Biomedical Engineering Reference
In-Depth Information
be more opportune to wait 1 year to avoid the recidivism risk.8 Furthermore, the treatment
in the hyperbaric room is effective in the bone life, with higher success percents.8,9 Another
fundamental aspect is the epithesis stability,which depends frommany circumstances such
as hygienic condition, material quality, and the correctmethod of the epithesis
production;when these conditions are respected, the epithesis can resist for 2 years. The
application of an epithesis happens with no invasive and immediate results, both fromthe
aesthetic and psychologic point of views, allowing to get around with the heavy social
insertion problems derived from his facial deformation. The therapeutic iter in the
reconstructive treatment with epithesis foresees a dynamic study with few fundamental
stages:
clinical, radiologic, and psychologic evaluation;
surgical planning;
positioning of the fixtures;
templating;
preparation of the epithesis;
fixtures; and epithesis exposure.
Beyond the application of bone implants, several retentionmethods are possible: anatomic,
exploiting the premade cavity getting to the deficit (ocular epithesis), andmechanical,
exploiting outside anchorage strengths (sight glasses) and adhesive, by glue.10 Thanks to
the use of the bone implants, it has been able to get around the problems caused by the use
of adhesives like decoloration, the precocious deterioration of the epithesis, and
inflammatory phenomena of the skin in contact with epithesis' materials. Under the point of
view of the aesthetic result, the margins of an epithesis can be easily hidden, and the
prosthesis ismore stable, is easy to wear, and keeps under a hygienic point of view.
Furthermore, the psychologic appearance should not be neglected because, unlike
traditional prosthesis, the epithesis fixed with implants are not considered as an extraneous
object, with the consequent improvement of a good quality of life. At present, our
experience teaches us that the indication to the position of epithesis as the first choice of
treatment is when the conventional reconstructive interventions turn out to be inapplicable
or ineffective
4. References
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Fini Hatzikiriakos G. Uno sguardo al passato, curiosita` sulle protesi nasali. Il Valsala
1985;61:61Y64
Tjellstrom A. Osteointegrated implants for replacement of absent or defective ears. Clin
Plast Surg 1990;17:355Y366
Tjellstrom A, Granstrom G. One stage procedure to establish osteointegration: a zero to five
years follow-up report. J Laryngol Otol 1995;109:593Y598
Schaaf NG. Maxillofacial prosthetics and the head and neck cancer patients. Cancer
1984;54:2682Y2690
Labbe´ D, Be´nateau H, Compe`re JF, et al. Implants extra-oraux: indications et contre-
indications. Rev Stomatol Chir Maxillofac 2001;102:239Y242
