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1.
Int J Prosthodont ; 34(1): 54-60, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33570520

RESUMEN

PURPOSE: To evaluate the physical and mechanical properties of maxillofacial silicone elastomers following the incorporation of a specific particle size and concentration of nano-titanium dioxide (TiO2) and nano-zinc oxide (ZnO). MATERIALS AND METHODS: Nano-TiO2 and nano-ZnO of 20-nm and 40-nm particle sizes and in 1% and 2% concentrations were chosen. Silicone elastomer samples were prepared according to the manufacturer's recommendations. The nano-oxides were incorporated via hand spatulation. The samples were subsequently tested for hardness and color stability and were then subjected to aging in an aging chamber for 1,008 hours, following which they were again evaluated for hardness, color stability, and surface roughness. RESULTS: A significant change was noted in the physical and mechanical properties post-aging in all the groups. The samples with nano-TiO2 of 40-nm particle size/2% concentration had the highest hardness, while color stability and surface roughness were higher in samples with nano-TiO2 of 20-nm particle size/1% and 2% concentrations, respectively. CONCLUSION: It can be concluded that 20-nm nano-TiO2 particles best maintain the ideal properties of maxillofacial silicone elastomers and can potentially be used as alternative opacifiers when mixed with A-2186 maxillofacial silicone elastomers.


Asunto(s)
Prótesis Maxilofacial , Elastómeros de Silicona , Color , Ensayo de Materiales , Óxidos , Tamaño de la Partícula
2.
Support Care Cancer ; 29(1): 11-15, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32856215

RESUMEN

During the current pandemic scenario, maxillofacial rehabilitation specialists involved with supportive care in cancer must transform its practice to cope with COVID-19 and improve protocols that could quickly return the oral function of complex cancer patients who cannot wait for surgical complex rehabilitation. This includes the role of the maxillofacial prosthodontist for the rehabilitation of surgically treated patients with maxillary cancers by the means of filling obturator prostheses that are considered an optimal scientific-based strategy to reduce hospital stay with excellent pain control, oral function (speech, swallowing, mastication, and facial esthetics), psychologic and quality of life outcomes for the patients following intraoral cancer resection. Therefore, the aim of this commentary was to bring new lights to the strategic use of obturator prostheses for the rehabilitation of oral cancer patients during the COVID-19 pandemic as well as to present a protocol for managing such cases.


Asunto(s)
/epidemiología , Vías Clínicas/organización & administración , Accesibilidad a los Servicios de Salud/organización & administración , Prótesis Maxilofacial , Neoplasias de la Boca/rehabilitación , Obturadores Palatinos , Atención Ambulatoria/métodos , Atención Ambulatoria/organización & administración , Vías Clínicas/normas , Diseño de Prótesis Dental/normas , Estética , Humanos , Reconstrucción Mandibular/instrumentación , Reconstrucción Mandibular/métodos , Reconstrucción Mandibular/normas , Prótesis Maxilofacial/estadística & datos numéricos , Neoplasias de la Boca/cirugía , Ortodoncia/métodos , Ortodoncia/organización & administración , Ortodoncia/normas , Obturadores Palatinos/estadística & datos numéricos , Pandemias , Patología Bucal/organización & administración , Patología Bucal/normas , Calidad de Vida , Flujo de Trabajo
3.
J Contemp Dent Pract ; 21(6): 678-682, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-33025938

