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At least 181 records · Page 10Linked to original sources
PubMed2006

[The construction and analysis of three-dimensional finite element model of human unilateral maxillary defect].

PURPOSE: To built a three-dimensional finite element model of the common unilateral maxillary defect, and to study the stress of the traditional maxillofacial prostheses for unilateral maxillary defect. METHODS: The three-dimensional finite element model of unilateral maxillary defect and maxillofacial obturator prosthesis were constructed by means of spiral CT scanning, digital image transfer, self-developed software MedGraphics, UG engineering design program and ANASYS software. Then 3-D finite element stress analysis was carried out, for the prosthesis. RESULTS: The three-finite element models of the unilateral maxillary defect and maxillofacial obturator prosthesis were established. In the traditional obturator prosthesis, the stress was on the posterior teeth of the healthy side; the area of stress concentration was on the palatal base near the position of the anterior teeth. CONCLUSIONS: The three-dimensional finite element models of the unilateral maxillary defect and maxillofacial obturator prosthesis have good similarity in geometry and biology. The obturator prosthesis is in accorded with the biomechanical demands.

Dental Stress Analysis↗
PubMed1997

[The management of extra-oral implants. Anachronisms and paradoxes].

Used in France for ten years and in Sweden since 1977. Extra-Oral Implants (EOI) represent one of the new therapeutic approach of facial defects treatment by maxillo-facial prostheses fixed on implants and of some transmission deafnesses. Audiologic applications are free of charges for the patient but not the prosthetic applications; the authors note this paradox and some other anachronisms. Finally the authors wonder why Extra-Oral implantology is a "correct" science and why Intra-Oral Implantology remains absent from the Administrative texts as if it was a sort of doubtful therapy without scientific principles.

Aged↗
PubMedDate not supplied

Implant-supported facial prostheses.

The application of the principles of osseointegration to the craniofacial skeleton can offer the patient with defects from trauma or ablative cancer surgery a functional and esthetic restoration, with minimal morbidity. Implant-supported restorations offer a retrievable prosthesis with increased retention and support, by the use of tissue bars with clip retention, magnetic retentive mechanisms, or both. Implant-supported auricular, nasal, orbital, midfacial or combination prostheses are presently being provided for patients in hospitals, maxillofacial prosthetic training programs, and private practice settings in North America and elsewhere.

Bone Screws↗
PubMed1997

Effects of implant anchorage on midface prostheses.

STATEMENT OF PROBLEM: Acquired midface defects may produce functional and psychologic impairments that adversely effects a patient's quality of life. Conventional prostheses may lack adequate retention and stability, diminishing the patient's confidence that the prosthesis will remain in place during routine activities. PURPOSE: The experience with and patient response to endosseous implants in prosthetic restoration of midface defects is presented in this study. MATERIAL AND METHODS: Five patients in age from 36 to 88 years were treated with 19 titanium endosseous root-form implants to provide retention and stability for prostheses. Patients responded to a questionnaire rating overall use, effectiveness, and satisfaction of their prosthesis, before and after the use of implants. RESULTS: All 19 implants were judged to be osseointegrated at abutment connection. Of the 17 implants used prosthetically, 14 (82%) remained osseointegrated and 3 (18%) failed. Analysis of the questionnaire tends to indicate an improvement of the quality of life for the patients with an implant-retained prosthesis.

Activities of Daily Living↗
PubMedDate not supplied

Survival rate of zygomatic implants in atrophic or partially resected maxillae prior to functional loading: a retrospective clinical report.

PURPOSE: The purpose of this article was to evaluate the survival rate of 34 remote anchorage implants placed in 18 patients from placement to uncovering, prior to any prosthetic loading. MATERIALS AND METHODS: A total of 18 patients (9 women and 9 men with a mean age of 63 years) who required rehabilitation with a fixed prosthesis because of severely atrophic maxillae (including 1 patient who had undergone primary and secondary cleft lip and palate repair), traumatic maxillary bone loss, and maxillectomy procedures received 1 or 2 zygomatic implants and 2 to 4 standard maxillary dental implants. The survival rate of the 34 zygomatic implants from placement to uncovering was investigated. Aspects of the placement technique or postoperative complications related to surgical procedures likely to affect the implant failure rate were detected and critically discussed. RESULTS: Osseointegration was evaluated using the reverse torque test and percussion after uncovering. Only 1 patient (5.6%) sustained postoperative clinical complications during the evaluation period which resulted in the loss of both zygomatic implants (5.9%). CONCLUSION: Although the handling of this anchorage implant system is somewhat complex, and the design has certain shortcomings, it might be an alternative to more extensive bone augmentation procedures. However, rehabilitation of partially or completely edentulous patients with fixed implant-supported prosthesis is only feasible when 2 to 4 standard implants are placed in the anterior maxilla and splinted with the zygomatic implants.

Aged↗
PubMed1999

Functional reconstruction after a total maxillectomy using a fibula osteocutaneous flap with osseointegrated implants.

The fibula osteocutaneous flap with osseointegrated implants was used for reconstruction of a total maxillectomy defect. We have achieved satisfactory reconstruction of three-dimensional facial structure, orbit support, and a functional prosthesis. Our procedure restored the patient's masticatory function of the maxilla and enabled good speech and a natural facial appearance. A very high quality of function was obtained without any complications, but long-term follow-up is necessary for maintenance of the implants.

