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To achieve success with an implant retained craniofacial prosthesis, the surgeon must be familiar with the indications and surgical technique which, although not technically demanding, require close attention to detail. The surgical procedure can often be performed under local anesthesia on an outpatient basis. Implantation can often be performed during the same operation as the ablative procedure. When placed in the mastoid process at the time of auriculectomy, the patient can be fitted with prosthesis 5 to 6 week after surgery. Implants may also be placed at the time of orbital exenteration but should be left undisturbed for 6 months.
CONCLUSION
Today, the use of titanium implants for retention of craniofacial prostheses is an
Established treatment modality. Plastic surgery procedures should of course contemplated, and implant retained prostheses should be regarded as an option. We feel that this option should be available at major cancer centers. One of the advantages is that the surgical procedure from the patient’s point of view is minor and can often be performed under local anesthesia. Another advantage is that the result is predictable. According to our experience, one of the most important advantages of this technique is the short time between tumor surgery and the time that the patient can return to his/her everyday social activities. This is important for elderly patients who often do not like an extended time schedule that involves multiple surgeries. We also feel that the cosmetic result often is superior compared with plastic surgery. This is especially true when an external ear or an eye, with or without maxillectomy, has been sacrificed.
Before this type of rehabilitation protocol is introduced, there are some factors we feel are of great importance. Close cooperation and understanding must exit between the surgical team and the team working with the anaplastologist. The patient only benefits if both teams co-operate. The teams must be aware that they are assuming a commitment for the rest of the patient’s life. The patient and his/her family must understand the concept of “prosthesis” and be willing to take part in a follow-up protocol. The selection of and information given to the patient is thus extremely important. Informing the patient that the prosthesis has to be remade at intervals should also be stressed during the preoperative information session. After fitting of the prosthesis, the patient has to make outpatient visits twice or three times a year. These visits are of course coordinated with the tumor control visits.
The longevity of prosthesis varies. If the patients is a heavy smoker or has a work environment where he/she is exposed to dirty oil, asphalt, fumes, and so on, the prosthesis may get discolored within a year. On the other hand, if the patient is not exposed to such contaminants and is careful with hygiene, the prosthesis may keep its freshness for 3 to 4 years, and sometimes even longer.
There are very few contraindications for this type of rehabilitation. Drug and alcohol abuse, psychiatric disease, immature personality, and lack of patient compliance are almost always considered to be contraindications. Among our patients, we have individuals with diabetes, psoriasis, scleroderma, and other skin diseases, but they do not have any increased frequency of adverse skin reactions.
Article Source: http://www.articlemotron.com
To achieve success with an implant retained craniofacial prosthesis, the surgeon must be familiar with the indications and surgical technique which, although not technically demanding, require close attention to detail. The surgical procedure can often be performed under local anesthesia on an outpatient basis.
Dr.Biju Thomas BDS., FFDRCSI., (Fellow of Royal College of Surgeons, Ireland) Consultant Dental and Maxillo Facial Surgeon-implantologist.Dr. Biju Thomas is a highly qualified and experienced dental implant surgeon, implant dentist in India, affordable dental implant, cheap dental implants.
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