RESUMEN

AIMS: The purpose of this study was to assess the influence of hot and dry weather on the hardness and surface roughness of four different maxillofacial silicone elastomeric materials (MFSEM) including two room-temperature vulcanized (RTV) and two high-temperature vulcanized (HTV) materials. MATERIALS AND METHODS: Eighty test specimens were fabricated according to the manufacturer's instructions into rectangular test specimens. The hardness and surface roughness were tested, after 6 months of exposure to natural hot and dry weather. The hardness was measured through the International Rubber Hardness Degree (IRHD) scale using an automated hardness tester. The surface roughness was measured using a novel 3D optical noncontact technique using a combination of a light sectioning microscope and a computer vision system. Statistical Package for Social Sciences software SPSS/version 24 was used for analysis and a comparison between two independent variables was done using an independent t test, while more than two variables were analyzed, F test (ANOVA) to be used followed by a post hoc test to determine the level of significance between every two groups. RESULTS: The hot and dry weather statistically influenced the hardness and surface roughness of MFSEM. Cosmesil M-511 showed the least hardness in test groups while A-2000 showed the hardest material (p < 0.05). A-2000 showed significant changes from rough in case of nonweathered to become smoother in weather followed by A-2186 (p < 0.05). Cosmesil M-511 showed the roughest material. CONCLUSION: Cosmesil M-511 showed the least hard MFSEM after outdoor weathering while A-2000, the highest and least material showed hardness and surface roughness, respectively. CLINICAL IMPLICATION: A-2000 had a high IRHD scale hardness. This makes this material more suitable for the replacement of ear and nose defects. Cosmesil M-511 is soft and easily adaptable material that makes the material more appropriate for the replacement of small facial defect with undercut area to be easily inserted and removed. Whilst A-2000 is smoother and finer in test specimens after weathering, Cosmesil M-511 became rougher after weathering.


Asunto(s)
Prótesis Maxilofacial , Dureza , Ensayo de Materiales , Propiedades de Superficie , Tiempo (Meteorología)
4.
J Oral Sci ; 62(4): 377-381, 2020 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-32741850

RESUMEN

In this study, analytic models were used to simulate marginal resection in the area of the second premolar to the second molar region, and the mechanical effects on the mandible of residual bone mass, a maxillofacial prosthesis, and a reconstruction plate were evaluated by three-dimensional finite element analysis. As residual bone mass decreased, maximum principal stress increased near the anterior ramus of the mandible, and maximum shear stress increased at the anterior buccal region of the resected area. In the mandible with a maxillofacial prosthesis, the maximum principal stress distribution at the anterior ramus was lower, and the distribution of maximum shear stress at the anterior buccal region of the resected area was higher. When a reconstruction plate was used, maximum principal stress and maximum shear stress were lower. Thus, lower residual bone mass was associated with increased mandible deflection and torsion. In addition, presence of a maxillofacial prosthesis decreased deflection but increased torsion, and presence of a reconstruction plate decreased deflection and greatly decreased torsion. These findings suggest that decreased residual bone mass and maxillofacial prostheses increase fracture risk; however, presence of a reconstruction plate was effective in decreasing torsional stress, thereby reducing fracture risk in the mandible.


Asunto(s)
Placas Óseas , Prótesis Maxilofacial , Fenómenos Biomecánicos , Análisis de Elementos Finitos , Mandíbula/cirugía , Estrés Mecánico
5.
Niger J Clin Pract ; 23(7): 1022-1025, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32620735

RESUMEN

Maxillofacial prosthetics is the branch of prosthodontics which involves rehabilitation of the defects in the maxillofacial region involving the hard and soft tissue with the prosthesis. Facial defects that occur in the midfacial regions are commonly due to trauma and neoplasms like basal cell carcinoma which involves the nose. Reconstruction of the nose is an important esthetic challenge due to its esthetic and retention problems. This article emphasis rehabilitation of the nasal defect of a patient with nasal prosthesis using donor method.


Asunto(s)
Carcinoma Basocelular/cirugía , Neoplasias Nasales/rehabilitación , Nariz/cirugía , Diseño de Prótesis , Procedimientos Quirúrgicos Reconstructivos/métodos , Carcinoma Basocelular/patología , Carcinoma Basocelular/rehabilitación , Humanos , Masculino , Prótesis Maxilofacial , Implantación de Prótesis Maxilofacial , Persona de Mediana Edad , Neoplasias Nasales/patología , Neoplasias Nasales/cirugía , Implantación de Prótesis , Donantes de Tejidos , Resultado del Tratamiento
6.
J Contemp Dent Pract ; 21(4): 458-462, 2020 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-32584286

