In order to restore an extraoral maxillofacial defect, a moulage impression is commonly made with traditional impression materials. This technique has some disadvantages, including distortion of the site due to the weight of the impression material, changes in tissue location with modifications of the patient position, and the length of time and discomfort for the patient due to the impression procedure and materials used. The use of the commercially available 3dMDface™ System creates 3D images of soft tissues to form an anatomically accurate 3D surface image. Rapid prototyping converts the virtual designs from the 3dMDface™ System into a physical model by converting the data to a ZPrint (ZPR) CAD format file and a stereolithography (STL) file. The data, in conjunction with a Zprinter(®) 450 or a Stereolithography Apparatus (SLA), can be used to fabricate a model for prosthesis fabrication, without the disadvantages of the standard moulage technique. This article reviews this technique and how it can be applied to maxillofacial prosthetics.

Purpose: To investigate the growth of primary human gingival epithelial (HGE) cells on polymer-infiltrated ceramic network (PICN) material (Vita Enamic) with different surface roughnesses. Materials and Methods: PICN material specimens were polished with either silica carbide paper (grit-polished) or the manufacturer's polishing wheels (wheel-polished), and the surface roughness (R a ) measured. HGE cells were seeded and grown for 1, 3, or 6 days. Growth on tissue culture plastic was used as a control. Non-linear regression analysis was used to examine the effect of surface roughness on cell growth. Results: HGE cell growth on tissue culture plastic fitted an exponential growth model over the 6-day experimental period (R 2 = 0.966). Through day 6, cell density on PICN decreased with increasing surface roughness, with a fit to an exponential decay model (R 2 = 0.666). A threshold R a value of 0.254 µm (95% CI 0.177-0.332) was determined as an upper limit for exponential growth. Cell growth was greatest on the group of specimens with R a value below 0.127µm. Specimens polished by the manufacturer's method produced surface roughness of 0.118 µm and below. Conclusions: PICN material polished to a smooth surface (R a < 0.254 µm) resulted in exponential growth of HGE cell growth compared to rough surfaces. Polishing PICN material as smooth as possible (below a R a of 0.127 µm) was found to maximize epithelial cell growth on the PICN material surface. The manufacturer's polishing method achieved a sufficiently smooth surface. These results are contrary to previous research regarding surface roughness of transgingival implant restoration components. The study results suggest that smoother restorative material surfaces could improve peri-implant soft tissue health.

Total auricular rehabilitation is a complex task involving reconstruction of extensive soft tissue defects, bony defects, and the hearing apparatus. Acceptable cosmetic and functional outcomes and high patient satisfaction is possible in committed patients.

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