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PubMed1991

Osseointegrated implant-supported and magnetically retained ear prosthesis: a clinical report.

Osseointegrated implants were placed in the temporal bone and were used to retain attachments for an ear prosthesis. A screw-retained magnetic alloy casting was used to retain an acrylic resin magnet keeper, to which a silicone ear prosthesis was attached. The keeper provided vertical support for the prosthesis and facilitated orientation for prosthesis insertion. Stability and retention were provided without the use of adhesives.

Ear↗
PubMed1999

[Rehabilitation with bone anchored facial prostheses].

BACKGROUND: Rehabilitation of orbita defects with loss of eyelids is difficult to achieve with plastic surgery. Here defect coverage with a facial prosthesis shows good results. PATIENTS AND METHODS: 105 patients with orbita defects were treated since 1991 with bone anchored facial prostheses. Preoperatively we measured the bone availability with computed tomography. We inserted Brånemark-titanium implants (Fa. Nobel Biocare), with a two-stage procedure. After a period of at least three months we exposed implants and connected the supraconstruction. Then our anaplastologist produced the facial prosthesis, either a "soft" facial prosthesis of silicone or a "solid" prosthesis of polymethylmetacrylate (PMMA). Not later than every three months patients came to recall. RESULTS: For all patients we found enough bone for implantation. The implants were screwed into the lateral bony orbital margin. There were no intraoperative complications accompanying implant insertion. For 96 patients we chose the silicone material; for nine patients we did produce the facial prosthesis of PMMA. In about 10.5% of the implants we had to remove subcutaneous tissue in local anesthesia because of recurrent periimplantary inflammations. Three years after insertion 95.8% of the implants were still firmly anchored in the bone. CONCLUSIONS: Performed by the experienced specialist the prosthetic treatment of orbita defects with a bone anchored facial prosthesis is a cosmetically satisfactory procedure with good long-term outcome. While modern plastic materials can replace the lost tissue with deceptively natural results, the implants guarantee firm secure retention of the facial prosthesis.

Adolescent↗
PubMedDate not supplied

Bone-anchored craniofacial prosthesis study.

A prospective study involving 24 centers and 145 patients was conducted to evaluate the long-term osseointegration survival rate for titanium implants anchoring a craniofacial prosthesis (auricular, orbital, or nasal) and to evaluate the long-term retention and stability of the prosthesis. Of 452 implants placed, 19 were lost (overall survival rate of 96%). Of the 145 patients, 115 were evaluated (remained active) throughout the study period and were followed-up for at least 30 months. The results of the study suggest that the bone-anchored craniofacial prosthesis system is a viable alternative to conventional reconstructive surgery and offers significant improvement in the quality of life when compared with the support systems previously available for these types of prostheses.

Adolescent↗
PubMedDate not supplied

Bone-anchored craniofacial prosthesis study: irradiated patients.

A prospective study involving 24 treatment centers and 145 patients was conducted to evaluate the long-term osseointegration success rate for titanium implants anchoring a craniofacial prosthesis (auricular, orbital, and nasal), and to evaluate the long-term retention and stability of the prosthesis. Twenty patients (14%) in this study had received prior irradiation therapy, and 60 implants were placed in these 20 irradiated patients. Nine of the 60 implants were lost (85% survival rate). Although the few patients and few implants may not allow for conclusions to be drawn, analysis and review of the data on these irradiated patients may assist in reliable and valid comparisons to be made with other published studies.

Adult↗
PubMed1992

Prosthetic rehabilitation of the edentulous patient requiring a partial maxillectomy.

A variety of problems faces the prosthodontist attempting reconstruction of maxillary defects. This article reviews developments in materials and techniques of obturator prosthesis design for patients experiencing maxillectomy. The size of the maxillectomy defect is one of the main factors governing the prognosis for treatment. Many patients require special prosthodontic techniques. However, routine attention to extension of the prosthesis and balanced occlusion is essential. Obtaining satisfactory retention and stability in the definitive obturator prosthesis can be elusive. Resilient denture base materials are extremely useful in retaining the prosthesis, which obturates small defects. However, the flexibility of these materials makes them unsuitable in large maxillectomy cavities because of the deformation that occurs during mastication. Alternative forms of retention, eg., osseointegrated implants and sectional prostheses retained by magnets, are discussed.

