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objective of all maxillofacial prosthetic treatment is to improve the quality of life
(AAMP 2019). Maxillofacial prostheses are mainly used in patients with congenital
defects or acquired defects induced by cancer, trauma or systemic disease (D’Souza
2015). Patients with maxillofacial deformities have aesthetic discomfort due to the
site of the defect. These defects could be localized at the sites of the cranial plate,
ear, nose or palatal and create psychological problems and social disabilities in such
patients. A maxillofacial prosthesis must thus be biocompatible and functional, as
well as have mechanical stability, allowing the long-term use. In this sense, maxillofacial prosthodontists should consider the prostheses’ possible mechanical and
physical deficiencies after long-term use (Cevik and Yildirim-Bicer 2017) and take
precautions against possible failures.
In addition, prosthetic treatment may include extraoral or intraoral management
of patients with deformities. Extraoral prostheses are referred to auricular, midfacial, nasal, ocular, orbital, somatic or radiation shield prostheses. On the other hand,
intraoral prostheses are referred to surgical obturator prosthesis, definitive obturator
prosthesis, palatal lift prosthesis, mandibular resection prosthesis and palatal augmentation prosthesis or fluoride carriers as protective apparatus (AAMP 2019).
A suitable personalized prosthesis should restore the patient’s deficiency by
referring to the current anatomy. In this regard, duplication of the remaining part of
the face or craniofacial tissues may result in an accurate treatment for the patients
with maxillofacial defects. The duplication of the healthy tissues with the help of
computerized technology would give more precise results than the construction of
the prosthesis individually.
Various materials have been used in the manufacture of maxillofacial prostheses,
such as chlorinated polyethylene, poly(methyl methacrylate), poly(urethane),
poly(vinyl chloride) and poly(dimethylsiloxane) (PDMS - silicone elastomers)
(Eleni et al. 2009). An ideal maxillofacial prosthetic material is expected to have
high tear resistance, tensile strength and elongation percentage with low hardness
(Veres et al. 1990; Cevik and Eraslan 2017).
Silicone elastomers have been materials used for many years in the process of
manufacturing dental prostheses due to their advanced mechanical and physical
properties (Jindal et al. 2018). In addition, they are inert, chemically resistant and
biocompatible. The most preferable silicone rubber consists of PDMS (Bellamy
et al. 2003; Jindal et al. 2016). Different factors such as the PDMS, the filler, the
cross-linker and the catalyst concentrations are the main components of silicone
elastomer, and they can modify the mechanical properties of silicone elastomer
(Bellamy et al. 2003; Jindal et al. 2016). Recent researches are based on the addition
of several filler nanoparticles (NPs) to improve the physical and mechanical properties of silicone rubbers (Ratner et al. 2006; Kiat-amnuay et al. 2006; Kiat-amnuay
et al. 2009; Pesqueira et al. 2012; Akay et al. 2016; Cevik and Eraslan 2017). The
silica NPs are most commonly used fillers to reinforce the silicone matrix (Zayed
et al. 2014; Cevik and Eraslan 2017). Different concentrations in silica NPs would
result in different mechanical and physical properties of silicone elastomers (Goiato
et al. 2011; Pesqueira et al. 2012; Cevik and Eraslan 2017).
P. Cevik
objective of all maxillofacial prosthetic treatment is to improve the quality of life
(AAMP 2019). Maxillofacial prostheses are mainly used in patients with congenital
defects or acquired defects induced by cancer, trauma or systemic disease (D’Souza
2015). Patients with maxillofacial deformities have aesthetic discomfort due to the
site of the defect. These defects could be localized at the sites of the cranial plate,
ear, nose or palatal and create psychological problems and social disabilities in such
patients. A maxillofacial prosthesis must thus be biocompatible and functional, as
well as have mechanical stability, allowing the long-term use. In this sense, maxillofacial prosthodontists should consider the prostheses’ possible mechanical and
physical deficiencies after long-term use (Cevik and Yildirim-Bicer 2017) and take
precautions against possible failures.
In addition, prosthetic treatment may include extraoral or intraoral management
of patients with deformities. Extraoral prostheses are referred to auricular, midfacial, nasal, ocular, orbital, somatic or radiation shield prostheses. On the other hand,
intraoral prostheses are referred to surgical obturator prosthesis, definitive obturator
prosthesis, palatal lift prosthesis, mandibular resection prosthesis and palatal augmentation prosthesis or fluoride carriers as protective apparatus (AAMP 2019).
A suitable personalized prosthesis should restore the patient’s deficiency by
referring to the current anatomy. In this regard, duplication of the remaining part of
the face or craniofacial tissues may result in an accurate treatment for the patients
with maxillofacial defects. The duplication of the healthy tissues with the help of
computerized technology would give more precise results than the construction of
the prosthesis individually.
Various materials have been used in the manufacture of maxillofacial prostheses,
such as chlorinated polyethylene, poly(methyl methacrylate), poly(urethane),
poly(vinyl chloride) and poly(dimethylsiloxane) (PDMS - silicone elastomers)
(Eleni et al. 2009). An ideal maxillofacial prosthetic material is expected to have
high tear resistance, tensile strength and elongation percentage with low hardness
(Veres et al. 1990; Cevik and Eraslan 2017).
Silicone elastomers have been materials used for many years in the process of
manufacturing dental prostheses due to their advanced mechanical and physical
properties (Jindal et al. 2018). In addition, they are inert, chemically resistant and
biocompatible. The most preferable silicone rubber consists of PDMS (Bellamy
et al. 2003; Jindal et al. 2016). Different factors such as the PDMS, the filler, the
cross-linker and the catalyst concentrations are the main components of silicone
elastomer, and they can modify the mechanical properties of silicone elastomer
(Bellamy et al. 2003; Jindal et al. 2016). Recent researches are based on the addition
of several filler nanoparticles (NPs) to improve the physical and mechanical properties of silicone rubbers (Ratner et al. 2006; Kiat-amnuay et al. 2006; Kiat-amnuay
et al. 2009; Pesqueira et al. 2012; Akay et al. 2016; Cevik and Eraslan 2017). The
silica NPs are most commonly used fillers to reinforce the silicone matrix (Zayed
et al. 2014; Cevik and Eraslan 2017). Different concentrations in silica NPs would
result in different mechanical and physical properties of silicone elastomers (Goiato
et al. 2011; Pesqueira et al. 2012; Cevik and Eraslan 2017).
P. Cevik