A radiation-shielding device for craniofacial implant placement.

The use of radiation shields in the head and neck cancer patient receiving adjuvant radiation therapy is a treatment alternative for protecting anticipated prosthetic implant sites. Shields can be fabricated easily as part of an interdisciplinary treatment protocol. In this article, the methods used to fabricate an extraoral radiation shield are described, and a patient treatment that illustrates possible uses of the shield for both extraoral and intraoral sites is presented.

Modification of a Super-Sep bottle for paint-on application of a separating medium used in flasking dentures.

Modifying a Super-Sep bottle by adding a brush to the lid for paint-on use allows for the precise application of the separating medium used when flasking dentures. Super-Sep offers many advantages over other commonly used separating mediums: It is virtually dimensionless, allowing for better accuracy; it dries quickly and functions best on moist stone; and it can be poured against immediately. The latter fact means less time is needed before the subsequent layers of stone can be applied when denture flasking.

Multidisciplinary treatment for an implant retained auricular prosthesis rehabilitation.

Retention of a facial prosthesis is the most important factor in creating a useful prosthesis for the patient. This paper presents a detailed case study of an auricular defect that was rehabilitated using two types of prosthetic retention: adhesive and osseointegration. We present the patient selection criteria, the surgical considerations prior to implant placement, retention component selection, prosthetic fabrication techniques and patient management after prosthetic delivery. The osseointegrated prosthesis made a large improvement in the patient's quality of life.

Auricular rehabilitation with bone-anchored titanium implants.

OBJECTIVE: To evaluate the effectiveness of the bone-anchored titanium implants in auricular reconstructions. STUDY DESIGN: Six patients who received implants for an auricular reconstruction were followed prospectively. Four patients had lost their ears to cancer, and the other two had congenital aural atresia. METHODS: All patients were thoroughly evaluated by the reconstruction team, which included a surgeon, a prosthodontist, and a facial prosthetist. Three patients were evaluated audiologically for a bone-anchored hearing aid. Four patients received implants in a single-stage procedure, and two underwent a two-stage procedure. A gold bar with retaining clips was used to anchor the prosthetic ear in four patients, and magnets were used in the remaining two. RESULTS: All six patients are completely satisfied with their reconstructions. No failures, extrusions, or bony complications were encountered. One patient had recurrent dermatitis, which subsided when his gold bar was replaced with magnets. CONCLUSION: Implanted under the guidance of an appropriate prosthetic team, bone-anchored titanium implants provide patients with a safe, reliable, adhesive-free method to anchor auricular prostheses with recovery of their normal appearance.

Fabrication and use of a surgical template for placing implants to retain an auricular prosthesis.

A procedure is described for the fabrication of a 3-dimensional surgical template to guide the placement of implants to retain an auricular prosthesis. This procedure requires a diagnostic wax pattern that is checked while on the patient to ensure it is positioned correctly and is also the correct size. The wax pattern is processed into a clear, methyl methacrylate resin, 3-dimensional surgical template. The most effective type of surgical template for planning implant placement is a 3-dimensional acrylic template that closely resembles the final prosthesis. This template will direct the implant placement where the retentive elements are most easily concealed, under the thickest areas of the prosthesis, which are the antihelix and antitragus. This location allows the best esthetic and functional results. An additional advantage of this technique is that it allows the retrieval of the diagnostic wax pattern of the auricle so that it can be used to fabricate the definitive prosthesis.