Animals↗
PubMed1998

Restoring the edentulous maxilla using an implant-supported, matrix-assisted secondary casting.

The selection of appropriate implant treatment modalities for the edentulous maxillary arch is complex. Although many patients are candidates for an implant-supported removable prosthesis, two major considerations affecting choice of treatment type are the amount of residual alveolar bone and soft tissue, and cost. A technique is described that employs a cast milled primary bar and a secondary casting constructed using a vacuum-formed 0.040-in plastic matrix. The secondary casting is intimately adapted to the primary bar and incorporates the retentive elements within it. The resulting prosthesis is less expensive than comparable designs, and retentive elements are easily replaceable. The technique is adaptable to most implant systems. The matrix-assisted secondary casting technique provides a design that is esthetic and hygienic. The prosthesis may also be easier to insert and remove than implant-supported removable prostheses that use plunger- or latch-type retention.

Alveolar Bone Loss↗
PubMed1987

Macrocellular silicone foam for mechanically retaining orbital prostheses.

The prosthesis processed with the technique described has a fitting surface that is smooth and glossy, a soft and uniformly compressible foam-filled mass to engage severe undercuts, and a lightweight mass for the completed prosthesis. The technique described increases laboratory time. However, the lightweight prosthesis provides intrinsic mechanical retention that justifies the extra time. Moreover, the controllable uniform compressibility of the foam-filled extension and the improved surface characteristics of the silicone fitting surface minimize the possibility of producing trauma while the prosthesis is inserted, worn, or removed by the patient.

Humans↗
PubMed1999

Overdenture retention of four resilient liners over an implant bar.

STATEMENT OF PROBLEM: Resilient denture liners offer an alternative method of designing implant-retained overdentures. Space is provided in the overdenture to envelop the implant bar with a resilient liner to be applied chairside or processed in the laboratory. The degree of retention may vary and these materials change over time. PURPOSE: This study evaluated the retention on an implant/bar prosthesis with overdentures lined with 4 resilient denture lining materials, after cyclic insertion and removal over a simulated 1.5-year period. MATERIAL AND METHODS: Four implants were placed in a mandibular edentulous cast and a gold bar superstructure was made. Overdentures were processed in Lucitone-199 and Tokuyama, Luci-Sof, Molloplast-B, and PermaSoft (with and without sealer) lining materials, cured according to manufacturers' instructions. Each of 5 overdentures contained each liner and were cycled 2740 times (simulating 1.5 years of service at 5 insertions daily) in 37 degrees C water in an Instron at 20 cm/min. Insertion and retention force were measured. RESULTS: The 3 silicone rubber liners were 3 to 5 times more retentive than the plasticized acrylic liner initially. After cycling, Tokuyama soft liner (autopolymerized silicone) gained 14% retention, Luci-Sof (heat-cured silicone) gained 8%, Molloplast-B (heat-cured silicone) lost 12%, whereas PermaSoft (autopolymerized plasticized acrylic) with sealer lost 43%, and without sealer lost 60%. PermaSoft lining material also chafed and crumbled after cycling and was significantly less retentive in most statistical comparisons. CONCLUSIONS: All the silicone-based resilient liners retained the overdentures well. The plasticized acrylic was less retentive initially, and lost significant retention after 2740 cycles, compared with silicone-based resilient liners.

Acrylic Resins↗
PubMedDate not supplied

Intrathoracic esophageal replacement with a collagen sponge--silicone double layer tube: evaluation of omental-pedicle wrapping and prolonged placement of an inner stent.

