J Adv Prosthodont.  2010 Sep;2(3):65-70. 10.4047/jap.2010.2.3.65.

Modified technique to fabricate a hollow light-weight facial prosthesis for lateral midfacial defect: a clinical report

• Patil PG

• KMID: 2118108
• DOI: http://doi.org/10.4047/jap.2010.2.3.65

Abstract

Large oro-facial defects result from cancer treatment consequences in serious functional as well as cosmetic deformities. Acceptable cosmetic results usually can be obtained with a facial prosthesis. However, retention of a large facial prosthesis can be challenging because of its size and weight. This article describes prosthetic rehabilitation of a 57-year-old man having a right lateral mid-facial defect with intraoral-extraoral combination prosthesis. A modified technique to fabricate a hollow substructure in heat-polymerizing polymethyl-methacrylate to support silicone facial prosthesis was illustrated. The resultant facial prosthesis was structurally durable and light in weight facilitating the retention with magnets satisfactorily. This technique is advantageous as there is no need to fabricate the whole prosthesis again in case of damage of the silicone layer because the outer silicone layer can be removed and re-packed on the substructure if the gypsum-mold is preserved.

Keyword

Extraoral surgical defects; Intraoral-extraoral combination prosthesis; Magnet retained prosthesis; Midfacial defects; Silicone facial prosthesis

MeSH Terms

Congenital Abnormalities
Cosmetics
Humans
Light
Magnets
Middle Aged
Prostheses and Implants
Retention (Psychology)
Silicones
Cosmetics
Silicones

Figure

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  Fig. 1 Extraoral view of the patient after completion of healing of the defect.

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  Fig. 2 Intraoral view of completed obturator prosthesis. Note gingival portion of prosthesis was color modified to match opposite side melanin-pigmented gingiva.

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  Fig. 3 Magnet embedded into superior-lateral aspect of obturator prosthesis.

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  Fig. 4 Counter-magnet fixed inside the tissue surface of PMMA framework by maintaining correct relationship of the framework with the defect and the exposed portion of the obturator.

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  Fig. 5 Wax sheet contoured to allow 3 mm of uniform thickness of silicone for future normal facial contour.

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  Fig. 6 Separately processed top layer framework attached with underlying framework using auto-polymerizing PMMA.

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  Fig. 7 Final wax festooning and contouring. Note the relationship of extraoral trial prosthesis with intraoral obturator prosthesis when stabilized against each other with the help of intermediate pair of magnets.

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  Fig. 8 Extraoral view of the patient wearing prosthesis. Note spectacles used to simulate natural appearance of the patient and hiding some of the marginal areas.

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