RESUMEN

AIM: To evaluate the change in color of the maxillofacial silicone after curing using a mobile phone colorimeter application. MATERIALS AND METHODS: A two-piece metal mold was fabricated. Twenty five samples were made using M511, maxillofacial silicone. A jig was prepared to hold the mobile phone at a fix distance from the samples. The color was measured for each sample in terms of HSV (hue, saturation, value) with the mobile phone colorimeter application after manipulation and after polymerization of the samples. Data were statistically analyzed using the Student's paired t test and the software used in the analysis was SPSS 22.0 version. RESULTS: The mean difference of hue was 1.32 ± 2.71, with p value 0.053. Mean differences in saturation was 0.72 ± 2.01, with p value 0.066. Mean differences in value were 2.16 ± 3.11, with a p value 0.002. The measure of value showed statistically significant differences (p < 0.05). CONCLUSION: There was a significant change in the value of the color of the maxillofacial silicone after polymerization. CLINICAL SIGNIFICANCE: Increasing the value of the color by 2-3% at the time of manipulation of the maxillofacial silicone with the use of a mobile phone colorimeter application can help the clinician to reproduce the same color in the final prosthesis after curing to achieve a predictable esthetic outcome for a facial prosthesis.


Asunto(s)
Teléfono Celular , Prótesis Maxilofacial , Color , Estética Dental , Humanos , Ensayo de Materiales , Coloración de Prótesis , Elastómeros de Silicona
7.
J Craniofac Surg ; 31(5): e488-e491, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32472877

RESUMEN

OBJECTIVE: Facial prosthetic rehabilitation using additive manufacturing technology relies on data acquisition from computed tomography or magnetic resonance imaging. Three-dimensional (3D) photography has become widespread in craniofacial and plastic surgery due to its ability to provide more comprehensive topographical data than radiographic techniques. Despite the rising popularity of 3D photography in preoperative planning, reports on the use of this technology for facial prosthetic rehabilitation are lacking. The present clinical report demonstrates the indirect fabrication of a nasal prosthesis using 3D surface-imaging by the VECTRA-M5 360 Head System. DESIGN: A 61-year-old woman presented with a nasal defect due to a partial rhinectomy secondary to multiple resections of recurrent basal cell carcinoma. After opting out of any further surgical intervention, the patient expressed a preference for prosthetic rehabilitation. Prosthesis fabrication using CAD/CAM technology typically relies on patient data from computed tomography or magnetic resonance imaging scans for the 3D printing of the replica of the nasal defect. In this case, facial data was acquired by a 3D surface-imaging system using a 3D photograph captured by the VECTRA-M5 360 Head System. CONCLUSIONS: Acquisition of facial data using 3D surface-imaging systems may be recommended for patients with external facial deformities to decrease subsequent radiation exposure. The integration of 3D photography and 3D printing provides a promising method for prosthetic rehabilitation that decreases total production time while minimizing radiation exposure.


Asunto(s)
Prótesis Maxilofacial , Nariz/diagnóstico por imagen , Diseño Asistido por Computadora , Femenino , Humanos , Imagenología Tridimensional , Persona de Mediana Edad , Nariz/cirugía , Impresión Tridimensional , Diseño de Prótesis , Implantación de Prótesis , Tomografía Computarizada por Rayos X
8.
Int J Prosthodont ; 33(3): 333-340, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32320188

RESUMEN

This report presents a digital technique for the fabrication of a two-piece hollow bulb maxillary obturator prosthesis. The procedure described resulted in an accurate prosthesis while avoiding the discomfort associated with analog impressions. The manipulation of a routine postoperative CT scan in conjunction with a 3D printer allowed for the fabrication of a 3D-printed anatomical cast, from which the two-piece hollow bulb obturator was fabricated. The obturator prosthesis framework was digitally designed and milled from a modified PEEK material, resulting in a lightweight prosthesis with excellent biocompatibility. The clinical and laboratory steps involved are described.


Asunto(s)
Diseño Asistido por Computadora , Prótesis Maxilofacial , Diseño de Prótesis Dental , Cetonas , Polietilenglicoles , Impresión Tridimensional
9.
Oral Maxillofac Surg ; 24(2): 157-161, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32147758