In a previous study, we replaced a 5 cm gap created in the canine intrathoracic esophagus with an artificial esophagus. However, although newly formed esophageal tissue subsequently bridged the gap, mild stenosis occurred, and this seemed to be caused by inadequate regeneration of the skeletal muscle. In the present study, we evaluated whether omental pedicle wrapping (OMPx) of the prosthesis could promote tissue regeneration and whether prolonged retention of the silicone tube within the prosthesis could prevent stenosis. A gap was created in 14 dogs, and the defect was repaired by our prosthesis. OMPx was performed in 5 of the 14 dogs (OMPx group) but not in the rest (control group). The silicone tube was retained for 4 weeks in the control group and for 8 weeks in the OMPx group. All of the dogs in the control group survived for more than 3 months, except for those that were killed. Four dogs in the OMPx group died within 3 months, one caused by perforation at 7 months. Only the thin epithelial and submucosal layer regenerated in the OMPx group. OMPx is not effective for promoting tissue regeneration, and prolonged retention of the silicone tube interrupts epithelial regeneration.

Animals↗
PubMed1978

An evaluation of facial prostheses.

A survey was conducted to evaluate patient reactions to facial prostheses that were provided to 143 patients in the past 7 years at Roswell Park Memorial Institute. Of the 76 patients who responded, 38 patients were wearing their prostheses and 38 patients were not wearing their prostheses. Reasons cited by the patients for not using their prosthesis included lack of retention, additional surgery, discomfort, and irritation. Most of the prostheses were prepared in silicone rubber with color characterization accomplished by the tattooing method. More than 69% of the prostheses were remade within a year because of rapid changes in the defect, prosthesis material, or prosthesis color. The study revealed the need for improvement in materials, adhesive techniques, and the psychological orientation of the patient. This project was conducted at a teaching and research institute. No fees for the patients were required. Therefore our data might differ from that collected from a private practice or clinic.

Adult↗
PubMed1999

Lipid uptake across the wall of an expanded polytetrafluoroethylene vascular graft.

Previous studies have shown that vascular grafts were prone to inducing an atherosclerosis-like phenomenon, thus possibly jeopardizing their performance. Furthermore, lipid retention, observed in most synthetic arterial prostheses explanted from humans, appears to have an important role in the progression of this atherosclerotic process, therefore hindering the healing process and neo-intima formation of these synthetic conduits. The current study examined lipid concentration profiles across prosthesis membranes exposed to lipid dispersion under various transmural pressures, flow rates, and durations of exposure. It was demonstrated that the lipids rapidly permeated the prosthesis membrane, as lipid advection increased to a maximum, then steadily decreased until the membrane became completely impermeable to the fluid. The concentration of lipids within the grafts was monitored using FT-IR microspectroscopy, then correlated as a function of time in order to evaluate the mass transfer coefficients and lipid saturation concentration. Lipid sorption, as a function of time, was described by a mechanism taking into account two first-order kinetic models. The lipids were first rapidly adsorbed onto the Teflon(R), potentially influenced by the strong affinity of these lipids for the highly hydrophobic polytetrafluoroethylene polymer. This affinity then enhanced the germination of the lipid deposits that filled in the prosthesis wall. For lipid retention as a function of the transmural pressure and flow rate, no clear tendency was established.

Bioprosthesis↗
PubMed1991

[Importance of the palatal seal for complete denture's retention].

By preserving the anatomic integrity of the stomatognathic system, a prosthesis allows its physiologic activities to proceed normally. A function imprint provides a picture of the prosthesis support and relationship between mobile tissues and prosthesis rims. A high-quality function imprint required, but current literature offers different opinions and views concerning the choice and method of taking a function imprint. Several procedures covering all methodologic differences can still be singled out: taking a function imprint without pressure, taking a function imprint with pressure, taking a function imprint with the mouth open, taking a function imprint with the mouth closed. The regions with a thin and less keratinized mucosa over the bone but without a submucosal interlayer must be relieved or imprinted without pressure. Forward inclination of the head and the position of the tongue make the soft palate to acquire a functional position on taking the imprint, thus allowing the posterior pharyngeal rim of the upper prosthesis to be determined. The greater the valve effect and the lesser the space between the prosthesis base and support, the higher the negative pressure upon the support. Imbibition is achieved by the prosthesis rims lying in the initial part of mobile mucosa, and the pharyngeal rim on the border between the hard and soft palate, in the region of the "ah" line. Retention of the prosthesis is mostly secured by its posterior, dorsal patal or pharyngeal rim. When pointing to its importance in retention, it applies to the rim margins, its relation to the support and its role in the valve closure of the upper total prosthesis.

Dental Impression Technique↗