A different wax sculpture technique for implant-retained auricular prosthesis

Abstract

Replacement of missing ears is a challenging task in which extensive array of materials and techniques have been employed. This article describes a different and simplified procedure for fabricating auricular prostheses very similar to the intact left ear of the patient. A 65-year-old male patient was referred to the Department of Prosthodontics with the loss of the right ear. In this case, the impression was made using hydrocolloid material (alginate) from the both defected and the opposite side. After hardening of the stone casts, a custom-made transparent splint plate was designed for the left auricular side. The splint was reversed and a cast model of the right auricular side was obtained as pouring the dental stone into transparent orthodontic splint. After getting the impression from cast model, conventional wax pattern and try on process was done. Finally, silicone elastomer was polymerized and the retention of the prosthesis acquired with the magnetic attachments. The technique described is economical, conventional, and time-saving. Furthermore, the prosthesis imitates the patient's intact auricular tissue.

Digital surgical planning and placement of osseointegrated implants to retain an auricular prosthesis using implant software with cone‐beam computed tomography and 3D‐printed surgical guides: A case report

“…Brandao et al 4 also reported an auricular implant success rate of over 98%; two-implant retention showed the lowest failure rate. While adhesive-and bar-retained prostheses have shown clinical success, 7,23,24 a 2012 review by Sharma et al 25 identified benefits of implant retention versus adhesive. While approaches similar to the current situation (scanning, digitization and 3D-printing) have been reported, 9,10,12,13,26 all used conventional CT 9,10,13,26 or electron-beam tomography.…”

“…Both acceptable 1,3,4,[6][7][8][9][10][11][12][13] and suboptimal outcomes have been reported. 6 Conventional analog approaches used to fabricate implant-retained auricular prostheses involve making a conventional impression of the affected and unaffected ear sites (using the intact ear as an indirect template), 7,14 fabrication of a gypsum-product master cast, 7,[15][16][17] and production of a wax pattern, 7,14,17 used to fabricate the definitive prosthesis via conventional flasking, wax-elimination, and molding and curing of the prosthesis, commonly using silicone. Various modifications of this conventional technique have been described with the objective of overcoming technique-sensitivity hurdles, such as tissue movement, 16 accurate reproduction of convoluted auricular anatomic dimensions with severe undercuts, 14 and impression distortion.…”

“…

Improvements in reliable auricular prosthetic replacement 1 necessitated by cancer, 2 trauma (including burns 3 ), [4][5][6] are increasingly in demand. Both acceptable 1,3,4,[6][7][8][9][10][11][12][13] and suboptimal outcomes have been reported. 6 Conventional analog approaches used to fabricate implant-retained auricular prostheses involve making a conventional impression of the affected and unaffected ear sites (using the intact ear as an indirect template), 7,14 fabrication of a gypsum-product master cast, 7,15-17 and production of a wax pattern, 7,14,17 used to fabricate the definitive prosthesis via conventional flasking, wax-elimination, and molding and curing of the prosthesis, commonly using silicone.

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Reconstrução total do pavilhão auricular com prótese bucomaxilofacial: Caso clínico

“…O que determina a técnica a ser escolhida é a habilidade do profissional e a economia de tempo para a conclusão do caso. 10,11 Apesar de na literatura existirem várias técnicas para realizar o padrão de cera, a direta apresenta maior fidelidade das características da orelha do paciente. 12,13 Contrapondo a este fato, no presente caso, a técnica indireta foi a melhor opção disponível, uma vez que a escultura pelo método direto demandaria mais tempo para ser realizada, maior número de sessões clínicas, mantendo o paciente afastado das suas funções de trabalho por um período maior, bem como maior tempo de trabalho laboratorial.…”

“…1,9,11 Assim, apesar das vantagens deste método, uma prótese auricular retida por adesivos, desde que manuseada adequadamente, proporciona também bons resultados e de uma forma não invasiva. 8,10 A retenção da prótese auricular por meio de armações de óculos é uma opção que, além de ser mais fácil fixação, favorece a higienização, uma vez que não apresenta o contato com substâncias químicas de forma frequente. 8 Apesar desta opção ter sido apresentada ao paciente, o mesmo ponderou o gasto na confeção de uma armação, uma vez que o mesmo não apresentava problemas visuais prévios, a falta de um apoio no tripé de suporte do óculos devido à falta do pavilhão auricular causando uma insegurança, além do fato de não poder utilizar a prótese sem o óculos, gerando um constrangimento caso necessitasse retirar o óculos em público e consequentemente ter que retirar a prótese, conforme questionamento em relação a banho de mar ou piscina.…”