title: Treatment Outcome of the Transfacial Titanium Epiplating System for Total Nasal Defects.
abstract: BACKGROUND
  Malignant tumors are the most frequent reason for acquired defects of the nose. Bone-anchored craniofacial prostheses represent a secure, uncomplicated, and cosmetically acceptable rehabilitative alternative to surgical reconstruction. The aim of this study was to determine a potential benefit of the Titanium Epiplating System (Fa. Medicon, Tuttlingen, Germany) as a grouped implant system in the anatomically difficult nasal region with limited bone supply.
  
  
  METHODS
  Patients with complete nasal defects who received a transfacial Titanium Epiplating System between January of 2009 and December of 2013 for nasal prostheses were included. The Epiplating titanium plates are specially adapted to the nasal region and were modified individually. Implant survival, periimplantitis, clinical course, and risk factors for implant survival were assessed retrospectively, including univariate statistics.
  
  
  RESULTS
  Fifty-three patients were included in this study. At the time of last follow-up, 51 of 53 Epiplating systems (96.2 percent) were stable in situ. One titanium plate had to be renewed because of a traumatic accident and one plate had to be removed because of disease recurrence. Periimplantitis occurred in 7.5 percent and could be treated successfully by either local or systemic antibiotic therapy without any loss of stability in bone anchorage. Only smoking significantly increased the risk of periimplantitis (p = 0.013), whereas age, irradiation, chemotherapy, and immunosuppression did not influence the outcome of therapy. The median healing time with use of the Titanium Epiplating System was 3.6 ± 2.7 months.
  
  
  CONCLUSIONS
  The Titanium Epiplating System is a safe and uncomplicated system for bone-anchored retention of nasal prostheses. Good aesthetic results can be achieved.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Münster, Germany From the Department of Cranio-Maxillofacial Surgery, Fachklinik Hornheide, Skin Cancer Centre and Head and Neck Cancer Centre.
authors.forename: Henning
authors.initials: H
authors.lastname: Lünenbürger
authors.forename: Nikola
authors.initials: N
authors.lastname: Roknic
authors.forename: Martin
authors.initials: M
authors.lastname: Klein
authors.forename: Kai
authors.initials: K
authors.lastname: Wermker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005145:Face; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000601:surgery*; D019637:Orthopedic Procedures / Q000295:instrumentation* / Q000379:methods*; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods*; D012189:Retrospective Studies; D053441:Suture Anchors; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium
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