title: Prosthetic reconstruction of a patient with an acquired nasal defect using extraoral implants and a CAD/CAM copy-milled bar.
abstract: Traditionally, patients with maxillofacial defects have been challenging to treat. A multitude of challenges associated with maxillofacial prosthetic treatment are not typically seen with patients who need conventional prosthodontic treatment. These types of patients generally require replacement of significant amounts of hard and soft tissues than do conventional prosthodontic patients. Most maxillofacial patients also warrant more emotional support than do conventional prosthodontic patients. Successful maxillofacial prosthetics still need to embrace the traditional goals of prosthodontic treatment: stability, support, retention, and esthetics. It is unlikely that a maxillofacial prosthesis will exactly duplicate the anatomy and function of missing or damaged structures. Although craniofacial implants (CFI's) have lower cumulative survival rates (CSR's) than intraoral endosseous implants, osseointegrated CFI's have proven to be significant adjuncts to improving retention of maxillofacial prostheses. However, CSR's of CFI's have been reported to be lower than CSR's for intraoral endosseous implants. Lately, computer-assisted design and computer-assisted machining (CAD/CAM) has been used in dentistry to facilitate fabrication of implant-supported frameworks. CAD/CAM protocols have numerous advantages over conventional casting techniques, including improved accuracy and biocompatibility, and decreased costs. The purpose of this paper is to review the literature on cumulative survival rates (CSR's) reported for CFI's and to illustrate the treatment of a maxillofacial patient using CFI's and a CAD/CAM copy-milled framework for retention and support of a nasal prosthesis.
authors.affiliation: Department of Prosthodontics, The University of North Carolina School of Dentistry, Chapel Hill, NC.
authors.forename: Carolina
authors.initials: C
authors.lastname: Vera
authors.forename: Carlos
authors.initials: C
authors.lastname: Barrero
authors.forename: William
authors.initials: W
authors.lastname: Shockley
authors.forename: Sandra
authors.initials: S
authors.lastname: Rothenberger
authors.forename: Glenn
authors.initials: G
authors.lastname: Minsley
authors.forename: Carl
authors.initials: C
authors.lastname: Drago
mesh_terms: D000368:Aged; D000497:Alloys / Q000737:chemistry; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D017076:Computer-Aided Design; D006801:Humans; D059346:Magnets; D008297:Male; D009300:Nasal Septum / Q000601:surgery; D037981:Neck Dissection / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009666:Nose; D009667:Nose Deformities, Acquired / Q000534:rehabilitation*; D009669:Nose Neoplasms / Q000601:surgery; D010347:Patient Care Planning; D019736:Prostheses and Implants; D011474:Prosthesis Design; D060489:Prosthesis Retention / Q000295:instrumentation*; D018714:Radiotherapy, Adjuvant / Q000379:methods; D016019:Survival Analysis; D014025:Titanium / Q000737:chemistry
chemical_list: D000497:Alloys; D014025:Titanium
keywords: Maxillofacial defects; craniofacial implants; extraoral implants; maxillofacial prosthetics; nasal prosthesis