Aged↗
PubMedDate not supplied

A study of 25 zygomatic dental implants with 11 to 49 months' follow-up after loading.

PURPOSE: The purpose of this study was to evaluate indications, surgical problems, complications, and treatment outcomes related to the placement of zygomatic implants. A second aim was to determine any prosthetic difficulties and complications. MATERIALS AND METHODS: Twenty-five zygomatic implants were placed in 13 patients between April 1999 and December 2001. The patient age range was between 49 and 73 years, with a mean age of 59 years. All patients showed severe resorption of alveolar bone in the maxilla. All but 2 patients were smokers. Two patients had a history of cleft palate surgery, and 2 patients were known to be bruxers. Standard recommended surgical protocol was followed, and treatment was performed under general anesthesia. After abutment surgery, 9 patients received bar-retained overdentures, and 4 patients received fixed prostheses. RESULTS: No implants were lost, and few surgical complications were experienced. The follow-up period was 11 to 49 months. DISCUSSION: Although surgical problems precipitated by difficult anatomy in cleft patients and a patient with reduced interarch access were experienced, the results were favorable. Fabricating a functional and esthetic prosthesis can be a challenge. CONCLUSION: Zygomatic implants provide a treatment option for patients with severe maxillary resorption, defects, or situations where previous implant treatment has failed. In this experience, treatment with zygomatic implants was a predictable method with few complications, even in a group of patients that would not be considered ideal for implant treatment.

Aged↗
PubMed1997

[Reconstruction in craniofacial contour and continuity defects with preoperatively designed individual implants].

Reconstruction of craniofacial bone defects with intraoperatively modeled prostheses restricts the choice of material and its biocompatibility and the prediction of the aesthetic result. This goes hand in hand with prolonged duration of the surgical procedure and increased stress for the patient. In contrast, modern industrial CAD/CAM systems allow prefabrication of titanium prostheses. Individual computer-based 3D models of the bony defect are generated after acquisition, transfer and evaluation of helical CT data. Based on these data, the individual shape of the prosthesis is designed using free-form surface geometry and fabricated by a numerically controlled milling machine. The conical margins of this prosthesis are designed with a precision of 0.25 mm to the borders of the defect, and the surface contours are generated harmonically to the non-affected neighboring contours with a constant thickness of 1.5 mm. Individual constructions for fixation with the dimensions of microplates are integrated in this process if screw-holes cannot be drilled in thin overlapping margins of the prosthesis. Reconstruction of 18 posttraumatic or postoperative cranial defects measuring up to 18 cm was performed using this new method. Wound-healing was uneventful in all cases, although some of the patients had been operated on several times before. The results were always predictable and constant using this highly precise technique, and duration of surgery was reduced dramatically.

Biocompatible Materials↗
PubMed1998

[Is a maxillary prosthesis difficult for patients with trismus?].

Of patients with a postoperative maxillary defect, around 30% are though to have trismus to some extent. In these patients, some difficulty in fabricating a maxillary prosthesis is expected. In this study, 54 patients with trismus were compared with a control group to find some proof of difficulty in making a maxillary prosthetics. Fifty-four of trismus less than 20 mm of a mandibular stroke were experienced out of 185 patients with maxillary prosthetics between October 1984 and October 1992. The trismus was divided into 4 groups of less than 5 mm (1 case), 5 mm-10 mm (10 cases), 11 mm-15 mm (19 cases), and 16 mm-20 mm (24 cases). These case were analyzed by in taking an impression failure, average weight of the prosthesis, time needed to complete the prosthesis and some special form of prosthesis. No apparent differences among the 4 groups or with the control group were found. The cause of the difficulty in making a prosthesis for such patients with trismus are suggested not to be simply due to the range of mouth opening but also to the complexed space formed by the dental defect, alveolar bone defect, spreadability of the lip and the cheek, the mandibular stroke and the so-called scar bundle of the cheek next to the defect.

Adult↗
PubMed1998

Facial rehabilitation by the application of osseointegrated craniofacial implants.

A new approach to the facial rehabilitation of patients with congenital and acquired deformities is introduced in this short note. This method involves having a bone implant that allows the anaplastologist to fabricate a custom prosthesis for use in patients with disfigurement. The design of the implantation site is done before the surgical procedure. The titanium oxide fixtures and abutments are submerged and extrude through the skin by a small window. The attachment for the replacement part is achieved by using a metallic bar or magnets. A small space is left at the interface for ventilation of the skin and to avoid any maceration that will compromise the integrity and long-term accepted outcome. This new method is not a replacement of the traditional techniques but an augmentation for the accepted methods in facial rehabilitation.

Ear, External↗
PubMed1989

Prosthetic rehabilitation of mandibulectomy and glossectomy patients.

The prosthodontic prognosis in patients with lateral discontinuity defects of the mandible is dependent on a number of complex factors. In some patients only esthetics can be improved, whereas in others mastication and speech improvement can be achieved. Two patients who had undergone the same surgical interventions but presented with different problems are described. The first patient had difficulty with mastication and mandibular movements, which was resolved by building a ramp on a maxillary prosthesis. The second patient had severe speech and swallowing problems, which were corrected with an acrylic, hollow speech prosthesis. In both patients the end result was satisfactory.

Adult↗