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  1. Rahman AM, Jamayet NB, Nizami MMUI, Johari Y, Husein A, Alam MK
    J Prosthet Dent, 2021 Jan 17.
    PMID: 33472753 DOI: 10.1016/j.prosdent.2020.07.026
    STATEMENT OF PROBLEM: The climate of tropical Southeast Asia includes high humidity and ultraviolet radiation that reduce the lifespan of silicone prostheses by inducing changes in their mechanical properties and color stability. Studies on the surface roughness (SR) and mechanical properties of different silicone elastomers (SEs) subjected to the natural tropical weather of Southeast Asia are lacking.

    PURPOSE: The purpose of this in vitro study was to evaluate the SR, tensile strength (TS), and percentage elongation (% E) of different SEs subjected to outdoor weathering in the Malaysian climate.

    MATERIAL AND METHODS: Type-II dumbbell-shaped specimens (N-120) (nonweathered=15, weathered=15) were made from 3 room-temperature vulcanized (A-2000, A-2006, and A-103) and 1 heat-temperature vulcanized (M-511) silicone (Factor II). For 6 months, weathered specimens were subjected to outdoor weathering inside a custom exposure rack. Simultaneously, the nonweathered specimens were kept in a dehumidifier. Subsequently, the SR was measured with a profilometer; TS and % E were measured by using a universal testing machine. Two-way ANOVA was used to compare the means of the tested properties of the nonweathered and weathered specimens, and pairwise comparison was carried out between the silicones (α=.05).

    RESULTS: After outdoor weathering, the SR, TS, and % E were adversely affected by weathering in the Malaysian environment. Among the silicone materials, A-2000 showed the least TS changes (2.51 MPa), while A-2006 demonstrated significant changes in percentage elongation after outdoor weathering (266.5%). M-511 exhibited the highest mean value (2.50 μm) for SR changes. In addition, A-103 SE showed statistically significant differences in most pairwise comparisons for all 3 dependent variables.

    CONCLUSIONS: Based on the evaluation of mechanical properties, A-103 can be suggested as a suitable silicone for maxillofacial prostheses fabricated for tropical climates. However, A-2000 can be a suitable alternative, although significant changes to surface roughness were detected after outdoor weathering.

    Matched MeSH terms: Maxillofacial Prosthesis
  2. Rahman AM, Jamayet NB, Nizami MMUI, Johari Y, Husein A, Alam MK
    J Prosthodont, 2019 Jan;28(1):36-48.
    PMID: 30043482 DOI: 10.1111/jopr.12950
    PURPOSE: This systematic review aims to identify and interpret results of studies that evaluated the changes in the physical properties of maxillofacial prosthetic materials (1) without aging, (2) after natural or artificial accelerated aging, and (3) after outdoor weathering.

    METHODS: Relevant articles written in English only, before January 15, 2017, were identified using an electronic search in the PubMed, Scopus, and Google Scholar databases. Furthermore, a manual search of the related major journals was also conducted to identify more pertinent articles. The relevancy of the articles was verified by screening the title, abstract, and full text if they met the inclusion criteria. A total of 37 articles satisfied the criteria, from which data were extracted for qualitative synthesis.

    RESULTS: Among the 37 included articles, 14 were without aging, 15 were natural or artificial accelerated aging, 7 were outdoor weathering, and 1 contained both artificial aging and outdoor weathering. Only 4 studies out of the 14 without aging had significant observations; whereas 9 articles with natural or artificial aging published significant results, and 3 out of 7 outdoor weathering articles showed significant changes in the evaluated silicone elastomers.

    CONCLUSIONS: Despite the varying research, it seems that the single "ideal" maxillofacial prosthetic material that can provide sufficient resistance against different aging conditions is yet to be identified. Therefore, it is imperative for standardization organizations, the scientific community, and academia to develop modified prosthetic silicones possessing improved physical properties and color stability, limiting the clinical problems regarding degradation of maxillofacial prostheses.

    Matched MeSH terms: Maxillofacial Prosthesis*
  3. Patil PG, Nimbalkar-Patil S
    J Indian Prosthodont Soc, 2017 2 22;17(1):84-88.
    PMID: 28216851 DOI: 10.4103/0972-4052.176538
    INTRODUCTION: Maxillary obturator prosthesis is more frequent treatment modality than surgical reconstruction for maxillectomy in patients suffering from oral cancer. The obturators often become heavy and hence are hollowed out in the defect portion to reduce its weight as a standard practice.

    MATERIALS AND METHODS: The processing technique described the incorporation of the preshaped "wax-bolus" during packing procedure of the Obturtor prosthesis and eliminated later by melting it once the curing procedure is completed.

    RESULTS: This article is a single step procedure resulting into the closed-hollow obturator as single unit with uniform wall thickness around the hollow space ensuring the least possible weight of the hollow obturator.

