Prosthetic Reconstruction of a Patient with an Acquired Nasal Defect Using Extraoral Implants and a CAD/CAM Copy‐Milled Bar

Abstract

Traditionally, patients with maxillofacial defects have been challenging to treat. A multitude of challenges associated with maxillofacial prosthetic treatment are not typically seen with patients who need conventional prosthodontic treatment. These types of patients generally require replacement of significant amounts of hard and soft tissues than do conventional prosthodontic patients. Most maxillofacial patients also warrant more emotional support than do conventional prosthodontic patients. Successful maxillofacial prosthetics still need to embrace the traditional goals of prosthodontic treatment: stability, support, retention, and esthetics. It is unlikely that a maxillofacial prosthesis will exactly duplicate the anatomy and function of missing or damaged structures. Although craniofacial implants (CFI's) have lower cumulative survival rates (CSR's) than intraoral endosseous implants, osseointegrated CFI's have proven to be significant adjuncts to improving retention of maxillofacial prostheses. However, CSR's of CFI's have been reported to be lower than CSR's for intraoral endosseous implants. Lately, computer-assisted design and computer-assisted machining (CAD/CAM) has been used in dentistry to facilitate fabrication of implant-supported frameworks. CAD/CAM protocols have numerous advantages over conventional casting techniques, including improved accuracy and biocompatibility, and decreased costs. The purpose of this paper is to review the literature on cumulative survival rates (CSR's) reported for CFI's and to illustrate the treatment of a maxillofacial patient using CFI's and a CAD/CAM copy-milled framework for retention and support of a nasal prosthesis.

Cyborg beast: a low-cost 3d-printed prosthetic hand for children with upper-limb differences

“…Most fitting procedures required for prosthetic hands include wrap casting using plaster bandages placed over the affected limb [ 2 ]. More recently, 3D scanning has also been used for the development of different type of prostheses and orthoses [ 11 , 15 , 16 ]. Casting procedures require the physical presence of the individual needing the prosthetic hand and the health care professional in the same physical location, which may not be possible for patients living in rural or isolated areas.…”

Systematic Review of Clinical Applications of CAD/CAM Technology for Craniofacial Implants Placement and Manufacturing of Nasal Prostheses

“…Furthermore, 238 studies were screened according to the inclusion and exclusion criteria; therefore, an additional 217 studies were excluded based on their study design and rehabilitation techniques (craniofacial surgical reconstruction with titanium plates, mesh and ceramic implants, craniofacial prosthetic rehabilitation without digital solutions, prosthetic rehabilitation of intra-oral defects, and short communications without digital techniques). A total of 21 studies [9,19,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] involving 23 cases were planned and executed with digital planning software for prosthetic rehabilitation of nasal defects (Table 1). Due to the included studies' quality and data heterogeneity, meta-analysis could not be performed.…”

“…Vera et al 2014 [39] The copy milled CAD/CAM framework was utilized successfully after testing with Sheffield, one screw test for a patient to retain nasal prosthesis. Patient expressed satisfaction with the nasal prosthesis.…”

Advancements in craniofacial prosthesis fabrication: A narrative review of holistic treatment

“…Such prostheses can be created with 3D printing techniques, traditional silicone, or other methods that can closely simulate the patient's original features. CAD/CAM can have many advantages over conventional techniques, including increased precision, biocompatibility, and lower costs 51. This is particularly important in light of information from a study by Hooper et al that surveyed patients who received facial prostheses.…”