RESUMEN

INTRODUCTION: Maxillectomy following tumors or, more rarely, traumatic injuries may result in maxillary defects that may determine physical dysfunctions and functional impairment of speech and swallowing. The aim of our study was to present our experience in the management of post-maxillectomy patients by the use of obturator prostheses that were obtained by 3D digital casts via an intraoral scanner. METHODS: Patients with maxillary defects following maxillary and/or palatal resection or maxillary traumatic avulsion were selected for this clinical study between 2015 and 2018. Five to 6 months after surgery, a definitive obturator prosthesis was fabricated thanks to an intraoral scanner. The following parameters of clinical outcome were considered: the absence of fluid leakage, the recovery of phonation, the recovery of swallowing, and personal satisfaction. RESULTS: Twenty-eight patients (20 males, 8 females) fulfilled the inclusion criteria and were included in the study. Most patients had a maxillary and/or palatal defect because of a malignant tumor. On the whole, 93% of patients reported a complete absence of fluid leakage between maxillary sinuses or nasal fossa and oral cavity; most patients reported a good or complete recovery of phonation and swallowing. CONCLUSIONS: Digital technology for the fabrication of maxillary obturator prosthesis may be effective and useful. The reduced laboratory working time, the avoidance of the risk of aspiration of impression materials, and the overcome of the difficulties associated with whole tissue undercut impression are just some of the most important advantages that have been encountered thanks to this promising technology.


Asunto(s)
Implantes Dentales , Prótesis Maxilofacial , Femenino , Humanos , Masculino , Maxilar , Obturadores Palatinos
10.
J Prosthodont Res ; 64(4): 431-435, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32063540

RESUMEN

PURPOSE: The purpose of this study was to evaluate the impact of silver nanoparticle incorporation into maxillofacial silicone material on its hardness, tear strength and color stability. METHODS: A total of 180 silicone specimens were fabricated according to the specification of American society for material and testing (ASTM) No. D142 and No. D624. The control samples were fabricated without silver nanoparticles and test samples were fabricate with 20 ppm concentration of silver nanoparticles. For outdoor weathering specimens were placed in a metal cage, which was suspended from the roof for a period of one month. Digital shore A hardness tests (Yuzuki, DIN 53505, ASTM D2240) was used to measure hardness, for tear strength the specimen was placed in the jaws of the universal testing machine (Lloyd instruments, LR 50 K) and stretched at a rate of 500 ram/rain, for color stability Spectrophotometer had been employed and the data recorded in the CIE L*a*b* system. The independent sample's "t" test was used to test significant differences. RESULTS: The mean difference for hardness between control and test group was 0.54 and t value was 2.08 and (p < 0.05).tear strength 0.66 and "t" value was 0.93 and (p < 0.05) and for color stability it was -0.02 and t value was -0.92 and (p < 0.05). CONCLUSION: The present study findings suggest that addition of silver nanoparticles at 20 ppm concentration decreased the hardness of Teksil 25(S25) silicone elastomer, and it did not affect tear strength and color stability.


Asunto(s)
Prótesis Maxilofacial , Nanopartículas del Metal , Animales , Dureza , Masculino , Ensayo de Materiales , Ovinos , Elastómeros de Silicona , Plata , Resistencia a la Tracción
11.
Curr Opin Otolaryngol Head Neck Surg ; 28(2): 122-128, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32102008

RESUMEN

PURPOSE OF REVIEW: The present review describes the latest development of 3D virtual surgical planning (VSP) and computer aided design (CAD) for reconstruction of maxillary defects with an aim of fully prosthetic rehabilitation. The purpose is to give an overview of different methods that use CAD in maxillary reconstruction in patients with head and neck cancer. RECENT FINDINGS: 3D VSP enables preoperative planning of resection margins and osteotomies. The current 3D VSP workflow is expanded with multimodal imaging, merging decision supportive information. Development of more personalized implants is possible using CAD, individualized virtual muscle modelling and topology optimization. Meanwhile the translation of the 3D VSP towards surgery is improved by techniques like intraoperative imaging and augmented reality. Recent improvements of preoperative 3D VSP enables surgical reconstruction and/or prosthetic rehabilitation of the surgical defect in one combined procedure. SUMMARY: With the use of 3D VSP and CAD, ablation surgery, reconstructive surgery, and prosthetic rehabilitation can be planned preoperatively. Many reconstruction possibilities exist and a choice depends on patient characteristics, tumour location and experience of the surgeon. The overall objective in patients with maxillary defects is to follow a prosthetic-driven reconstruction with the aim to restore facial form, oral function, and do so in accordance with the individual needs of the patient.


