Prosthetic Reconstruction of Patients with Auricular Defect Using Extraoral Implants and CAD/CAM Titanium Frameworks: Case series.

Year 2021, Volume: 5 Issue: 1, 14 - 18, 19.06.2021

Makbule Şahan Mustafa Gürkan

https://doi.org/10.29228/erd.3

Abstract

Auricular defects can occur because of trauma, congenital disorders, and ablative tumor surgery and affect quality of life, psychology, and social behavior. Auricular prosthesis that are supported by extraoral implants are the most effective treatment. Lately, computer-assisted design and computer assisted machining (CAD/CAM) has been used the fabrication of implant-supported frameworks. The purpose of the case series was to evaluate the treatment of ten maxillofacial patients using CAD/CAM copy-milled framework for retention and support of auricular prosthesis. 10 patients were referred to Ege University Faculty of Dentistry department of prosthodontics for processing the auricular prosthesis. After the clinical and radiographic evaluation of the patients, extraoral were placed in the proper positions. After a four month healing period, an impression of the implant position was made using a dental impression material The manufacture of the titanium frameworks were completed with the CAD-CAM system. Once the matrixes were placed on the titanium framework, silicone auricular epistheses were processed. At the control appointments of 10 patient after 3 years, there were not found any discomfort or clinical inflamation at the titanium framework part or around the tissues. The CAD- CAM systems make possible of the fabrication of titanium frameworks that are more precise, durable and retentive.

Keywords

extraoral implant, CAD CAM, titanium framework

Kulak Defektli Hastaların Ekstraoral İmplant Ve Cad Cam Titanyum Altyapı İle Protetik Rehabilitasyonu: Vaka Serisi

Abstract

Kanser cerrahisi, doğumsal anomaliler, travma veya yanık sebebiyle meydana gelen kulak defektleri, hastanın yaşam kalitesini, psikolojisini ve sosyal hayatını olumsuz yönde etkilemektedir. İmplant destekli kulak protezleri maksillofasiyal defektli hastalar için önemli bir tedavi seçeneğidir. Günümüzde bilgisayar destekli tasarım ve bilgisayar destekli üretim sistemleri (CAD-CAM) ile implant destekli protezlere titanyum alt yapılar üretilmektedir. Bu vaka serisinin amacı, kulak protezlerinin retansiyon ve sağlamlığı için CAD-CAM sistemleri ile üretilen titanyum alt yapıların tedavisini değerlendirmektir. Ege Üniversitesi Dişhekimliği Fakültesi Protetik Diş Tedavisi bölümüne kulak protezi yapımı için 10 hasta yönlendirildi. Klinik ve radyografik değerlendirmeleri yapıldıktan sonra uygun olan bölgelere ekstraoral implantlar yerleştirildi. 4 aylık iyileşme döneminden sonra ekstraoral implantların ölçüleri alındı. CAD-CAM sistemi ile titanyum alt yapıları üretildi. Barlar üzerine matriksler yerleştirildikten sonra silikondan kulak protezleri üretildi. Kulak protezi yapılan 10 hastanın 3 yıllık kontrollerinde titanyum alt yapılarda ve çevre dokularında herhangi bir yakınma ve klinik bulgu gözlenmedi. CAD-CAM sistemleri titanyum alt yapıların daha dayanıklı, hassas ve tutucu olmasını mümkün kılmaktadır.

Keywords

Ekstroral implant, CAD CAM, titanyum altyapı

References

• Chang TL, Garrett N, Roumanas E, Beumer J. Treatment satisfaction with facial prostheses, J Prosthet Dent(JPD) 2005; 94: 275-80.
• Saraçoğlu B, Zulfikar H, Atay A, Gunay, Y. Treatment Outcome of Extraoral Implants in the Carniofacial Region J Craniofac Surg(JCS) 2010; 21: 751-8.
• Nemli SK, Çağlar A, Sarısoy Ş. İmplant destekli kulak protezinde doku uyumunun sağlanması: Olgu sunumu. GÜ Diş Hek Fak Derg. 2010; 27(3): 201-6.
• Atay A, Karayazgan B, Günay Y, Oruç S. Kulak protezi yapımı: farklı bir teknikle. Gülhane Med J 2009; 51: 122-5.
• Atay A, Uzel G, Günay Y. İmplant destekli kulak protezi: Olgu sunumu Gülhane Tıp Derg 2013; 55: 314-7.
• Beumer j, Curtis TA, Marunick MT. Maxillofacial rehabilitation: prosthodontic and surgical considerations. St.Louis: Medico Dental Media Intl, 1996: 81-83, 444-9.
• Roumanas ED, Freymiller EG, Chang TL, et al. Implantretained prostheses for facial defects: an up to 14-year follow-up report on the survival rates of implants at UCLA. Int J Prosthodont (IJP) 2002; 15: 325-7.
• Pehlivan N, Nemli SK, Karacaer Ö. Çene yüz protezleri ve ekstraoral implantlar GÜ Diş Hek Fak Derg 2011; 28(2): 123-9.
• Daniel S, Eggbeer D. A CAD and AM process for maxillofacial prostheses bar-clip retention Rapid Prototyping Journal (RPJ), 2016; 22(1): 170-7.
• Gitto CA, Plata WG, Schaaf NG. Evaluation of the peri implant epithelial tissue of percutaneous implant abutments supporting maxillofacial prostheses. Int J Oral maxillofac Impl (JOMI) 1994; 9: 197-206.
• Jacobsson M, Tjellstrom A, Fine L,et al. A retrospective study of osseointegrated skin-penetrating titanium fixtures used for retaining facial prostheses. Int J Oral Maxillofac Implants (JOMI) 1992; 7: 523-8.
• Nishimura RD, Roumanas E, Moy PK, Sugai T. Nasal defects and osseointegrated implants: UCLA experience. J Prosthet Dent (JPD) 1996;76: 597-602.
• Wright RF, Zemnick C, Wazen JJ, Asher E. Osseointegrated implants and auricular defects: A case series study. J Prosthodont (JOP) 2008; 17: 468-75.
• Curi MM, Oliveira MF, Molina G, et al: Extraoral implants in the rehabilitation of craniofacial defects: implant and prosthesis survival rates and peri-implant soft tissue evaluation. J Oral Maxillofac Surg (JOMS) 2012;70:1551-7.
• Karakoca S, Aydin C, Yilmaz H, et al: Retrospective study of treatment outcomes with implant-retained extraoral prostheses: survival rates and prosthetic complications. J Prosthet Dent (JPD) 2010;103:118-126.
• Feng Z, Dong Y, Zhao Y, Bai S, Zhou B, Bi Y, Wu G. Computer-assisted technique for the design and manufacture of realistic facial prostheses. Br J Oral Maxillofac Surg (BOMS), 2010, 48: 105-9.
• Ciocca L, Scotti R. CAD-CAM generated ear cast by means of a laser scanner and rapid prototyping machine. J Prosthet Dent (JPD), 2004, 92: 591-5.
• Cheah CM, Chua CK, Tan KH, Teo CK. Integration of laser surface digitizing with CAD/CAM techniques for developing facial prostheses. Part 1: Design and fabrication of prostheses.