A comparison of three methods to evaluate the position of an artificial ear on the deficient side of the face from a three-dimensional surface scan of patients with hemifacial microsomia.

PURPOSE: Patients with hemifacial microsomia may have a missing ear on the deficient side of the face. The fabrication of an ear for such individuals usually has been accomplished by directly measuring the ear on the normal side to construct a prosthesis based on these dimensions, and the positioning has been, to a large extent, primarily operator-dependent. The aim of the present study was to compare three methods, developed from the identification of landmarks plotted on three-dimensional surface scans, to evaluate the position of an artificial ear on the deficient side of the face compared with the position of the natural ear on the normally developed side. MATERIALS AND METHODS: Laser scans were undertaken of the faces of 14 subjects with hemifacial microsomia. Landmarks on the ear and face on the normal side were identified. Three methods of mirroring the normal ear on the deficient side of the face were investigated, which used either facial landmarks from the orbital area or a zero reference point generated from the intersection of three orthogonal planes on a frame of reference. To assess the methods, landmarks were identified on the ear situated on the normal side as well as on the face. These landmarks yielded paired dimensional measurements that could be compared between the normal and deficient sides. Mean differences and 95% confidence intervals were calculated. RESULTS: It was possible to mirror the normal ear image on to the deficient side of the face using all three methods. Generally only small differences between the dimensional measurements on the normal and deficient sides were observed. However, two-way analysis of variance revealed statistically significant differences between the three methods (P = .005). CONCLUSIONS: The method of mirroring using the outer canthi was found to result in the smallest dimensional differences between the anthropometric points on the ear and face between the normally developed and deficient sides. However, the effects of the deformity can result in limitations in relation to achieving a precise alignment of the ear to the facial tissues. This requires further study.

A comparison of prosthetic ear models created from data captured by computerized tomography, magnetic resonance imaging, and laser scanning.

PURPOSE: To compare the dimensional measurements and surface topography of stereolithographic models generated from computerized tomography (CT), magnetic resonance imaging (MRI), and laser scanning (LS) data with the same subjects' natural ears and ear casts. MATERIALS AND METHODS: Stereolithographic models were manufactured from images of the subjects' ears and ear casts recorded by CT, MRI, and LS, and dimensional measurements were compared. In the second part of the study, all stereolithographic models were CT scanned and reconstructed in an STL file format. A comparison of the surface topography of the CT, MRI, and LS model ears was made. RESULTS: Intraclass correlation coefficients indicated that dimensions could be reliably measured on the CT, MRI, and LS stereolithographic models. A 2-way analysis of variance revealed no statistical differences between the various sources of data (P = .991). The smallest differences of surface topography were observed on the MRI/CT superimpositions. CONCLUSION: The dimensional measurements on the stereolithographic models were similar to those from the original source. Only small differences were apparent between the surface topography of the CT, MRI, and LS models. MRI may be particularly appropriate to fabricate a prosthesis because it involves no radiation for the patient and internal form can be reproduced. The use of this technique in clinical practice requires further study.

A comparison between computerized tomography, magnetic resonance imaging, and laser scanning for capturing 3-dimensional data from a natural ear to aid rehabilitation.

PURPOSE: To compare dimensional measurements on computer images generated from data captured digitally by 3 different methods to those obtained directly from natural ears and ear casts, so as to determine the optimal method of creating a computer-generated ear image. MATERIALS AND METHODS: Magnetic resonance imaging (MRI) was used to obtain 3-dimensional (3D) data images of the normal ears of 14 subjects. Computerized tomography (CT) and laser scanning (LS) were used to obtain 3D data images from stone casts of the same ears. Dimensional measurements were recorded on 2 occasions between anthropometric landmarks on the subjects' natural ears, casts of the ears, and reconstructed ear images obtained by CT, MRI, and LS. The intraclass correlation coefficients and coefficients of repeatability were calculated. The means of the 2 measurements for each of the dimensions were analyzed using 2-way analysis of variance to determine whether there were differences between the methods of data collection. RESULTS: The intraclass correlation coefficients indicated that dimensions could be reliably measured on the natural ears, casts, and CT, MRI, and LS images. The coefficients of repeatability were all of a small magnitude in relation to the overall dimensions studied. No statistical differences existed between the various sources of data (P = .866) (i.e., direct, cast, CT, MRI, and LS). CONCLUSION: The 3 methods of imaging have generally resulted in dimensional measurements on the reconstructed images that are similar to those of the original source. These are considered appropriate for manufacturing 3D models that can be used to fabricate a prosthesis. However, other factors may also be important, such as shape, contour, and internal form, and these require further investigation.

A comparison between computerized tomography, magnetic resonance imaging, and laser scanning for capturing 3-dimensional data from an object of standard form.