Asunto(s)
Diseño Asistido por Computadora , Neoplasias Maxilares/cirugía , Prótesis Maxilofacial , Procedimientos Quirúrgicos Reconstructivos/métodos , Cirugía Asistida por Computador/métodos , Humanos , Osteotomía Maxilar , Modelación Específica para el Paciente
13.
Int J Artif Organs ; 43(5): 343-347, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31739725

RESUMEN

PURPOSE: Patients with maxillofacial deformities always seek for aesthetic prosthesis. Recently, three-dimensional printing technologies have been used for dental treatments on such patients. CASE REPORT: A 24-year-old man reported to the Department of Prosthodontics for replacement of his missing right ear induced by a trauma. A magnet-retained auricular prosthesis was planned for the patient. Three-dimensional scanning was performed on the healthy side by using a three-dimensional optical scanner and the data were mirrored. The mirrored image was then imported to a software and a virtual model of the future prosthesis was obtained for the defect side. A three-dimensional printer was used to fabricate a negative mold for the mirrored image by using additive manufacturing. Initially, an impression of the defect side was made; then, the cast model was obtained in a dental flask. Magnets of the prosthesis were inserted to the acrylic resin framework on the cast model. Room temperature vulcanized silicone elastomer was mixed and poured into the three-dimensionally fabricated mold. Then, the flask was placed over the negative mold firmly. After polymerization of the silicone, the auricular prosthesis was delivered to the patient and the patient was instructed to clean the prosthesis daily. CONCLUSIONS: Three-dimensional printing technology was used for the fabrication of the patient's missing ear. This method eliminated the conventional laboratory steps and reduced the number of stages of the fabrication of a silicone prosthesis. The negative mold of the defect side allowed us a direct fabrication of the silicone prosthesis without a need for waxing or flasking procedures.


Asunto(s)
Amputación Traumática/cirugía , Oído Externo/lesiones , Prótesis Maxilofacial , Impresión Tridimensional , Implantación de Prótesis/métodos , Resinas Acrílicas/uso terapéutico , Materiales Biocompatibles/uso terapéutico , Diseño Asistido por Computadora , Humanos , Masculino , Diseño de Prótesis , Elastómeros de Silicona/uso terapéutico , Resultado del Tratamiento , Adulto Joven
14.
J Stomatol Oral Maxillofac Surg ; 121(3): 268-277, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31610244

RESUMEN

A systematic review was conducted in early 2019 to evaluate the articles published that dealt with digital workflow, CAD, rapid prototyping and digital image processing in the rehabilitation by maxillofacial prosthetics. The objective of the review was to primarily identify the recorded cases of orofacial rehabilitation made by maxillofacial prosthetics using computer assisted 3D printing. Secondary objectives were to analyze the methods of data acquisition recorded with challenges and limitations documented with various software in the workflow. Articles were searched from Scopus, PubMed and Google Scholar based on the predetermined eligibility criteria. Thirty-nine selected papers from 1992 to 2019 were then read and categorized according to type of prosthesis described in the papers. For nasal prostheses, Common Methods of data acquisition mentioned were computed tomography, photogrammetry and laser scanners. After image processing, computer aided design (CAD) was used to design and merge the prosthesis to the peripheral healthy tissue. Designing and printing the mold was more preferred. Moisture and muscle movement affected the overall fit especially for prostheses directly designed and printed. For auricular prostheses, laser scanning was most preferred. For unilateral defects, CAD was used to mirror the healthy tissue over to the defect side. Authors emphasized on the need of digital library for prostheses selection, especially for bilateral defects. Printing the mold and conventionally creating the prosthesis was most preferred due to issues of proper fit and color matching. Orbital prostheses follow a similar workflow as auricular prosthesis. 3D photogrammetry and laser scans were more preferred and directly printing the prosthesis was favored in various instance. However, ocular prostheses fabrication was recorded to be a challenge due to difficulties in appropriate volume reconstruction and inability to mirror healthy globe. Only successful cases of digitally designed and printed iris were noted.


