Magnet-retained auricular prosthesis with an implant-supported composite bar: a clinical report

Abstract

The use of craniofacial implants to assist in retaining auricular prostheses often requires complex laboratory procedures, involving production of an accurate casting, fitting of a precious alloy bar, and the use of clips. A simplified method for the retention of an auricular prosthesis with a composite bar and magnets is described in this article. (J Prosthet Dent 2003;89:446-9.) The use of craniofacial implants for retention of extraoral prostheses, such as ears, offers excellent support and retentive abilities 1-3 and improves a patient's appearance and quality of life. The use of implants can eliminate or minimize the need for adhesive and allows for proper orientation and seating of an ear prosthesis by the patient. However, a satisfactory outcome may only be achieved by careful planning in terms of the number and position and orientation of the implants and the proper connection of the ear prosthesis to implant retention structure with a cast or machined bar. Precious alloys are commonly used for construction of a bar because of their excellent strength, but casting precious alloys onto wrought metals may not result in a perfect union. 4 The dental laboratory procedures involved are complex and expensive. The use of magnets is advantageous over conventional bar and clips for maintenance because metal clips may fracture over time making revision and repair difficult. 5,6 This clinical report describes an auricular prosthesis retained by implants with a composite bar and magnets. CLINICAL REPORTA 20-year-old man with right hemifacial microstomia was referred by his plastic surgeon to the Maxillofacial Prosthdontic Clinic at The University of Hong Kong for fabrication of a right ear prosthesis. On examination, the patient had a bilaterally symmetrical face after orthognathic surgical reconstruction of maxilla and mandible, but the right ear was aplastic. To assist the placement of implants, a full contour wax pattern of the missing auricle was fabricated before implant placement. After proper positioning of the wax pattern, the surgeon outlined the boundary of ear prosthesis with gentian violet on the patient's skin. Two 4-mm flanged implants (model no. SEC 002-0; Branemark, Nobel Biocare, Goteborg, Sweden) were placed in the temporal bone. Three months after the placement of the implants, 5.5-mm abutments (model SEC 007-0; Branemark) were inserted (Fig. 1). A moulage impression was made at the abutment level with polyvinyl siloxane impression material (Aquasil; Dentsply, Milford, Del.).Two gold cylinders (model no. DCA 073-0; Nobel Biocare) were positioned on the abutment replicas (DCB 175-0; Nobel Biocare) and secured with laboratory guide pins. A light-polymerizing composite

Implant-Retained Maxillofacial Prostheses for Reconstruction of Burned Patients: A Report of Two Cases

“…[26][27][28][29][30][31] The most commonly used retentive attachments are bar-clip and magnetic systems. The attachment type is selected in each case by assessing the advantages and drawbacks of bar-clip retention and magnetic retention.…”

A Blue Tooth – Auricular Prosthesis: A Case Report

“…The prosthetic replacement options include adhesives retained, Implant retained or prosthesis using anatomico-mechanical undercuts as means of retention [4,6,9,10]. Rehabilitation using adhesive retained silicone prostheses is a conservative and a reversible treatment [11].…”

“…Implant-retained prosthesis may not be an ideal option in majority of cases due to financial constraints and apprehensions for surgical interventions. Also, the extra oral implant requires adequate thickness of the bone in the temporal and mastoid regions that may be deficient in certain cases [4,6,12]. Good retention of the prosthesis in the facial region is difficult to obtain unless precise lab work and skill in the entire procedure is followed.…”

Prosthetic rehabilitation of a patient with partial ear amputation using a self suspension technique

“…The use of implants is also very difficult to achieve successfully in people who have lost part of their ear. 3,7,12 When a patient does not want to use these suspension approaches for any reason, or is unable to be offered them, a new system such as the one designed in this paper that is stable and easy to use is needed. For these reasons we therefore recruited help from the residual surfaces for suspension.…”