Auricular rehabilitation by means of bone grafting from the iliac crest in combination with porous extraoral implants: a case report.
BACKGROUND
Maxillofacial defects caused by cancer treatment are a huge problem affecting the quality of life of patients. Some of these deformities are minimized using facial epitheses, which need some additional retention devices like glasses or skin adhesives. The use of extraoral fixtures as bone anchorage was introduced many years ago and since then many patients were rehabilitated with better results.


OBJECTIVE
Because of poor bone conditions, for example, irradiated bone, the success rate of extraoral implants is less than in the oral cavity, causing difficulties to rehabilitation. One possible cause of fixture failure could be the poor primary stability achieved in some cases, hence, with an increased bone contact implant stability and survival could be improved. The present report discusses possibilities to use extraoral fixtures with a modified surface structure.


METHODS
A new porous surfaced Brazilian extraoral implant (MasterExtra, Conexão, Sistema de Próteses, São Paulo, Brazil) was used. A bone transplant from the iliac crest was taken to make it possible to insert at least three extraoral implants for an auricle epithesis. Clinical evaluation and resonance frequency analysis (RFA) measurements were performed during the course of the treatment.


RESULTS
Eight months after grafting, four fixtures were inserted. Three fixtures were used for connection of an auricular epithesis. RFA measurements did show high initial values and the values remained stable during the course of the treatment and at later checkups.


CONCLUSIONS
Porous fixture is a good option in areas where the bone is compromised. RFA is a good tool also in the clinical setting to evaluate immediate and long-term stability of extraoral fixtures.
Dib
Luciano Lauria
LL
Universidade Paulista (UNIP), São Paulo, Brazil. lldib@uol.com.br
de Oliveira
Joaquim Augusto Piras
JA
Neves
Rogerio Izar
RI
Sandoval
Renata Lazari
RL
Nannmark
Ulf
U
D000328:Adult; D016025:Bone Transplantation; D002280:Basal Cell Carcinoma / Q000534:rehabilitation*; D004431:Ear, External / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000534:rehabilitation*; D006801:Humans; D009364:Neoplasm Recurrence, Local; D016062:Porosity; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D016038:Skin Transplantation; D014732:Vibration