Osseointegrated implants and auricular defects: a case series study.
OBJECTIVE
The objective of this study was to report on the survival rate of 16 patients treated with extraoral implants in the auricular region, analyze treatment outcomes, and discuss important clinical variables encountered during treatment.


METHODS
Sixteen patients who received extraoral dental implants to retain auricular prostheses between 1987 and 2003 were followed retrospectively. The variables recorded were gender, initial diagnosis, number and size of implants, implant placement date, age at implant placement, history of radiation to the treated field, abutment size, design of initial prosthesis, age of initial prosthesis (when a remake was indicated), date of prosthesis delivery, soft tissue response, grafting procedure, date of last follow-up, and complications. All patients were thoroughly evaluated presurgically by the reconstruction team, which consisted of prosthodontists, a facial prosthetist, and an otolaryngologist. Surgical templates were used for all patients. The criteria for success of the prostheses included marginal accuracy, overall stability and function, symmetry/position, texture, color stability, and patient acceptance.


RESULTS
Thirty-nine implants were placed in 16 patients. All 16 patients were completely satisfied with their reconstructions. No surgical complications, implant failures, or prosthetic failures were encountered. Therefore, the survival rate was 100%. Three patients (18.75%) had grade 0, seven (43.75%) had grade 1, five (31.25%) had grade 2, and one (6.25%) had grade 3 soft tissue inflammation. The inflammation completely resolved in 7 of the 13 patients (54%) with hygiene reinforcement or soft tissue reduction.


CONCLUSIONS
The survival rate for bone-anchored titanium implants and prostheses was 100%. Bone-anchored titanium implants provided the 16 patients in this study with a safe, reliable, adhesive-free method to anchor auricular prostheses with recovery of normal appearance. Under the guidance of an appropriate implant team, proper positioning of implants was optimized to allow prosthodontic rehabilitation using implant-retained prostheses.
Advanced Graduate Prosthodontics, Harvard School of Dental Medicine, Boston, MA 02115, USA. robert_wright@hsdm.harvard.edu
Robert F
RF
Wright
Candice
C
Zemnick
Jack J
JJ
Wazen
Eric
E
Asher
D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D003902:Detergents / Q000627:therapeutic use; D004431:Ear, External / Q000601:surgery*; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008280:Magnetics / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D019736:Prostheses and Implants; D017797:Prosthesis Coloring; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D012737:Sex Factors; D013499:Surface Properties; D016019:Survival Analysis; D014025:Titanium; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D003902:Detergents; D014025:Titanium