Asunto(s)
Implantes Dentales , Prótesis Maxilofacial , Ojo Artificial , Humanos , Imagenología Tridimensional , Diseño de Prótesis
15.
J Prosthodont Res ; 64(3): 296-300, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31554602

RESUMEN

PURPOSE: Maxillofacial prosthetic rehabilitation replaces missing structures to recover the function and aesthetics relating to facial defects or injuries. Deep learning is rapidly expanding with respect to applications in medical fields. In this study, we apply the artificial neural network (ANN)-based deep learning approach to coloration support for fabricating maxillofacial prostheses. METHODS: We compared two machine learning algorithms, ANN-based deep learning and the random forest algorithm, to determine the compounding amount of pigment. We prepared 52 silicone elastomer specimens of varying colors and measured the CIE 1976 L* a* b* color space information using a spectrophotometer on the input dataset. The output of these algorithms indicated the compounding amount of four pigments. According to the algorithms' pigment compounding predictions, we prepared the specimens for validation analysis and measured the CIE 1976 L* a* b* values. We determined the color differences between the real skin color of five research participants (22.3 ± 1.7 years) and that of the silicone elastomer specimens fabricated based on the algorithm predictions using the CIEDE00 ΔE00 color system. RESULTS: The color differences (ΔE00 value) between the real skin color and silicone elastomer validation specimens were 3.45 ± 0.87 (ANN) and 5.54 ± 1.41 (random forest), which indicates that the deep ANN approach produced superior results with respect to the ΔE00 value compared with the random forest algorithm. CONCLUSIONS: These results suggest that applying deep ANN is a promising technique for the coloration of maxillofacial prostheses.


Asunto(s)
Prótesis Maxilofacial , Coloración de Prótesis , Color , Ensayo de Materiales , Redes Neurales de la Computación , Elastómeros de Silicona
16.
Rev. Ciênc. Plur ; 6(1): 137-149, 2020. ilus
Artículo en Portugués | LILACS, BBO - Odontología | ID: biblio-1052873

RESUMEN

Introdução:Aenorme dificuldade de deglutição e fala apresentada em pacientes que sofreram maxilectomiatotal ou parcial por consequência de patologias bucais, afeta grande parte da população que realizou tal procedimento. A alternativa de minimizar o impacto causado pela sequela deixada após cirurgia em maxila está na confecção de um obturador palatino, que tem como objetivo obstruir a comunicação oronasal.Objetivo:Este trabalho objetivou descrever um relato de caso evidenciando o passo a passo clínico e laboratorial de uma prótese total obturadorae a satisfação do paciente com a mesma.Método:Paciente do gênero masculino, maxilectomizado há seisanos devido a presença de um CarcinomaAdenóideCístico foi reabilitado com prótese total obturadora superior e prótese total convencional inferior. A reabilitação superior seguiu os mesmos passos de uma prótesetotal convencional, com exceção da moldagem funcional, na qual foi feita a moldagem da comunicação bucosinusal com silicona de condensação antes da moldagem do selado periférico e moldagem funcional propriamente dita. Na etapa laboratorial, foi necessáriaa realização de três prensagens a fim de deixar a prótese oca na porção obturadora.Resultados:O tratamento restabeleceu a dimensão vertical perdida, proporcionou uma oclusão adequada, se mostrou melhor esteticamentee o paciente mostrou-se extremamente satisfeito com a reabilitação.Conclusões:Como conclusão, obteve-se uma prótese total obturadora superior com qualidades funcionais e estéticas satisfatórias. Ademais, ao comparar com a antiga, a novamostrou-se satisfatória de acordo com a percepção do usuário epossui um menor peso, favorecendo uma melhor retenção (AU).


Introduction:The enormous difficulty in swallowing and speaking presented in patients who underwent total or partial maxillectomy as a result of oral pathologies affects a large part of the population that performed this procedure. The alternative of minimizing the impact caused by the sequelae left after maxillary surgery is by making a palatal obturator, which aims to obstruct oronasal communication.Objective:This study aimed to describe a case report highlighting the clinical and laboratory step by step of a complete obturator prosthesis and patient satisfaction with it. Methods:A male patient who had been maxillectomized for 6 years due to the presence of a cystic adenoid carcinoma was rehabilitated with superior obturator total denture and inferior conventional total denture. The superior rehabilitation followed the same steps of a conventional total prosthesis, except for the functional molding, in which the bucosinusal communication with condensation silicon was molded before the peripheral sealing molding and the functional molding itself. In the laboratory stage, it was necessary to perform three presses in order to leave the hollow prosthesis in the obturator portion.Results:The treatment restored the lost vertical dimension, provided an adequate occlusion,was better aesthetically and the patient was extremely satisfied with the rehabilitation.Conclusions:In conclusion, a superior total obturator prosthesis with satisfactory functional and aesthetic qualities was obtained. Moreover, when compared to the old one, the new one was satisfactory according to the user's perception and has a lower weight, favoring a better retention (AU).


