Implant-supported facial prostheses provided by a maxillofacial unit in a U.K. regional hospital: longevity and patient opinions.

PURPOSE: The aim of this study was to acquire information on the types and longevity of implant-retained facial prostheses and the opinions of patients on several factors related to their prostheses. MATERIALS AND METHODS: A survey of 75 maxillofacial prosthetic patients currently under treatment and review at the Maxillofacial Unit, Morriston Regional Hospital was conducted through a 23-question postal questionnaire. These patients were selected as representative of a group of individuals receiving treatment or under review for the fabrication of maxillofacial prostheses. RESULTS: Of the prosthetic replacements, 83% were ear prostheses, 8% nose, 6% eye, and 2% combination prostheses. Of the 47 respondents, 8 (17%) reported that they were currently wearing their original prostheses. The remaining 39 (83%) respondents had all been provided with at least 1 replacement prosthesis. The mean lifetime of the prostheses was found to be 14 months (range: 4-36 months). The majority of replacement prostheses in this study were provided as a result of color fade or wear of the silicone material of the previous prosthesis. Individuals with no previous experience wearing a prosthesis had an unrealistic expectation of their prosthesis longevity, with a mean value of 17.8 months. In comparison, individuals with previous experience had reduced expectations, with a mean of 14.4 months. In terms of the patients' opinions of the overall quality of their prostheses, the results demonstrated that a large number of patients were satisfied. Thirty-five patients rated their prostheses as excellent and 9 as good. At 7-12 months, 4 patients rated their prostheses as excellent and 8 as good. At 13 months, 4 patients rated their prostheses as excellent and 5 as good. CONCLUSIONS: It is important that advice be given to patients on the expected average longevity of their prostheses, together with information on factors affecting the longevity (i.e., environmental staining, cosmetics, and cleaning regimes). In this study, 26% of the replacement prostheses were provided due to color fading of the original prosthesis. This highlights the need for continuing research in the development of materials used for the construction of facial prostheses with improved properties, and in particular, improved color stability.

Titanium plate reconstruction of the osseous defect after harvest of a composite free flap using the deep circumflex iliac artery.

Hernia formation following harvest of bicortical iliac crest bone occurs infrequently as a late complication and may lead to chronic pain at the donor site and rarely to obstruction and strangulation of bowel. We describe the use of a custom-made titanium plate used to reconstruct the iliac donor site following harvest of a DCIA composite free flap. A pre-operative 3D CT and stereolithography model of the ilium are used to fabricate a titanium plate of the desired shape and size. This plate is used to reconstruct the donor site defect at the time of primary surgery. This technique may reduce late complications following DCIA composite free flap harvest.

Alkylphenolic compounds in edible molluscs of the Adriatic Sea (Italy).

This paper reports the first group of results on alkylphenol (APE) contamination of seafood in the Adriatic Sea, in the framework of a national project on the quality of this Sea (PRISMA 2). Nonylphenol (NP), octylphenol (OP), and their ethoxylates (NPE and OPE) were detected in edible molluscs, either filter feeders or predators (clams, mussels, cuttlefishes, and squids), caught from 15 harbors along the Italian coast in the Adriatic Sea in 1997. NP was the compound found always at levels much higher than the other APEs in all the examined species. It reached the maximum concentration of 696 ng/g fresh weight in the squids from the central Adriatic Sea. OP generally occurred at levels 30 times lower than NP. OP was found up to a level of 18.6 ng/g in squids from central Adriatic Sea. OPE was the compound always spotted at the lowest concentrations, up to 0.43 ng/g. NPE was always below the detection limit. The pattern of contamination in the three areas examined was different between bivalve and cephalopod species. No exhaustive risk assessment for marine organisms and human health can be conducted on the basis of these results because data are insufficient. Yet, the occurrence of NP suggests a negligible risk for mussels, which represent the only molluscs for which data are adequate. As to the possible human health implications, the consumption of molluscs of the Adriatic Sea implies APE intakes that are some orders of magnitude lower than those responsible for toxic effects in laboratory animals. Despite these apparently low risks for mussels and human health, the reasons for concern still remain because the levels of alkylphenols found in this study indicate a general contamination of the Adriatic Sea even far from the cost. Furthermore, these levels might represent an unacceptable hazard for other marine organisms. Finally, they contribute to the general environmental estrogen pool.