Limits...
Rehabilitation of a partial nasal defect with facial prosthesis: a case report.

Negahdari R, Pournasrollah A, Bohlouli S, Sighari Deljavan A - J Dent Res Dent Clin Dent Prospects (2014)

Bottom Line: Facial defects can be devastating in their impact on physical structure and function of the affected individual, leading to potentional compromises in quality of life.Reconstruction of nasal defects is a challenge for the prosthodontist because of esthetic and retention problems associated with the facial prosthesis.This paper reports the rehabilitation of a partial nasal defect caused by basal cell carcinoma treatment using a nasal prosthesis made with silicone elastomers and mechanical and anatomical retentive aids.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran ; Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran.

ABSTRACT
>Malignancies of the midface result in cosmetic deformities that make maxillofacial prosthesis as an integral part of the treatment plan. Facial defects can be devastating in their impact on physical structure and function of the affected individual, leading to potentional compromises in quality of life. Reconstruction of nasal defects is a challenge for the prosthodontist because of esthetic and retention problems associated with the facial prosthesis. This paper reports the rehabilitation of a partial nasal defect caused by basal cell carcinoma treatment using a nasal prosthesis made with silicone elastomers and mechanical and anatomical retentive aids. The patient had no problem with the prosthesis, except for a partial loss of extrinsic coloration in the two-year follow-up.

No MeSH data available.


Related in: MedlinePlus

© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4288918&req=5

Mentions: A fifty-four year-old man was referred to Tehran Cancer Institute, with a history of multiple recurrences of basal cell carcinoma (BCC) in the nasal septum and right nasal wall (Figure 1). After surgical resection, radiotherapy was initiated for the facial defect consisting of 50 Gy in 25 fractions. Six months after radiotherapy the boundary for the impression was outlined on the face and an impression was taken with an irreversible hydrocolloid impression material (Alginate; Tropicalgin, Zermack, Rovigo, Italy; Figure 2). The irreversible hydrocolloid was reinforced with gauze and dental plaster. The impression was poured in dental stone (Moldano; Bayer, Leverkusen, Germany). The wax pattern of the nose was sculpted on the plaster cast with dental base plate wax (Trubyte; Dentsply, York, USA). After the completion of the wax pattern, in order to improve the whole morphology of the nose on the face, we verified the contour, surface texture and the position of the wax pattern, during try-in procedure. The wax pattern sculpting procedure was done according to preoperative photographs of the patients in straight form. The position of the nostrils was verified with the inner canthus distance of the eyes. Nose profile matched the line between the ear’s top point and bottom of tragus (Figure 3).7 In order to improve the marginal adaptation of the wax pattern, it was relined with an elastomeric impression material (Speedex; Coltene AG, Switzerland). After verification of the shape, size, contour, fit, and surface texture of the corrected pattern on the face and ensuring that it is acceptable to both the patient and the practitioner, the mold was fabricated to reproduce the wax pattern in silicone. The molding procedure was carried out and the silicone elastomers (Cosmesil RTV) were colored intrinsically with Intrinsic Coloring Kit (Factor II Inc., Lakeside, AR, USA) on the face to match different shades of the patient’s skin (Figure 4). Approximately 100 gr of silicon materials with the selected base color was mixed to fill the mold. The target base color was selected according to the overall skin tone without characterization from the lightest area of the skin. Small amounts of red, blue, yellow, white, and green pigments was added conservatively to the mixed silicon and blended thoroughly to match the selected base color for the skin. Opacity and value of the silicon was increased with small amounts of kaolin. Trace amounts of red and yellow pigments were used to achieve closer match to the skin. Blue pigment was added to reduce the value. Layers of laminar glazes painted onto the mold for illustrating the histologic structure of the skin; then colored silicone was filled into the mold and light pressure was applied to the mold for removing excess material. The mold was then transferred to clamp and placed into a dry-heat oven at the manufacturer’s prescribed polymerization time and temperature. After the polymerization cycle was completed, the mold was allowed to cool in room temperature. Then the prosthesis was removed carefully from the mold, excess material was trimmed with scissors to make the prosthesis more esthetically acceptable. Appearance of the prosthesis was improved with extrinsic coloring and using eyeglasses. The prosthesis was delivered to the patient and home care instructions were given. Medical grade skin adhesive (Pros-Aide; FX Warehouse Inc, Philadelphia, USA) was used to enhance the retention of prosthesis. Periodic follow-ups were scheduled one month, three months, six months and one year after. The patient reported to be comfortable with the prosthesis (Figure 5). The patient gave consent to the publication of the treatment report including the full face figures.


