramic material.

STATEMENT OF PROBLEM: Long-term fluoride application on the teeth of patients receiving radiation therapy for head and neck tumors results in excessive staining and roughening of ceramic restorations. PURPOSE: The purpose of this in vitro study was to compare the staining effects of 2 fluoride treatments on ceramic disks by simulating 1 year of clinical exposure at 10 minutes per day. In addition, 2 different surface preparations were tested. MATERIAL AND METHODS: Eighty ceramic disks (IPS Empress), 20 x 2 mm, were fabricated. Half of the disks were glazed, and the remaining disks were polished. All disks were brushed for 3 minutes with a soft-bristle power toothbrush and mild dentifrice (baseline) and were immersed in 1 of the 2 fluoride products (0.4% SnF(2), Gel-Kam Gel, or 1.1% NaF, Prevident 5000) for 10 days (n=20). Means and standard deviations of color change (Delta E), surface roughness (Ra, um), and surface gloss (GU) of the ceramic material were measured with a reflection spectrophotometer, a profilometer, and a gloss meter, respectively, at baseline and after fluoride treatment. Two- and 3-way ANOVA (alpha=.05), with surface preparation (polished vs. glazed) and fluoride treatment (0.4% SnF(2) or 1.1% NaF) as independent variables and condition (baseline vs. after fluoride treatment) as a repeated measure, was used to analyze the data. Fisher's PLSD intervals (alpha=.05) were calculated for comparisons among the means. RESULTS: The polished specimens had significantly higher Delta E values, significantly higher surface gloss values, and significantly lower surface roughness values than the glazed specimens before fluoride treatment (P<.001). After both fluoride treatments, ceramic disks exhibited significantly higher surface roughness values when polished and significantly lower surface gloss values when glazed or polished (P<.001). The glazed specimens presented significantly higher surface roughness (P<.001) and lower surface gloss values (P<.001) when treated with 0.4% SnF(2) as compared to NaF. For the polished specimens, there was no significant difference in surface roughness and surface gloss values between the 2 fluoride treatments. CONCLUSIONS: Use of 0.4% SnF(2) and 1.1% NaF gels, in vitro, caused significant color change in the polished IPS Empress ceramic disks. Polishing of the ceramic surface before immersion in either fluoride agent caused the ceramic tested to be more resistant to etching by the 2 solutions tested. The NaF caused less deterioration of the porcelain surface and was less stain inducing than SnF(2).

Prosthodontic rehabilitation of a 10-year-old ectodermal dysplasia patient using provisional implants.

Ectodermal dysplasia (ED) is a hereditary condition diagnosed in childhood that is characterized by developmental and morphological abnormalities of anatomic structures derived from the ectoderm. Multidisciplinary management and team approach are important to ensure the patient's quality of life and to provide the family members with needed support. Several conventional prosthetic treatment regimens have been available for the oral rehabilitation of ED patients, but definitive dental implants still remain a challenge for the growing patient. The purpose of this clinical report was to describe the use of provisional implants in the prosthodontic management of a young ectodermal dysplasia patient.

Materials used in prefabricated post and core systems. A review of the literature.

A plethora of prefabricated post and core materials is currently available for the restoration of endodontically treated teeth. The materials presented demonstrate a variety of mechanical properties and esthetic potential, while the selection of the optimum post and core system depends upon clinical judgment and the specific clinical situation.

Effect of core diameter and surface treatment on the retention of resin composite cores to prefabricated endodontic posts.

PURPOSE: With advances in adhesive dentistry and current emphasis on esthetic restorations, dowel systems have been developed to take advantage of these new techniques. Of interest when using these systems is the interaction between core materials and post materials. This investigation compared the tensile retentive force of two resin composite core materials to two metallic and one non-metallic prefabricated endodontic posts. Two dimensions of core build-up and two post-surface treatments were tested. MATERIALS AND METHODS: One hundred twenty posts (stainless steel, titanium alloy, and glass fiber-impregnated resin) were secured in a jig with 4 mm of the post extending into a cylindrical matrix. The matrix formed cylinders with diameters of 3 and 5 mm into which resin composite was inserted. The posts were treated or not treated with a bonding agent. After storage for 24 hours at 100% humidity, five specimens per condition were tested in an Instron testing machine at a crosshead speed of 0.5 mm/min. Failure loads were recorded in kilograms and failure modes were observed under light microscopy (40 x). Four-way analysis of variance and multiple comparison testing were used to compare means at the 0.05 level of significance. RESULTS: The means and standard deviations of tensile loads were calculated. All variables were significant in either main effects or interactions ( p<0.05). Fisher's PLSD intervals for post, core, treatment, and diameter were 2.0, 1.6, 1.6, and 1.6 kg, respectively. In most cases, the retentive force recorded for metallic posts was higher than that of glass fiber posts. Titanium posts had higher retentive forces than did the stainless steel posts. For metallic posts, 5-mm cores provided higher forces than 3-mm cores. In the glass fiber group, core diameter was not significant. For core materials, Build-It gave higher results with stainless steel posts, and FluoroCore gave higher results with the titanium ones. The surface treatment results were mixed. In the metallic post groups the adhesive failure data ranged between 80% and 100%, whereas in the glass fiber post groups, adhesive failures ranged between 60% and 70%. CONCLUSIONS: Within the limitations of this study, the metallic post groups always provided higher tensile retentive forces, with the titanium post groups showing higher retentive forces than the stainless steel ones. In the glass fiber post groups, different core diameters did not affect retention values.

Stent fabrication for graft immobilization following wide surgical excision of myofibroblastic sarcoma of the buccal mucosa: a clinical report.

Sarcomas of the head and neck are rare tumors derived from cells of mesenchymal origin. This article briefly discusses the epidemiology, etiology, and classification of head and neck sarcomas. Emphasis is placed on myofibrosarcoma, a malignant tumor of the myofibroblasts. Histologic criteria, prognostic factors, and the multidisciplinary management of these tumors are reviewed. A situation of a surgically excised myofibrosarcoma of the buccal mucosa is reported. In this patient, a stent was fabricated to stabilize a split-thickness skin graft used for the buccal mucosa reconstruction.

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.

Postsurgical use of prosthetic palatal appliances. Two case reports.

Patients with cleft lip or palate encounter a myriad of difficulties in their early years of life, some of which begin at birth. The defect often impairs suckling and deglutition in the neonate. It can hinder appropriate speech development and may impose undue social and psychological stresses. Surgical and orthodontic interventions are essential and prosthetic palatal appliances play an important role not only throughout the patient's treatment course, but also in the treatment of unfavorable surgical sequelae.