Introduccion: La enorme dificultad para tragar y hablarpresentada en pacientes que han sufrido una maxillectomía total o parcial como resultado de patologías orales afecta a gran parte de la población que realizó este procedimiento. La alternativa de minimizar el impacto causado por las secuelas que quedan después de la cirugía maxilar es hacer un obturador palatino, que tiene como objetivo obstruir la comunicación oronasal. Objetivo: Este estudio tuvo como objetivo describir un informe de caso que muestra la clínica y el laboratorio paso a paso de una prótesis obturadora completa y la satisfacción del paciente con ella. Método:Un paciente masculino que había sido maxillectomizado durante seis años debido a la presencia de un carcinoma adenoide quístico fue rehabilitado con una prótesis obturadora total superior y una prótesis total inferior convencional. La rehabilitación superior siguió los mismos pasos de una prótesis total convencional, excepto el moldeado funcional, en el cual la comunicación bucosinusal con silicio de condensación se moldeó antes del moldeado de sellado periférico y el moldeado funcional en sí. En la etapa de laboratorio, fue necesario realizar tres prensas para dejar la prótesis hueca en la porción del obturador. Resultados:El tratamiento restableció la dimensión vertical perdida, proporcionó una oclusión adecuada, fue mejor estéticamente y el paciente quedó extremadamente satisfecho con la rehabilitación. Conclusiones:Como conclusión, se obtuvo una prótesis obturadora superior con cualidades funcionales y estéticas satisfactorias. Además, en comparación con el anterior, el nuevo fue satisfactorio de acuerdo con la percepción del usuario y tiene un peso menor, lo que favorece una mejor retención (AU).


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Obturadores Palatinos , Cirugía Bucal/rehabilitación , Satisfacción del Paciente , Prótesis Maxilofacial , Rehabilitación Bucal , Brasil , Dentadura Completa
17.
Int J Comput Dent ; 23(4): 325-333, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33491928

RESUMEN

AIM: The goal of this case series was to evaluate the clinical outcome at the 2-year follow-up of immediately loaded combined screw- and conometric-retained implant-supported full-arch restorations virtually planned using digital scanning technology. MATERIALS AND METHODS: This series included 12 patients presenting hopeless teeth in the maxilla treated with computer-guided flapless implant placement. A total of 72 implants were inserted. All implants were immediately loaded with a complete-arch restoration supported by an intraorally welded framework. Digital scanning technology was used to virtually plan a combined screw and conometric retention of the frameworks. Clinical parameters were assessed at 1 week and at 1, 3, 6, 12, and 24 months follow-up. RESULTS: The survival rate after 2 years was 98.6%, as one implant failed during the osseointegration period. No major prosthetic complications were observed such as issues with mobility, unscrewed abutments, disconnected conometric copings, and prosthetic fracture. Only one patient registered the chipping of a prosthesis. CONCLUSION: Based on the results of the present study, the use of combined screw and conometric retention for fixed immediate restorations properly planned using digital scanning technology seems to be a viable treatment alternative to screw or conometric retention alone for immediately loaded rehabilitations.


Asunto(s)
Implantes Dentales , Carga Inmediata del Implante Dental , Arcada Edéntula , Prótesis Maxilofacial , Tornillos Óseos , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Maxilar , Tecnología , Resultado del Tratamiento
18.
Niger J Clin Pract ; 22(12): 1629-1634, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31793467

RESUMEN

Defects in the face area caused by trauma, accident, tumor or congenital defects are treated with special facial prostheses. Besides esthetics, the most common problem with these prostheses is the retention of prostheses. In the present article review, the methods used for the retention of prostheses from past to present were researched, and the advantages of adhesives and implants, which are the most commonly used current methods, were evaluated. Current techniques, new materials, treatment options, and implementation procedures are described. The success of maxillofacial prostheses in meeting the expectations of patients and dentist doctors is increasing day by day with the development of adhesive material science, the emergence of technical knowledge, and the development of implant technology. Increasing the retention provides both ease of use and acceptance by the patient. Therefore, the chosen method for retention has great importance in the long-term prognosis of the prosthesis.


