Lupine Publishers | Maxillofacial Prosthetics

 Lupine Publishers | Journal of Pediatric Dentistry

Mini Review

Overview

A prosthesis can be defined as- “An artificial replacement of part of the human anatomy restoring form, function, and esthetics”. Patients who have suffered maxillofacial impairment exhibit a compromised appearance making them incapable of leading a normal life. Such patients experience a change in societal acceptance that greatly affects their mental health, and often their expectation to return to a normal life crumbles. With sophistication in plastic surgery, aesthetic corrections of such defects is possible, but, if surgery is contraindicated or the defect is so extensive that full closure is not possible or if the patient is unwilling to expose him/herself to surgery, maxillofacial prosthetics appear to be a viable option.

What is maxillofacial prosthetics?

Maxillofacial prosthetics is a branch of dentistry that deals with congenital and acquired defects of the head and neck. Maxillofacial prosthetics integrates parts of multiple disciplines including head and neck oncology, congenital malformation, plastic surgery, speech, and other related disciplines. With recent advancements in prosthetic materials, coloring techniques and retentive mechanisms, a life like prosthesis can be given. The biggest impact of such prostheses is not only on the appearance but majorly on the mental health of the patient. The main objective is not only rehabilitation of the defect but also restoring confidence and improving quality of life of the patient.

Objectives

The objectives of maxillofacial prosthetics includes the following important objectives:
a) Re-establishment of esthetics or cosmetic appearance of patient.
b) Re-establishment of function.
c) Protection of tissue.
d) Therapeutics or healing effect.
e) Psychological therapy.

Types of maxillofacial prostheses

Extra oral Prostheses:

a) Ocular Prosthesis: Replaces Eye
b) Orbital Prosthesis: Replaces Eye and surrounding tissues
c) Auricular Prosthesis: Replace Ear
d) Nasal Prosthesis: Replaces Nose
e) Midfacial Prosthesis: Replaces part of the face which may involve more than One structure.
f) Somatic Prosthesis: Replaces a body part like fingers, hands, etc.
g) Radiation Shield: Worn during radiation therapy for protection of normal tissues.

Intraoral Prostheses

a) Surgical Obturator Prosthesis: Covers palate after partial or total loss of the maxilla (upper jaw). This is used after surgery to provide closure.
b) Interim and Definitive Obturator: Covers palate after partial or total loss of maxilla or due to cleft palate. It restores teeth and gums and has an extension which closes the defect or hole for swallowing, eating, chewing, and speaking.
c) Palatal Lift Prosthesis: Helps soft palate assume correct position for speech.
d) Palatal Augmentation (Drop) Prosthesis: Alters palate prosthetically for speech.
e) Mandibular Resection Prosthesis: Replaces portion of the jaw that has been lost and restores gums and teeth.

Materials Used

a) Acrylic resin.
b) Acrylic polymer.
c) Pvc- hard, clear resin, flexible, odorless and tasteless.
d) Chlorinated polyethylene- thermoplastic elastomer
substitute for silicone.
e) Silicone- most successful.
f) Polyphosphazenes.

Ideal Properties of the Material

a) High tear strength
b) Biocompatible
c) High edge strength
d) Long working time
e) Reusable mould
f) Non allergic
g) Softness and elongation
h) Translucent

Conclusion

The rehabilitation of intraoral and extra oral defects and reestablishment of function is a challenging aspect of maxillofacial prosthodontics. It requires continuing practice of the art to gain confidence and expertise. The goals of the surgeon and prosthetic specialist regarding rehabilitation of the patient are closely allied. The maxillofacial prosthodontist should always try to provide the comprehensive and thorough treatment. Sophistication in the prosthetic reconstruction of structural and functional defects improves the final results, if carefully planned, unbiased rehabilitation regimens are established. It is a basic right to look human.

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