Rehabilitation of a partial nasal defect with facial prosthesis: a case report.

Negahdari R, Pournasrollah A, Bohlouli S, Sighari Deljavan A - J Dent Res Dent Clin Dent Prospects (2014)

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4288918&req=5

Mentions: A fifty-four year-old man was referred to Tehran Cancer Institute, with a history of multiple recurrences of basal cell carcinoma (BCC) in the nasal septum and right nasal wall (Figure 1). After surgical resection, radiotherapy was initiated for the facial defect consisting of 50 Gy in 25 fractions. Six months after radiotherapy the boundary for the impression was outlined on the face and an impression was taken with an irreversible hydrocolloid impression material (Alginate; Tropicalgin, Zermack, Rovigo, Italy; Figure 2). The irreversible hydrocolloid was reinforced with gauze and dental plaster. The impression was poured in dental stone (Moldano; Bayer, Leverkusen, Germany). The wax pattern of the nose was sculpted on the plaster cast with dental base plate wax (Trubyte; Dentsply, York, USA). After the completion of the wax pattern, in order to improve the whole morphology of the nose on the face, we verified the contour, surface texture and the position of the wax pattern, during try-in procedure. The wax pattern sculpting procedure was done according to preoperative photographs of the patients in straight form. The position of the nostrils was verified with the inner canthus distance of the eyes. Nose profile matched the line between the ear’s top point and bottom of tragus (Figure 3).7 In order to improve the marginal adaptation of the wax pattern, it was relined with an elastomeric impression material (Speedex; Coltene AG, Switzerland). After verification of the shape, size, contour, fit, and surface texture of the corrected pattern on the face and ensuring that it is acceptable to both the patient and the practitioner, the mold was fabricated to reproduce the wax pattern in silicone. The molding procedure was carried out and the silicone elastomers (Cosmesil RTV) were colored intrinsically with Intrinsic Coloring Kit (Factor II Inc., Lakeside, AR, USA) on the face to match different shades of the patient’s skin (Figure 4). Approximately 100 gr of silicon materials with the selected base color was mixed to fill the mold. The target base color was selected according to the overall skin tone without characterization from the lightest area of the skin. Small amounts of red, blue, yellow, white, and green pigments was added conservatively to the mixed silicon and blended thoroughly to match the selected base color for the skin. Opacity and value of the silicon was increased with small amounts of kaolin. Trace amounts of red and yellow pigments were used to achieve closer match to the skin. Blue pigment was added to reduce the value. Layers of laminar glazes painted onto the mold for illustrating the histologic structure of the skin; then colored silicone was filled into the mold and light pressure was applied to the mold for removing excess material. The mold was then transferred to clamp and placed into a dry-heat oven at the manufacturer’s prescribed polymerization time and temperature. After the polymerization cycle was completed, the mold was allowed to cool in room temperature. Then the prosthesis was removed carefully from the mold, excess material was trimmed with scissors to make the prosthesis more esthetically acceptable. Appearance of the prosthesis was improved with extrinsic coloring and using eyeglasses. The prosthesis was delivered to the patient and home care instructions were given. Medical grade skin adhesive (Pros-Aide; FX Warehouse Inc, Philadelphia, USA) was used to enhance the retention of prosthesis. Periodic follow-ups were scheduled one month, three months, six months and one year after. The patient reported to be comfortable with the prosthesis (Figure 5). The patient gave consent to the publication of the treatment report including the full face figures.

Bottom Line: Facial defects can be devastating in their impact on physical structure and function of the affected individual, leading to potentional compromises in quality of life.Reconstruction of nasal defects is a challenge for the prosthodontist because of esthetic and retention problems associated with the facial prosthesis.This paper reports the rehabilitation of a partial nasal defect caused by basal cell carcinoma treatment using a nasal prosthesis made with silicone elastomers and mechanical and anatomical retentive aids.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran ; Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran.

ABSTRACT
>Malignancies of the midface result in cosmetic deformities that make maxillofacial prosthesis as an integral part of the treatment plan. Facial defects can be devastating in their impact on physical structure and function of the affected individual, leading to potentional compromises in quality of life. Reconstruction of nasal defects is a challenge for the prosthodontist because of esthetic and retention problems associated with the facial prosthesis. This paper reports the rehabilitation of a partial nasal defect caused by basal cell carcinoma treatment using a nasal prosthesis made with silicone elastomers and mechanical and anatomical retentive aids. The patient had no problem with the prosthesis, except for a partial loss of extrinsic coloration in the two-year follow-up.

No MeSH data available.


Related in: MedlinePlus