Effect of Accelerated Aging on the Sorption and Solubility Percentages of Silicone Facial Prostheses

Objective This study aimed to evaluate the effect of accelerated aging on the sorption and solubility percentages of the MDX4-4210 and A-2186 silicones. Materials and Methods Two silicones (A-2186 and MDX4-4210) and three intrinsic pigments (bronze, black, and pink) were used in this study. Thus, six groups were created (n = 10): Group 1 = bronze MDX4-4210; Group 2 = black MDX4-4210; Group 3 = pink MDX4-4210; Group 4 = bronze A-2186; Group 5 = black A-2186; and Group 6 = pink A-2186. The dimensions of all samples were the same (45-mm diameter (ø) × 1-mm thickness). The samples were aged for a total of 1,008 hours. In this period of 1,008 hours of accelerated aging, the sorption and solubility percentages of each sample were calculated at three time points (252, 504, and 1,008 hours). Statistical Analysis Three-way analysis of variance (ANOVA) and the Tukey test were performed (α = 0.05). Result Accelerated aging can significantly increase the sorption and solubility percentages of the MDX4-4210 and A-2186 silicones.

Reconstruction of Orbital Exenteration Defects with Cheek Rotation Flaps: Indications, Technique, Complications, Rehabilitation, and Survival

The objective of this study was to examine the role of cheek rotation flaps in the reconstruction of orbital defects after exenteration. From January 2000 to August 2018, patients undergoing orbital exenteration and reconstruction with cheek rotation flaps were enrolled in this retrospective study. All patients were evaluated for wound complications, orbital rehabilitation, tumor relapse, and survival. Thirty patients completed the study. Fourteen complications allocated to 11 patients were assessed. The most common complications were seroma (13%), temporary facial nerve weakness (13%), and partial necrosis of the flap (10%). A major complication occurred in a total of two patients (7%), so that surgical correction was necessary. Eleven patients had a relapse; 15 patients died as part of the follow-up. Fifteen patients were treated with facial prostheses. The overall survival rate was 61% after 1 year and 42% after 5 years. Follow-up periods ranged from 6 to 95 months. Cheek rotation flap reconstruction after exenteration is a reliable method with a low rate of major complications. It is indicated when an approach to the parotid gland or the neck region is necessary because of suspected lymph node metastasis and in elderly patients because of their skin's laxity. It can be performed as primary or secondary reconstruction. Good esthetic results can be achieved, especially after endosseous implantation.

Palatomaxillary Obturation and Facial Prosthetics in Head and Neck Reconstruction

Rehabilitation of head and neck defects following trauma, oncologic resection, or congenital malformation is a challenging task. Not only is the restoration of three-dimensional form necessary for acceptable cosmesis, but simultaneous restoration of functional speech and swallow is also essential for optimal reconstruction outcomes. While advances in free tissue transfer have allowed surgical reconstruction of head and neck defects once considered inoperable and associated with poor quality of life, not all patients are ideal surgical candidates. As such, nonsurgical solutions to both functional and cosmetic restoration remain a necessary alternative option. Facial prostheses and palatomaxillary obturators have evolved with increasingly biocompatible materials as well as retention systems to address significant defects that challenge the limits of surgical reconstruction.

Reabilitação facial por meio de prótese oculopalpebral

A prótese bucomaxilofacial visa a reabilitação de pacientes que sofreram mutilações na face, restituindo estética e autoestima. Este trabalho visa relatar o caso clínico de um paciente reabilitado com prótese oculopalpebral após sofrer exenteração de órbita, decorrente de um carcinoma espinocelular em pálpebra inferior direita. Paciente, gênero masculino, 56 anos, procurou atendimento odontológico queixando-se de desconforto estético do rosto. Ao exame clínico foi observada ausência do globo ocular, pálpebras e arco superciliar do lado direito, por isto, foi planejada a confecção de uma prótese oculopalpebral. Foi realizada moldagem dos terços superior e médio da face, obteve-se o molde em alginato e, posteriormente, o modelo em gesso. Em seguida, foi confeccionado um globo ocular caracterizado em resina acrílica termopolimerizável. Posteriormente realizou-se, sobre o modelo de gesso, a escultura da área amputada utilizando-se plastilina e cera e após prova e ajustes no paciente, inclusão do conjunto modelo/escultura em mufla e contramufla, com posterior eliminação da peça esculpida. Foi selecionada a cor da pele do paciente e misturou-se uma base ao silicone, que foi incluído na mufla para prensagem. Após a vulcanização do silicone, foram realizados os acabamentos, caracterização e instalação da prótese. Na proservação o paciente relatou grande satisfação com a reconstituição da estética facial. Conclui-se que a prótese bucomaxilofacial é uma alternativa satisfatória para a reabilitação de pacientes que sofreram mutilações faciais, pois restabelece a estética facial, autoestima e convívio social. Descritores: Prótese Maxilofacial; Olho Artificial; Reabilitação; Carcinoma de Células Escamosas. Referências Duncan BGF, Calhoun ME. Facial prostheses in the rehabilitation of burn patients. 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Pinheiro BCL, De Mattos TCB, Dias ST, Braga FP, Leal CMB, Nichthauser B. Reabilitação com prótese ocular em paciente anoftálmico. Full Dent. Sci. 2020;11(42):98-103. Wondergem M, Lieben G, Bouman S, van den Brekel MW, Lohuis PJ. Patients' satisfaction with facial prostheses. Br J Oral Maxillofac Surg. 2016;54(4):394-9. Lanzara R, Thakur A, Viswambaran M, Khattak A. Fabrication of ocular prosthesis with a digital customization technique - a case report. J Family Med Prim Care. 2019;8(3):1239-42. Brandão TB, Filho AJV, Batista VES, Ribeiro ACP, Nary Filho H, Chilvarquer I, et al. Assessment of treatment outcomes for facial prostheses in patients with craniofacial defects: A pilot retrospective study. J Prosthet Dent. 2017;118(2):235-41. Koyama S, Sasaki K, Hanawa S, Sato N. The potential of cohesive silicone for facial prosthetic use: a material property study and a clinical report. J Prosthodont. 2011;20(4):299-304. Soares LHS, Bello CV, Reis AKL, Nunes RR, Mason EM. 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Implant-supported orbital prosthesis: a technical innovation of silicone fabrication

Background Silicone-based facial prostheses have traditionally been considered difficult to make and require time-consuming fabrication due to their basic liquid characteristics. Methods and results A detailed procedure for creating an ideal silicone orbital prosthesis was developed, including dental implant-supported retention, three-dimensional (3D) orbital scanning with symmetric volume and size measurement based on matching the opposite side, master mold fabrication for convenient pouring of the liquid silicone elastomer, and easy and comfortable management of the prosthesis by the patient. Conclusion A silicone orbital prosthesis could be more easily and conveniently produced using updated surgical skills and modern 3D technology. The combination of 3D scanning with digital reconstruction and an innovative fabrication protocol using a reproducible major mold and multiple prototypes fitting resulted in an accuracy personalized facial prosthesis with accessible cost and short production period.