Use of Immediate Obturator Prosthesis as a Rehabilitation Option in Cases of Squamous Cell Carcinoma.

ABSTRACT: Maxillary defects caused by surgical resection generate abnormal communication between the nasal and oral cavities, hindering proper eating and phonetics, and causing aesthetic damage. Prosthetic intervention is necessary to rehabilitate these patients, in order to block communication and allow correct speech and swallowing functions. This article reports the manufacture of an immediate palatal obturator prosthesis after hemimaxillectomy due to the surgical removal of an intraoral squamous cell carcinoma, which guaranteed better conditions for postoperative recovery, as well as better adaptation to the definitive prosthesis and the use of the prosthetic apparatus.

Effect of different disinfectants on the microhardness and roughness of acrylic resins for ocular prosthesis.

BACKGROUND: Ocular prosthesis materials should have specific properties for their indication and durability; therefore, it is important to investigate their physical behaviour when affected by several disinfectants. OBJECTIVES: This study evaluated the influence of different disinfecting solutions on the microhardness and surface roughness of acrylic resins for ocular prosthesis. MATERIALS AND METHODS: Fifty samples simulating ocular prostheses were fabricated with N1 resin and colourless resin and divided (n = 10) according to the disinfectant used: neutral soap, Opti-free, Efferdent, 1% hypochlorite (HYC) and 4% chlorhexidine (CHX). Samples were stored in saline solution at 37°C and disinfected during 120 days. Both microhardness and roughness were investigated before, after 60 days and 120 days of disinfection and storage. Microhardness was measured using a microhardner and the roughness with a roughness device. RESULTS: N1 resin showed lower microhardness when compared with colourless resin (p < 0.05). HYC and CHX groups exhibited the highest change of microhardness and roughness values (p < 0.05). An increase in roughness and reduction in microhardness of ocular acrylic resins were observed after both periods of disinfection and storage (p < 0.05). CONCLUSION: Both disinfection/storage periods affected the microhardness and roughness values of the samples.

Hyperbaric oxygen therapy treatment for the fixation of implant prosthesis in oncology patients irradiated.

OBJECTIVES: This study aimed to present a clinical report of an irradiated oncologic patient who underwent hyperbaric oxygen therapy to be rehabilitated with implant-supported prosthesis. MATERIALS AND METHODS: A 67-year-old man was admitted at Oral Oncology Center (FOA-UNESP) presenting a lesion on the mouth floor. After clinical evaluation, incisional biopsy and histopathological exam, a grade II squamous cell carcinoma was diagnosed. The patient was subjected to surgery to remove the lesion and partial glossectomy. Afterwards, the radiotherapy, in the left/right cervicofacial area of the supraclavicular fossa, was conducted. After 3 years of the surgery, the patient was submitted to hyperbaric oxygen therapy. Then, four implants were installed in patient's mandible. Five months later, an upper conventional complete denture and lower full-arch implant-supported prosthesis were fabricated. CONCLUSION: The treatment resulted in several benefits such as improving his chewing efficiency, swallowing and speech, less denture trauma on the mucosa and improving his self-esteem.

Rehabilitation with ear prosthesis linked to osseointegrated implants.

BACKGROUND: The absence of an ear, which can be the result of a congenital malformation, surgical tumour resection or traumatic injury, is a significant aesthetic problem. Attachment of ear prostheses with adhesives can cause local irritation for the wearer and affect the colour of the prostheses. Use of implants in craniofacial reconstruction can improve the retention and stability of prostheses giving to patient greater comfort and security relative to adhesive attachment. OBJECTIVE: The aim of this report was to present a clinical case of a mutilated patient who was rehabilitated by means of installing an ear prosthesis fixed through osseointegrated implants. MATERIALS AND METHODS: The patient had two implants installed in the mastoid region that were linked by a bar, and a clip-type system was used. The ear prosthesis was constructed from medical-use silicone, pigmented to match the patient's skin colour and linked to the retention system. CONCLUSION: The patient's rehabilitation was satisfactory from both a functional and an aesthetic point of view, making it possible for the patient to return to a normal social life and regain lost self-esteem.

Effect of disinfection and storage on the flexural strength of ocular prosthetic acrylic resins.

OBJECTIVE: To evaluate the influence of chemical disinfection and storage duration on the flexural strength of acrylic resins commonly used to make ocular prostheses. METHODS: A total of 260 samples were manufactured with N1 resin and colourless resin. Both resins were thermopolymerised using a microwave oven. Samples were stored and periodically disinfected and were divided into groups: control (no disinfection) (I), neutral soap (II), Opti-free (III), Efferdent (IV), 1% hypochlorite (V) or 4% chlorhexidine (VI). The flexural strength was measured before and after 60 and 120 days of storage. Data were analysed by anova and Tukey test (0.05). RESULTS: The flexural strength of the N1 resin was higher than that for the colourless resin. There was a significant difference in the flexural strength before and after 60 and 120 days of storage with disinfection, regardless of the resin and disinfectant. Group I in the initial period exhibited greater flexural strength, with significant difference only in group VI after 120 days. CONCLUSION: It can be concluded that the flexural strength only changed after 120 days of storage for samples disinfected with chlorhexidine. However, all flexural strength values obtained herein were acceptable clinical limits for the acrylic resins.

Influence of opacifiers on dimensional stability and detail reproduction of maxillofacial silicone elastomer.

BACKGROUND: We evaluated the influence of chemical disinfection and accelerated aging on the dimensional stability and detail reproduction of a silicone elastomer containing one of two opacifiers. METHODS: A total of 90 samples were fabricated from Silastic MDX 4-4210 silicone and divided into groups (n = 10) according to opacifier content (barium sulfate or titanium dioxide) and disinfectant solution (neutral soap, Efferdent, or 4% chlorhexidine). The specimens were disinfected 3 times per week during 60 days and then subjected to accelerated aging for 1008 hours. Dimensional stability and detail reproduction tests were performed after specimens' fabrication (baseline), chemical disinfection and periodically during accelerated aging (252, 504, and 1008 hours). The results were analyzed using 3-way repeated-measures ANOVA and the Tukey HSD test (α = 0.05). RESULTS: All groups exhibited dimensional changes over time. The opacifier (p = .314), period (p < .0001) and their interactions (p = .0041) affected the dimensional stability of the silicone. Statistical significant dimensional differences occurred between groups with (0.071) and without opacifiers (0.053). Accelerated aging influenced the dimensional stability of the samples. All groups scored 2 in the detail reproduction tests, which represents the fully reproducing of three test grooves with accurate angles. CONCLUSIONS: Incorporation of opacifiers alters the dimensional stability of silicones used in facial prosthetics, but seems to have no influence on detail reproduction. Accelerated aging is responsible for most of the dimensional changes in Silastic MDX4 4210, but all dimensional changes measured in this study remained within the limits of stability necessary for this application.