Assessment of treatment outcomes for facial prostheses in patients with craniofacial defects: A pilot retrospective study

Abstract

Patients should be recalled frequently so that retouches can be performed, avoiding the repeated fabrication of new prostheses. Well-designed studies are necessary to identify more relevant complications and factors that lead to prosthetic failure.

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

“…To the authors' knowledge, this is the first clinical report to describe 3D CBCT use for both (a) assessment of soft‐tissue and temporal bony topography and (b) 3D‐printing of soft‐tissue and bone surgical guides for an auricular prosthesis. Clinically reliable auricular replacement has been reported as early as 2002 1‐6,8,10‐13 . More prospective studies assessing multilevel 3D anatomic visualization are needed.…”

“…1,4,5 Of note, a 25-year retrospective analysis of 341 craniofacial implants in 110 patients by Subramaniam et al 11 , temporal implants overall showed the highest comparative success rate (97%) and statistically significant) prosthetic (P < .0001) and implant survival rates (P < .0001). 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.…”

“…14 The co-evolution of digital planning and design with temporally placed osseointegrated implants has improved auricular replacement workflows and outcomes. [4][5][6]10,11,19 Twenty-year survival rates of over 97% were reported in a retrospective analysis by Subramaniam et al 11 of 341 temporal osseointegrated implants placed in 110 patients. Extraoral craniofacial implants placed in patients with histories of head-and-neck oncologic surgery or radiation therapy have consistently higher failure rates.…”

Reabilitação facial por meio de prótese oculopalpebral

“…Em relação aos métodos de retenção, Papaspyrou et al 16 expuseram quatro técnicas de ancoragem de prótese disponíveis: o anatômico (usando estruturas já existentes), o mecânico (armações de óculos), o químico (usando adesivos) e a ancoragem cirúrgica (utilizando implantes de titânio). Brandão et al 9 enfatizaram ainda que a retenção da prótese é assumida como sendo o determinante primário de uma abordagem de sucesso e tem sido tradicionalmente alcançada usando adesivos ou óculos. No entanto, nenhum desses métodos fornece retenção satisfatória e duradoura.…”

“…Próteses faciais de silicone têm sido propostas como as melhores abordagens para reabilitação de pacientes com defeitos craniofaciais, entretanto a longevidade e manutenção destas próteses são as principais preocupações dos clínicos e dos pacientes que receberão a reabilitação 9,10 . Esta deve ser confeccionada de modo a respeitar as etapas clínicas e laboratoriais e realizando todos os ajustes para que fique esteticamente satisfatória.…”