    CONCLUSION: This processing technique achieves predictable internal dimension of the hollow space providing uniform wall thickness of the obturator.

    Matched MeSH terms: Maxillofacial Prosthesis
  4. Mousa MA
    J Contemp Dent Pract, 2020 Jun 01;21(6):678-682.
    PMID: 33025938
    AIMS: The purpose of this study was to assess the influence of hot and dry weather on the hardness and surface roughness of four different maxillofacial silicone elastomeric materials (MFSEM) including two room-temperature vulcanized (RTV) and two high-temperature vulcanized (HTV) materials.

    MATERIALS AND METHODS: Eighty test specimens were fabricated according to the manufacturer's instructions into rectangular test specimens. The hardness and surface roughness were tested, after 6 months of exposure to natural hot and dry weather. The hardness was measured through the International Rubber Hardness Degree (IRHD) scale using an automated hardness tester. The surface roughness was measured using a novel 3D optical noncontact technique using a combination of a light sectioning microscope and a computer vision system. Statistical Package for Social Sciences software SPSS/version 24 was used for analysis and a comparison between two independent variables was done using an independent t test, while more than two variables were analyzed, F test (ANOVA) to be used followed by a post hoc test to determine the level of significance between every two groups.

    RESULTS: The hot and dry weather statistically influenced the hardness and surface roughness of MFSEM. Cosmesil M-511 showed the least hardness in test groups while A-2000 showed the hardest material (p < 0.05). A-2000 showed significant changes from rough in case of nonweathered to become smoother in weather followed by A-2186 (p < 0.05). Cosmesil M-511 showed the roughest material.

    CONCLUSION: Cosmesil M-511 showed the least hard MFSEM after outdoor weathering while A-2000, the highest and least material showed hardness and surface roughness, respectively.

    CLINICAL IMPLICATION: A-2000 had a high IRHD scale hardness. This makes this material more suitable for the replacement of ear and nose defects. Cosmesil M-511 is soft and easily adaptable material that makes the material more appropriate for the replacement of small facial defect with undercut area to be easily inserted and removed. Whilst A-2000 is smoother and finer in test specimens after weathering, Cosmesil M-511 became rougher after weathering.

    Matched MeSH terms: Maxillofacial Prosthesis*
  5. Mousa MA, Abdullah JY, Jamayet NB, Alam MK, Husein A
    Biomed Res Int, 2021;2021:6419774.
    PMID: 34447852 DOI: 10.1155/2021/6419774
    Aim: This systematic review is aimed at investigating the biomechanical stress that develops in the maxillofacial prostheses (MFP) and supporting structures and methods to optimize it. Design and Methods. A literature survey was conducted for full-text English articles which used FEA to examine the stress developed in conventional and implant-assisted MFPs from January 2010 to December 2020.

    Results: 87 articles were screened to get an update on the desired information. 74 were excluded based on a complete screening, and finally, 13 articles were recruited for complete reviewing. Discussion. The MFP is subjected to stress, which is reflected in the form of compressive and tensile strengths. The stress is mainly concentrated the resection line and around the apices of roots of teeth next to the defect. Diversity of designs and techniques were introduced to optimize the stress distribution, such as modification of the clasp design, using materials with different mechanical properties for dentures base and retainer, use of dental (DI) and/or zygomatic implants (ZI), and free flap reconstruction before prosthetic rehabilitation.

    Conclusion: Using ZI in the defective side of the dentulous maxillary defect and defective and nondefective side of the edentulous maxillary defect was found more advantageous, in terms of compression and tensile stress and retention, when compared with DI and free flap reconstruction.

    Matched MeSH terms: Maxillofacial Prosthesis*
  6. Khalaf S, Ariffin Z, Husein A, Reza F
    J Prosthodont, 2015 Jul;24(5):419-23.
    PMID: 25219956 DOI: 10.1111/jopr.12213
    PURPOSE: This study aimed to compare the surface roughness of maxillofacial silicone elastomers fabricated in noncoated and coated gypsum materials. This study was also conducted to characterize the silicone elastomer specimens after surfaces were modified.

    MATERIALS AND METHODS: A gypsum mold was coated with clear acrylic spray. The coated mold was then used to produce modified silicone experimental specimens (n = 35). The surface roughness of the modified silicone elastomers was compared with that of the control specimens, which were prepared by conventional flasking methods (n = 35). An atomic force microscope (AFM) was used for surface roughness measurement of silicone elastomer (unmodified and modified), and a scanning electron microscope (SEM) was used to evaluate the topographic conditions of coated and noncoated gypsum and silicone elastomer specimens (unmodified and modified) groups. After the gypsum molds were characterized, the fabricated silicone elastomers molded on noncoated and coated gypsum materials were evaluated further. Energy-dispersive X-ray spectroscopy (EDX) analysis of gypsum materials (noncoated and coated) and silicone elastomer specimens (unmodified and modified) was performed to evaluate the elemental changes after coating was conducted. Independent t test was used to analyze the differences in the surface roughness of unmodified and modified silicone at a significance level of p < 0.05.

