The history and development of facial prostheses.

This paper includes the historical development of the modern-day facial prosthesis, the various materials used from the early days to the present, and the historical input of various people and their contributions towards the development of the qualities in fabricating a lifelike facial prosthesis.

Resection of a giant ossifying fibroma through an intraoral approach in a 9-year-old child: immediate reconstruction and 6-year cephalometric follow-up.

An unusual opportunity was afforded to study the growth and development of the facial structures of a 9-year-old child who underwent major mandibular reconstruction. The longitudinal studies confirmed the present concepts of the factors responsible for mandibular growth as well as their repercussions on other facial structures. An intraoral subperiosteal resection of a major portion of the right hemimandible sparing the upper part of the mandibular ramus was required to eradicate a large ossifying fibroma. An iliac bone graft consisting of the outer table of cortical bone and cancellous bone was placed within the mucoperiosteal sac to repair the defect. It also was used to control the ramus remnant. The patient was followed for 6 years. The growth of the reconstructed mandible was in effect nearly symmetrical with the unaffected contralateral portion of the mandible, resulting in minimal facial asymmetry. The mucoperiosteum provided a vascular bed for the bone graft and the buccal sulcus was preserved, thus providing a retentive ridge and sulcus for a denture without the need to perform a skin or mucosal graft inlay procedure. The symmetrical growth of the mandible is attributed to the growth of the ramus by remodeling, resorption, deposition, and relocation and by the muscle-bone interface (the functional matrix).

Maxillofacial prosthetics.

In the wide variety of maxillofacial deformities resulting from congenital malformation, trauma, or excision of malignant tissue, restoration of function and of facial form is achieved by the replacement of missing soft tissue, repositioning of displaced bone, bone grafting of osseous defects, and restoration of adequate contour. In these cases, the surgeon and prosthodontist must work hand in hand. Prostheses may be temporary or permanent, depending on the extent of deformity, the age of the patient, and the long-term needs. Prostheses can be made from various materials, including methyl methacrylate, silicone, and polyvinyl, but until a substance is found that fulfills all the properties of an ideal prosthesis, the search for suitable substances will continue.

Diseases of the oral mucosa.

Lesions of the oral mucosa are numerous. The purpose of this article is to review the more common and most serious of them, to explore some basic-science aspects of their development and to discuss prevention and treatment.