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PubMedDate not supplied

Implants in the treatment of the maxillofacial patient.

Despite the apparent advantages provided by implants to the maxillofacial patient, complete documentation of these benefits is lacking in the literature. This review uses existing published material as a basis to discuss the efficacy of implant use in maxillofacial prosthetics and the biologic rationale of the procedures. The use of implants with bone-anchored hearing aids; in maxillofacial surgery; and in maxillary, mandibular, and facial defects is presented. Reliable and valid patient-based evidence of treatment success, as suggested by the NIH Consensus Conference of 1988, is needed.

Dental Implantation↗
PubMed1994

Maxillofacial restoration after tumor ablation.

Communication between the surgeon and the maxillofacial prosthodontist before, during, and after surgery is the most important aspect to successful prosthetic rehabilitation of the head and neck cancer patient. Surgeons should understand the problems and limitations involved in prosthetic rehabilitation so that the patient is adequately educated during rehabilitation. Osseointegrated implants, although an important advancement in this field, should not take the place of proper defect preparation. The use of implants in the irradiated patient is currently being evaluated by controlled studies. However, if implants are used, then their position and number should be carefully planned in the pretreatment phase. Preparation of the defect by skin grafting and controlling the position of the remaining structures is important to the overall aesthetic and functional result of the prosthesis.

Head and Neck Neoplasms↗
PubMed1979

Multiple-abutment fixed partial dentures in maxillofacial prosthetics.

Ten patients were presented to illustrate multiple-abutment fixed partial dentures used in combination with auxiliary prosthetic attachments of a fixed or removable design to solve diverse problems encountered in the rehabilitation of congenital and acquired orofacial defects. While such fixed prostheses have high initial costs, their effectiveness and long-term cost-benefits suggest that, where appropriate, they represent optimum therapy that will prove most economical over the long term.

Adolescent↗
PubMedDate not supplied

Advances in osseointegrated implants for dental and facial rehabilitation following major head and neck surgery.

Osseointegrated implants can be used to facilitate retention stability and support for facial and intraoral prostheses used to restore head and neck defects. Preliminary studies indicate that in nonirradiated maxillectomy patients the success rates are about 75%. In the reconstructed mandible the results appear to be more favorable--over 90% for implants placed in free nonvascularized bone grafts and over 90% for free revascularized bone grafts. Similar high success rates have been observed for most sites used to support facial prostheses. Success rates for auricular sites exceed 95% and for floor of nose sites success rates exceed 90%. Success rates have been lower (77%) for implants placed in the frontal bone for retention of orbital prostheses. Success rates for irradiated bone sites have been lower and range from 60.4% in the maxilla to 68.6% in facial bone sites. Of greater concern is that most implants placed in irradiated sites are beginning to show signs of impending failure.

Combined Modality Therapy↗
PubMed1993

Natural coral skeleton used as onlay graft for contour augmentation of the face. A preliminary report.

The skeletons of two different genera of Madreporaria were used as onlay graft material for contour augmentation of the face. With coral blocks or granules in a subperiosteal fashion, patients with hemifacial microsomia, maxillary hypoplasia, microgenia, and Treacher Collins' syndrome have been adequately treated. Sixteen augmentations were performed in 14 patients, followed up for 6-34 months. One graft had to be removed because its inadequate fixation resulted in mobility. Delayed healing was observed in another case for the same reason. Coral skeleton is a cheap, natural biomaterial with excellent biocompatibility. It can easily be prepared and shaped, and it maintained its form over the period observed.

Adolescent↗
PubMed1993

A new application of a screw-plate for prosthetic reconstruction after bilateral total maxillectomy.

Satisfactory functional and aesthetic rehabilitation of a patient after total bilateral maxillectomy is a great challenge to the surgeon and prosthodontist. A particular problem is support and retention of the obturator. In the case described, the problem was solved by attaching the prosthesis with finger clasps to a classic AO-reconstruction plate anchored rigidly with screws to both zygomata. The results in terms of mastication, swallowing, phonation and aesthetics were satisfactory for more than 2 years, when the patient died from brain metastasis and pneumonia. The technique seems promising and merits further study using titanium screws and plates.

Bone Plates↗
PubMed2005

[A case of unilaterally designed obturator prosthesis].

PATIENT: A 50-year-old female patient with minor maxillary defect was afflicted with an ipsilateral oroantral fistula. A unilaterally designed obturator was constructed for the patient. She was satisfied with the obturator because no leakage or seepage into the antrum occurred during mastication. It was also aesthetically acceptable due in particular to the small size of the denture. In this clinical report, treatment with the unilaterally designed obturator is discussed. DISCUSSION: The use of functional impression techniques during the trial denture stage registered the optimal shape of the soft tissues while they were loaded under a variety of functional conditions. This acted to distribute the functional forces to the saddle area proportionally and prevented any leakage and seepage of food into the defect. CONCLUSION: The unilaterally designed obturator prosthesis has served to restore masticatory function as well as to obturate the maxillary defect.

Dental Prosthesis Design↗
PubMed2005

Long-term stability of prosthetic treatment of oronasal and oroantral communications.

This five-year prospective study demonstrates prosthetic treatment by multidisciplinary therapy: surgeon, orthodontist, and prosthodontist. 10 patients volunteered for the study (a group of 7 men and 3 women at an average age of 33.2 years). 10 obturators, 49 fixed dentures were inserted to the upper jaw. Based on ADA (American Dental Association) recommendation a special card was prepared containing relevant information on the patients. Clinical assessments were carried out in accordance with the US Public Health Service System. In a 5-year period only 50.0% of restorations were excellent, receiving 100% alpha rating. The marginal ridge contour and adaptation of obturator achieved 60.0% alpha rating. The anatomic form of dental arch was destroyed in 50.0%. The presence of caries was not detected. Six teeth were extracted due to periodontal disease. The general contour of the restoration followed the overall contour of the fixed denture in 95.9%. Plaque accumulation was found in 50%. The colour match of crowns was darker and translucent in 27.7%, but discoloration of removable denture was seen in 30.0%. The three case reports demonstrate the long-term stability of treatment (from alpha to charlie evaluation). Attachment retention, fixed and removable denture with metal base are the first method of choice, due to acceptable long-term stability.

Adult↗
PubMed1991

[Osteomas of the jaws. A clinical and rehabilitative problem].

The authors study, based on three cases of maxillary osteoma brought to their attention, evaluates the most suitable type of operation to perform, and the method with which to attention which to approach the problem of postoperative functional rehabilitation. This pathological condition is characterized by slow developments and the late appearance of symptoms deriving from the invasion of surrounding tissues. The chosen technique is surgery, involving the removal of the neoplasm. The benign nature of the neoplasm makes conservative surgery possible, including the partial removal of the neoplasm, in order to preserve the bone tissue indispensable for prosthetic rehabilitation. In cases in which the neoplasm spreads to surrounding tissues, in which more destructive surgery is required with an attendant loss of considerable portions of bone, we have used osteo-muscular pedicle flaps in combination with implantation techniques to obtain adequate functional and prosthetic rehabilitation.

Adolescent↗