Page 132 - Craniomaxillofacial Implant Surgery - Jeroen P.J. Dings

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Chapter 7
Mean life-span for orbital-, nasal- and auricular prostheses in our study was 26-, 17- and 31-months, respectively. For facial prostheses, life-span reported in literature ranges from 1.5 to 2 year16,49. Discoloration was the predominant problem that limited the life-span of prostheses. Suboptimal junction was the second factor that restricted the longevity of prostheses.
Therefore, and with regard to the limited life-span of facial prostheses, continuous daily care of the implants in combination with a long-term commitment of the patient is required. Also, after implant installation and the subsequent placement of the CMF- prosthesis, the surgeon and maxillofacial-prosthodontist remain co-responsible for continuing patient care. Fortunately, fabrication of a new prosthesis is relatively simple and fast to accomplish using the existing patient specific mould.
A disadvantage of a newly introduced questionnaire is the difficulty of comparing our results with other studies42. Furthermore, the initial quality of life could not be retrieved, so additional benefits from prosthetic rehabilitation could not be determined. Literature shows that patients with facial deformities generally have overall poorer physical- and psychological health, as well as lower quality of life compared to controls41. Although patient self-confidence and satisfaction was shown to be improved wearing a facial prosthesis, no comparison with healthy controls was executed.
Autologous versus prosthetic nasal- and auricular reconstruction – patient, professional and layman’s perception (Chapter 6).
Restoration of craniomaxillofacial (CMF) defects occupies a high priority in the physical- and psychological rehabilitation of the patient. CMF defects may be reconstructed by plastic surgery or restored by implant-retained prosthetic constructs. Although numerous advantages have been described in literature with regard to microsurgery and reconstructive transplantation, autologous reconstruction of CMF defects remains challenging51,52, as surgical reconstruction may be hampered by the general health status of the patient, radiation therapy, risk of recurrence of illnesses, anatomical complexity or size of the defect33. Also, conventional surgery often comprises multiple procedures and the introduction of donor site morbidity34,42,52,53. Furthermore, in elderly patients, autologous tissue may be more brittle and less suitable for auricular reconstruction42.