Asunto(s)
Adhesivos , Cara/cirugía , Prótesis Maxilofacial , Prótesis e Implantes , Diseño de Prótesis , Implantación de Prótesis/métodos , Retención de la Prótesis/instrumentación , Estética , Humanos
19.
Eur J Prosthodont Restor Dent ; 27(4): 172-181, 2019 Nov 28.
Artículo en Inglés | MEDLINE | ID: mdl-31769939

RESUMEN

AIM: The colour stability of the silicone is essential for the longevity of facial prostheses. This in vitro study investigates the colour degradation of two different skin shade silicones moulded in Type II and Type III dental stone. METHODS & MATERIALS: Two different types of dental stone were used to fabricate 168 silicone samples (n=42 for each group) using M511 maxillofacial silicone, which was coloured with Spectromatch Procolourants. The polymerisation was carried out at 85°C 1.5 hours. A spectrophotometer was used to record the colour differences (ΔΕ) of each group before and after polymerisation. The CIEL*a*b* formula was used to obtain the measurements and a one-way ANOVA was carried out for the statistical analysis of the data. RESULTS: There is a statistically significant colour difference (ΔΕ) for all groups. For the Afro-Caribbean skin tone, Type III dental stone demonstrated the greatest colour change (ΔΕ = 4.36), whereas, for the Caucasian skin tone, it was the Type II dental stone (ΔΕ = 2.21). CONCLUSION: This study showed that regardless of the investing material, the colour of the silicone lightens after polymerisation. Both types of dental stone resulted in visible colour changes, with a ΔΕ ranging from 1.64 - 4.36.


Asunto(s)
Prótesis Maxilofacial , Elastómeros de Silicona , Región del Caribe , Color , Ensayo de Materiales , Pigmentación de la Piel
20.
J Dent ; 90: 103212, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31618671

RESUMEN

OBJECTIVES: To explore the long-term impact for patients living with an obturator prosthesis, following a maxillectomy for a head and neck neoplasm. METHODS: A qualitative approach was employed, using semi-structured interviews. A purposive sample of eight men and four women, living with an obturator prosthesis for at least five years, were recruited. Interviews were digitally recorded and transcribed. Using thematic analysis, two researchers analysed the data. RESULTS: The data were categorised into four themes: 1. Preparedness for living with an obturator, 2. Impact of living with an obturator - what changes to expect, 3. Stability and retention of the obturator, and 4. Coping strategies to aid adjustment. Long-term effects of living with an obturator spanned many aspects of life to include: chewing and eating, speaking, dealing with nasal leakage and altered body image, employment and intimacy issues, along with embarrassment during social encounters. Optimal retention and stability of the obturator, as perceived by the patient, lead to improved social confidence and engagement. The emotional impact varied greatly on peoples' lives. CONCLUSIONS: Patients experiencing the greatest long-term challenges had larger defects, were of employment age and had not returned to work. Gaining an improved understanding of the psychology of coping overtime is clearly important, as this can inform interventions to facilitate adjustment for those who are emotionally struggling. Furthermore, the findings of this study could inform the design of a communication tool to facilitate shared-decision making and aid preparedness for living with an obturator following a maxillectomy. CLINICAL SIGNIFICANCE: The multidisciplinary head and neck team should provide patients with detailed pre-operative information, including potential effects on social, work and personal relationships. The restorative dentistry team has a pivotal role in the long-term management of these patients, as obturators have a finite lifespan with ongoing maintenance necessary to promote optimal retention and stability.


Asunto(s)
Maxilar/cirugía , Neoplasias Maxilares/cirugía , Prótesis Maxilofacial/psicología , Obturadores Palatinos/psicología , Calidad de Vida/psicología , Femenino , Humanos , Entrevistas como Asunto , Masculino , Neoplasias Maxilares/psicología , Satisfacción del Paciente , Investigación Cualitativa
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