ABSTRACT
Aim: To bring into light an evidence-based approach to fabricate an orbital prosthesis in a post-coronavirus disease 2019 (COVID-19) mucormycosis-affected individual, which is simple, efficient, and economically advantageous. Background: Rehabilitation of facial defects becomes a demanding task as it is noticed distinctly and might be a socially awkward situation for the individual. Especially, a missing eye/contents of the orbit have a negative impact on the patients, which necessitates immediate rehabilitation. Various treatment modalities are at hand to rehabilitate such patients, of which implant-supported prosthesis has a finer retentive outcome. However, it cannot be administered among all patients due to economic or other unfavorable surgical limitations. Case description: This case report projects a 54-year-old male;a case of exenterated orbit secondary to post-COVID-19 mucormycosis surgery. The reconstruction of this patient was planned by a two-piece magnet-retained prosthesis with a silicon outer prosthesis. A heat-processed acrylic conformer was fabricated for the defected part, and a silicon superstructure to reconstruct the missing anatomy was done. Retention was achieved using natural undercuts, magnet, and adhesive. Conclusion: A systematic and meticulous approach is warranted based on the tissue makeup, material handling, and retentive aids as per the patient's expectations and affordability for maxillofacial rehabilitation. An evidence-based, multidisciplinary approach with the skill of the clinician is essential in providing effective and optimum rehabilitation. The treatment strategy adopted in this case is simple and economical and can be adapted for mass rehabilitation of orbital defects at an accelerated pace. Clinical significance: Much research is necessary in the digital domain of maxillofacial prosthodontics such that it is financially affordable, accessible, and an approach that reduces chairside time. Also, retentive aids which have a more predictable outcome, like implants, should be considered so as to improve the quality of life of the patient. © The Author(s).
ABSTRACT
Objective: The production of personalized prosthesis depends on human resources and involves a manufacturing process in which patients are involved individually in. As the world is experiencing the COVID-19 pandemic, less contact with the manufacturer is needed to stay safe. 3D printed prosthesis has reduced the need for human resource in the process, while allowing the patient to be completely removed from the design and manufacturing process. In this study an approach in which the patient is kept out of the manufacturing process was investigated. Material(s) and Method(s): The prosthesis model was created by using the image data obtained from the medical imaging devices. The outer part of the prosthesis was shaped with a developed image sampling system. The model was produced using three-dimensional printer. A cytotoxic analysis of the raw material used in the manufacturing process was performed. Result(s): The total production cost of the orbital implants was approximately about 8$. The cytotoxic analysis showed that layered manufacturing strategies could be used to develop implants and prostheses applicable to patients. Conclusion(s): COVID-19 underlined the importance of social distancing which is hard to apply during manufacturing of an eye prosthesis. The manual method results in an eye prosthesis which suits well after numerous trials. On the contrary, Digital Imaging and Communications in Medicine (DICOM) based eye prosthesis designation and manufacturing is not only rapid but also flawlessly fitting due to precise measurement during the manufacturing. Copyright © 2022, Nobelmedicus. All rights reserved.