Psychosocial impact on anophthalmic patients wearing ocular prosthesis

The aim of this study was to assess the improvement in psychosocial awareness of anophthalmic patients wearing ocular prostheses and its relationship with demographic characteristics, factors of loss/treatment, social activity, and relationship between professional and patient. Surveys including a form for evaluation of psychosocial pattern were conducted with 40 anophthalmic patients rehabilitated with ocular prosthesis at the Center of Oral Oncology in the authors' dental school from January 1998 to November 2010. The improvement in psychosocial awareness was assessed by comparing the perception of some feelings reported in the period of eye loss and currently. Wilcoxon tests were applied for comparison of patients' perception between the periods. χ2 tests were used to assess the relationship between the improvement in psychosocial awareness and the variables of the study. In addition, the logistic regression model measured this relationship with the measure of odds ratio. The feelings of shame, shyness, preoccupation with hiding it, sadness, insecurity and fear were significant for improvement in psychosocial awareness. It was concluded that the anophthalmic patients wearing an ocular prosthesis has significant improvement in psychosocial awareness after rehabilitation. © 2012 International Association of Oral and Maxillofacial Surgeons.

Effect of different disinfectants on the microhardness and roughness of acrylic resins for ocular prosthesis

Background: Ocular prosthesis materials should have specific properties for their indication and durability; therefore, it is important to investigate their physical behaviour when affected by several disinfectants. Objectives: This study evaluated the influence of different disinfecting solutions on the microhardness and surface roughness of acrylic resins for ocular prosthesis. Materials and Methods: Fifty samples simulating ocular prostheses were fabricated with N1 resin and colourless resin and divided (n = 10) according to the disinfectant used: neutral soap, Opti-free, Efferdent, 1% hypochlorite (HYC) and 4% chlorhexidine (CHX). Samples were stored in saline solution at 37°C and disinfected during 120 days. Both microhardness and roughness were investigated before, after 60 days and 120 days of disinfection and storage. Microhardness was measured using a microhardner and the roughness with a roughness device. Results: N1 resin showed lower microhardness when compared with colourless resin (p < 0.05). HYC and CHX groups exhibited the highest change of microhardness and roughness values (p < 0.05). An increase in roughness and reduction in microhardness of ocular acrylic resins were observed after both periods of disinfection and storage (p < 0.05). Conclusion: Both disinfection/storage periods affected the microhardness and roughness values of the samples. © 2012 The Gerodontology Society and John Wiley & Sons A/S.

Rehabilitation of maxillary cleft with hybrid obturator prosthesis

The hybrid obturator prosthesis aims to provide a sense of well-being to the patient, offering improvements in speech, chewing, and swallowing. Thus, the retention and stabilization of the prosthesis become decisive factors for the success of the rehabilitation treatment. The objective of this study was to describe the treatment of a 70-year-old man with a congenital maxillary cleft performed through aesthetic and functional prosthetic rehabilitation with hybrid obturator prosthesis. In this study, the fabricated prosthesis achieved its purpose by providing adequate functional and aesthetic conditions to the patient, promoting the reduction of airspace through the sealing of the oronasal communication, with consequent improvement in the quality of life. Copyright © 2013 by Mutaz B. Habal, MD.

Análise fotoelástica da tensão entre diferentes tipos de sistemas de retenção em próteses obturadoras palatinas implanto-retidas ou não e com ou sem reembasamento “soft”

Pós-graduação em Odontologia - FOA

Retention Systems to Implant-Supported Craniofacial Prostheses

Osseointegrated implants in craniofacial reconstructions improve prostheses retention and stability and comfort and safety for a patient. According to biomechanical principles, the treatment success regarding osseointegration maintenance depends on an adequate surgical technique associated to a retention system that provides favorable tension distribution to implants. Furthermore, patient expectation, esthetics, function, and anatomic limitations must be evaluated during treatment planning. Therefore, the aims of this study were to present available retention systems to implant-supported craniofacial prosthesis and to highlight the advantages, indications, and limitations. A literature review was conducted through a MEDLINE search. Sixteen articles and 2 textbooks met the inclusion criteria and were included in the review. It was concluded that the success of craniofacial rehabilitation with implants depends on an adequate surgical technique and an adequate selection of a retention system.

Oral Rehabilitation After Surgical Removal of Pleomorphic Adenoma

Although tumors of minor salivary glands are rare, the pleomorphic adenoma is the most common pathology among the benign neoplasm and can be found with high prevalence in the junction between hard palate and soft palate. The treatment of choice for most of maxillary tumors is surgical through either a total or partial maxillectomy. However, surgical defects caused by such type of treatment lead to both clinical and psychologic disorders for the patient. The immediate oral rehabilitation using interim palate obturator after maxillectomy provides optimization on the healing process, recovers the stomatognathic functions after surgery, and avoids psychosocial sequelae for the patients. This clinical report aimed to present the rehabilitation with immediate palate obturator of a patient who underwent a partial maxillectomy due to a hard palate pleomorphic adenoma of minor salivary glands. We report the clinical importance of the prosthetic rehabilitation and the improvements on both quality of life and stomatognathic functions of this patient. It can be concluded that the immediate rehabilitation of the patient after partial maxillectomy by using an interim palate obturator was a great option and provided clinical benefits in the immediate postoperative period, improving the patient's quality of life, allowing the patient's reinsertion into society, and reducing the surgical treatment sequelae.