PURPOSE: The study's aim was to compare dimensional measurements on computer images generated from data captured digitally by 3 different methods of the surfaces of a plastic cube of known form to those obtained directly from the cube itself. MATERIALS AND METHODS: Three-dimensional images were reconstructed of a plastic cube obtained by computerized tomography (CT), magnetic resonance imaging (MRI), and laser scanning. Digital calipers were used to record dimensional measurements between the opposing faces of the plastic cube. Similar dimensional measurements were recorded between the cube faces on each of the reconstructed images. The data were analyzed using a 2-way ANOVA to determine whether there were differences between dimensional measurements on the computer images generated from the digitization of the cube surfaces by the different techniques, and the direct measurement of the cube itself. RESULTS: A significant effect of how the measurements were taken (ie, direct, CT, MRI, and laser scanning) on the overall variation of dimensional measurement (P < .0005) was observed. Post hoc tests (Bonferroni) revealed that these differences were due principally to differences between the laser-scanned images compared to other sources (ie, direct, CT, and MRI). The magnitude of these differences was very small, up to a maximum mean difference of 0.71 mm (Cl +/- 0.037 mm). CONCLUSION: All 3 methods of imaging would be of value in further studies, not only for the fabrication of complex shapes such as prosthetic ears, but also for other facial prostheses.

Single tooth crowns supported on hydroxyapatite coated endosseous dental implants: a prospective 5-year study on twenty subjects.

AIM: To evaluate the success and maintenance requirements of cylindrical, hydroxyapatite coated implants used as single-tooth implants. DESIGN: A five-year prospective trial. METHOD: Twenty patients, attending the Department of Prosthetic Dentistry at GKT Dental Institute, London, were provided with 23 Calcitek, Integral Omniloc single tooth implants. Annual reviews were undertaken for five years. Assessment criteria included implant survival; abutment or crown looseness; radiographic evidence of bone loss; evidence of plaque and inflammation of the mucosal cuff; the patient's perception of the restoration. RESULTS: All implants integrated. Two subjects, with three crowns, dropped out giving a known cumulative survival rate of 87%. Twelve implants exhibited no measurable bone loss and six demonstrated funnel formation up to 2mm in depth which, at five years, appeared to be stable; three implants exhibited continuing bone loss and their inclusion as failures gives a known success rate of 74%. The abutments came loose on four occasions; the crowns decemented on 12 occasions; two crowns were repaired and one remade. The appearance was judged to be good or very good. CONCLUSION: The prospective study indicated that hydroxyapatite coated implants can be successful as single tooth implants, over a five-year period.

Maintenance requirements of implant-supported fixed prostheses opposed by implant-supported fixed prostheses, natural teeth, or complete dentures: a 5-year retrospective study.

PURPOSE: The purpose of this study was to compare the maintenance requirements of implant-supported fixed prostheses with cantilever arms in edentulous jaws when opposed by fixed prostheses of similar design, by natural teeth, or by complete dentures. MATERIALS AND METHODS: The maintenance requirements for the 5-year follow-up period were obtained by examining the dental records of 37 people. Six were provided with fixed prostheses in both arches, 22 with a fixed prosthesis in the mandible opposed by a complete denture, and 9 with a fixed prosthesis opposed by natural teeth. Everyone was treated with Nobel Biocare implants using standard implant and prosthetic protocols. RESULTS: The denture teeth and acrylic resin were repaired on 44 occasions in the group with implants in both jaws, on 14 occasions in the group with implants opposed by natural teeth, and twice in the group in which the implants were opposed by a complete denture. The group with implants in both jaws was more likely to fracture the gold-alloy framework, which occurred on six occasions. The group with implants in both jaws was significantly different from the other two groups in relation to higher incidence of fracture of the teeth and gold-alloy framework. CONCLUSION: The maintenance requirements of implant-supported fixed prostheses with cantilever arms opposed by fixed prostheses of similar design were much greater than when opposed by natural teeth or complete dentures.

The effects of fixed and removable implant-stabilised prostheses on posterior mandibular residual ridge resorption.

This study investigated the change over time in the area of the posterior mandibular residual ridge in patients wearing either i) mandibular overdentures stabilised by two implants (Brånemark System; Nobel Biocare, Göteborg, Sweden) connected by a bar, or ii) mandibular fixed cantilever prostheses stabilised on five or six implants. Proportional measurements were made in order to compare the area of the residual ridge with an area of bone uninfluenced by resorption. Measurements were made by digitising tracings of panoramic radiographs that were taken shortly after implant insertion and up to seven years later. With the use of overdentures, the posterior bone area index reduced by a mean of 1.1% per annum, while a mean bone area index increase of 1.6% per annum was demonstrated in association with fixed prostheses. A multiple linear regression model was fitted to predict the change in posterior area from type of prosthesis, gender, age, years of edentulism and initial height of the mandible. The model was only significant for initial height of mandible (P = 0.04) and type of prosthesis (P = 0.0001). In conclusion, patients rehabilitated with implant-stabilised mandibular overdentures demonstrated low rates of posterior mandibular residual ridge resorption, while patients rehabilitated with implant-stabilised mandibular fixed cantilever prostheses demonstrated bone apposition in the same area.