Beruflich Dokumente
Kultur Dokumente
a
Specialty Registrar, Restorative Dentistry, Moriston Hospital Restorative Department, Swansea, Wales.
b
Lead Restorative Technologist, Moriston Hospital Restorative Department, Swansea, Wales.
c
Maxillofacial Prosthesist, Moriston Hospital Restorative Department, Swansea, Wales.
d
Consultant in Restorative Dentistry, Moriston Hospital Restorative Department, Swansea, Wales.
magnetically retained nasal prosthesis. In addition, a However, maxillofacial prostheses are not without
polymerized silicone impression with the bar and magnets caveats, and the potential complications of the prosthe-
in situ was made. Magnet analog xtures were located on ses described in this article include risk of zygomatic
top of the impression magnets, and the impression was implant infection, irritation of supporting tissues, lifelong
poured in gypsum (Crystacal R Plaster; SWIP Dental). A prosthesis maintenance, and signicant patient cooper-
baseplate was fabricated with magnets and light- ation for successful acclimatization. Specic difculties
polymerized resin (Triad Gel; Dentsply Intl) and evalu- described by the patients include degradation of nasal
ated to verify the accuracy of the cast. A wax prototype was prosthesis, food leakage, dropping of posterior borders of
fabricated from a preoperative computed tomography the obturator, and generalized discomfort. A specic
scan in CAD software (Freeform; Geomagics) to dene the problem occurred for Patient 2; the titanium bar fractured
shape. A postoperative 3D surface scan (5-pod; 3DMD) at the welding spot soon after placement. Titanium is
was made, and the preoperative nose was adjusted to form more difcult to weld than Co-Cr because of the need for
a virtual nasal prosthesis. This was fabricated in stereo- a pure argon environment. The weld was repeated with
lithography resin (PDR) and duplicated in wax (Anutex; no further problems. All 3 bars, obturators, and nasal
Kemdent). Finally, the wax prototype was incorporated prostheses t well and were clinically stable and reten-
into the baseplate, and denitive carving was conducted at tive. As of the present writing, 2 patients are functioning
the clinical evaluation appointment. A gypsum cast of the well with their prostheses, but 1 patient struggled psy-
wax prototype was produced and the wax was eliminated. chologically with the appearance of the bar, so it was not
The plaster cast was lled with silicone elastomer (Cos- tted. Instead she has a magnetically retained nasal
mesil HC2; Cosmesil), color matched, and polymerized. prosthesis with an obturator retained with soft tissue
Figure 8 shows the denitive nasal prosthesis and obtu- undercuts.
rator in situ.
REFERENCES
DISCUSSION
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Corresponding author:
prostheses by the patient; provision of upper lip support Dr Elizabeth King
from the obturator, and avoidance of further invasive Morriston Hospital Restorative Dentistry Department
Heol Maes Eglwys
surgical procedures (such as dental implant placement, Morriston, Swansea
bone grafting) for obturator retention. Use of zygomatic WALES
Email: elizabeth.king@hotmail.com
implants for the concurrent retention of obturator and
nasal prostheses signicantly simplies orofacial reha- Acknowledgments
The authors thank Peter Llewelyn Evans for providing Figure 1.
bilitation and removes the need of further invasive sur-
gical procedures. Copyright 2016 by the Editorial Council for The Journal of Prosthetic Dentistry.