Influence of Pigments and Opacifiers on Color Stability of an Artificially Aged Facial Silicone

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of Disinfection and Accelerated Aging on Color Stability of Colorless and Pigmented Facial Silicone

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Postsurgical Care for Rehabilitation With Implant-Retained Extraoral Prostheses

The health of a peri-implant tissue is a critical factor for the long-term success of treatment with extraoral implants. However, infection and inflammation may occur and lead to implant loss and prostheses failure. Therefore, some postsurgical care as hygiene with soap and water, soft toothbrush, and Superfloss type dental floss and medication with anti-inflammatory and antibiotic are suggested to avoid complications. In addition, a thin and smooth layer of subcutaneous tissue in the peri-implant area should be preserved during implant insertion to favor the assistance recommended in this phase.

Color Stability Comparison of Silicone Facial Prostheses Following Disinfection

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Craniofacial Implants Success in Facial Rehabilitation

The use of craniofacial implants is an effective treatment for patients with deformities, burns, and cancer sequelae. The sites with the most successful implants are the auricular, nasal, and orbital regions. Furthermore, other factors can affect the implant longevity such as irradiated area, surgical technique, bone quality and quantity, macrostructure and microstructure of the implant, maintenance, and systemic factors.

Aortic aneurysm surgery: problems and innovations

Um longo caminho foi percorrido desde as primeiras intervenções cirúrgicas feitas para o tratamento do aneurisma de aorta abdominal. Ao longo deste tempo, várias inovações foram criadas, no sentido de reduzir a invasividade dos procedimentos e melhorar sua segurança e durabilidade. Nesta revisão, são discutidos os principais e recentes avanços em intervenções sobre aneurismas aórticos, incluindo a restauração aórtica endovascular, a cirurgia aórtica videolaparoscópica, as técnicas híbridas convencionais e endovasculares, as técnicas combinadas videolaparoscópicas e endovasculares, bem como as perspectivas futuras, tanto para aorta torácica como abdominal. Diante de tantas transformações e evolução, o cirurgião vascular moderno terá que ter sua mente aberta para as novidades e desenvolver capacitação ampla com diferentes técnicas para proporcionar a melhor opção terapêutica para seus pacientes.

DESENVOLVIMENTO DE UMA ESCALA em SILICONA PARA TONS DE PELE HUMANA

O autor desenvolveu em silicona uma escala de tonalidades de pele humana. Foram confeccionados vinte e sete corpos-de-prova em silicona acética (Silastic 732 RTV), pigmentados com óxidos de ferro e dióxido de titânio. A quantidade de silicona acética manteve-se constante (dois gramas) em todos os corpos-de-prova, e os pigmentos foram misturados a ela em várias proporções até a obtenção de vinte e sete diferentes tonalidades. Através da comparação da cor dos corpos-de-prova com a cor da pele de quarenta e um indivíduos, foram selecionados os cinco corpos-de-prova com as tonalidades que mais se igualavam à cor da pele dos pacientes, compondo, assim, um guia de tonalidades. Com a metodologia empregada, foi possível desenvolver uma escala de tonalidades de pele que poderá facilitar a definição do tom da pele do paciente quando da confecção de próteses faciais em silicona, permitindo economia de tempo e de material no momento da seleção da cor.

Gelatinous polyethylene in the treatment of the anophthalmic cavity

PURPOSE: Gelatinous polyethylene (GP) has been used as an orbital implant to evaluate volume maintenance and tissue reaction in the anophthalmic socket in a rabbit model. METHODS: Twenty-eight Norfolk white rabbits underwent unilateral evisceration with placement of 2ml GP (GP group - 16 animals) or 2ml 0.9% sodium chloride solution (Control group - 12 animals). Animal behavior, postoperative tissue response and socket conditions were evaluated. The animals were sacrificed at 7, 15, 30 and 60 days after the surgery and the bulbs were enucleated; volume maintenance and histopathological evaluation were done in the enucleated bulbs. The results were submitted to statistical analysis. RESULTS: All animals showed normal behavior. The orbital volume maintenance was better in the GP group. Histopathology in the GP animals showed mild tissue inflammation throughout the evaluation period and a thin pseudocapsule formation surrounding the orbital implant material. CONCLUSION: The clinical findings, good orbital volume maintenance and mild inflammatory tissue response make GP a good choice to replace the lack of volume in anophthalmic socket reconstruction.

Prototipagem como forma alternativa para realização de cranioplastia com metilmetacrilato: Nota técnica

The prototyping is a method for reconstruction of human body segments by computer software. It has been used in neurosurgery for cranial reproduction in patients allowing the programming of surgical procedures and the production of prosthesis to reconstruct bone failures in the skull. We present two cases of cranioplasty performed with the use of acrylic prosthesis constructed by prototyping. After 10 months of follow-up, they donot present signs of infection and show good aesthetic result. The advantages pointed at the literature for this method (reduction of surgical time, easy technical handle, and good aesthetic result) were confirmed.