Articulator modification for maxillofacial prosthetics.
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A facial impression technique that uses a thermoplastic splint material as a custom tray has been described. The use of this technique simplifies a time-consuming and cumbersome procedure for both the patient and the dentist.
The use of Silastic Medical Adhesive Type A in the fabrication of facial prostheses may cause health hazards to the patient and the operator because of acetic acid emissions. Caution must be exercised to remove acetic acid vapors from the air and unliberated acetic acid from material applied directly to the skin.
The tensile strength, tear resistance, and hardness of four silicone elastomers were compared. Results suggest that Cosmesil has improved mechanical properties over commonly used facial prosthetic silicone elastomers.
Maxillofacial prosthodontists are in a unique position to aid in the detection of recurrent and secondary malignancies of the head and neck cancer patient. This is related directly to their intimate knowledge of normal and abnormal oral anatomy and to the large amount of time they spend with patients during treatment and follow-up. I have detected many recurrent and secondary tumors during the few years I have been in a relatively low volume maxillofacial prosthetics practice. The patient's recall visits to the maxillofacial prosthodontist should be evenly spaced between the patient's visits to the head and neck surgeon when possible. By earlier detection and immediate referral to the surgeon, there is the possibility of a higher long-term cure rate in head and neck cancer patients who are receiving maxillofacial prosthetic treatment.
A definition and classification of midfacial defects has been presented with a systematic approach to the prosthetic restoration of these defects. Patient factors, prognostic and diagnostic considerations, clinical procedures, fabrication, materials, and retention have been discussed. Patients with complex orofacial defects can be provided with prosthodontic treatment that results in an acceptable appearance and function consistent with the deficits encountered (Figs. 14 and 15).
The need for more acceptable materials for use in maxillofacial prosthetics has long been recognized. In this study, the physical properties of several currently available polydimethyl siloxane materials were evaluated and compared with those of two previously tested materials. The properties chosen were tensile strength, elongation, tear strength, and hardness. These properties were chosen as indicators of the strength, flexibility, durability, and lifelike feel of the materials in clinical service. Testing procedures were intended to duplicate as nearly as possible those used by Chalian and Jones and to conform closely to ASTM specifications. In general, the physical properties of the five silicone materials tested in this study were superior to those of MDX-4-4210 and MDX-4-4514, tested previously. This superiority was particularly evident in terms of strength and elongation. Although the materials failed to demonstrate the softness of other materials, they may prove acceptable with the addition of available modifiers. Although no material was consistently superior to the others, potential merit is seen especially in Q7-4635 and SE-4524U. These materials exhibited high strength and softness and are available in one component system. Unlike the two-component addition chemistry systems, these materials have an indefinite pot life and are much more easily manipulated.(ABSTRACT TRUNCATED AT 250 WORDS)
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Several effective measures to reduce xylene exposure of clinicians during the extrinsic coloring of facial prostheses have been described. These measures can be used to modify the xylene exposure problem until an adequate ventilation system can be installed in the treatment room.
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Management of gunshot wounds to the head and neck is a challenge for the maxillofacial prosthodontist. Care of these patients can be divided into early, intermediate, and definitive phases. Psychologic management is often the most important aspect of treatment in ultimately resolving patient needs.
Six magnet-keeper systems were tested to determine the relationship between an air gap and the resulting breakaway force. The maximum retention was obtained when the magnet and keeper were in apposition. However, as the air gap increased in 0.1 mm increments, the breakaway force diminished rapidly initially and, then began to taper off at 0.2 to 0.3 mm. Ideally, the preferred placement of the magnet into the denture is with a carefully controlled system to provide an air gap. Then the magnet is attached with a minimal amount of autopolymerizing acrylic resin.
Graduates of maxillofacial prosthetic training programs during 1980 through 1984 were surveyed to evaluate the demand for maxillofacial prosthetic services in the United States. The recent change in requirements for advanced education programs in prosthodontics and the increasing numbers of those with additional training in maxillofacial prosthetics suggests that the demand for these services is decreasing. In addition, there appears to be a distinct separation of institutional from private office management of patients. Because of these changes, the concept of maxillofacial prosthetic training and practice as known in the past may change with an increasing role for the hospital-based dentist in the interim management of these patients.