    RESULTS: Roughness was significantly reduced in the silicone elastomers processed against coated gypsum materials (p < 0.001). The AFM and SEM analysis results showed evident differences in surface smoothness. EDX data further revealed the presence of the desired chemical components on the surface layer of unmodified and modified silicone elastomers.

    CONCLUSIONS: Silicone elastomers with lower surface roughness of maxillofacial prostheses can be obtained simply by coating a gypsum mold.

    Matched MeSH terms: Maxillofacial Prosthesis*
  7. Khalaf S, Ariffin Z, Husein A, Reza F
    J Prosthodont, 2017 Dec;26(8):664-669.
    PMID: 28177575 DOI: 10.1111/jopr.12460
    PURPOSE: To compare the adhesion of three microorganisms on modified and unmodified silicone elastomer surfaces with different surface roughnesses and porosities.

    MATERIALS AND METHODS: Candida albicans, Streptococcus mutans, and Staphylococcus aureus were incubated with modified and unmodified silicone groups (N = 35) for 30 days at 37°C. The counts of viable microorganisms in the accumulating biofilm layer were determined and converted to cfu/cm2 unit surface area. A scanning electron microscope (SEM) was used to evaluate the microbial adhesion. Statistical analysis was performed using t-test, one-way ANOVA, and post hoc tests as indicated.

    RESULTS: Significant differences in microbial adhesion were observed between modified and unmodified silicone elastomers after the cells were incubated for 30 days (p < 0.001). SEM showed evident differences in microbial adhesion on modified silicone elastomer compared with unmodified silicone elastomer.

    CONCLUSIONS: Surface modification of silicone elastomer yielding a smoother and less porous surface showed lower adhesion of different microorganisms than observed on unmodified surfaces.

    Matched MeSH terms: Maxillofacial Prosthesis*
  8. Hiong ET
    Dent J Malaysia Singapore, 1972 May;12(1):53-5.
    PMID: 4507359
    Matched MeSH terms: Maxillofacial Prosthesis
  9. Haider KG, Lewis GR
    Quintessence Int, 1994 Jan;25(1):23-6.
    PMID: 8190877
    A variety of problems faces the prosthodontist attempting reconstruction of maxillary defects. There are various treatment options for patients requiring a partial maxillectomy and an obturator prosthesis. Reduced adaptability makes it difficult for the patient to learn to use a new appliance, unless existing skills can be employed. It is therefore helpful to reproduce familiar features of a patient's existing obturator, especially if this has been used successfully over a transition period.
    Matched MeSH terms: Maxillofacial Prosthesis*
  10. Farook TH, Abdullah JY, Jamayet NB, Alam MK
    J Prosthet Dent, 2021 Feb 15.
    PMID: 33602541 DOI: 10.1016/j.prosdent.2020.07.039
    STATEMENT OF PROBLEM: Computer-aided design (CAD) of maxillofacial prostheses is a hardware-intensive process. The greater the mesh detail is, the more processing power is required from the computer. A reduction in mesh quality has been shown to reduce workload on computers, yet no reference value of reduction is present for intraoral prostheses that can be applied during the design.

    PURPOSE: The purpose of this simulation study was to establish a reference percentage value that can be used to effectively reduce the size and polygons of the 3D mesh without drastically affecting the dimensions of the prosthesis itself.

    MATERIAL AND METHODS: Fifteen different maxillary palatal defects were simulated on a dental cast and scanned to create 3D casts. Digital bulbs were fabricated from the casts. Conventional bulbs for the defects were fabricated, scanned, and compared with the digital bulb to serve as a control. The polygon parameters of digital bulbs were then reduced by different percentages (75%, 50%, 25%, 10%, 5%, and 1% of the original mesh) which created a total of 105 meshes across 7 mesh groups. The reduced mesh files were compared individually with the original design in an open-source point cloud comparison software program. The parameters of comparison used in this study were Hausdorff distance (HD), Dice similarity coefficient (DSC), and volume.

    RESULTS: The reduction in file size was directly proportional to the amount of mesh reduction. There were minute yet insignificant differences in volume (P>.05) across all mesh groups, with significant differences (P

    Matched MeSH terms: Maxillofacial Prosthesis
  11. Farook TH, Jamayet NB, Abdullah JY, Rajion ZA, Alam MK
    J Stomatol Oral Maxillofac Surg, 2020 Jun;121(3):268-277.
    PMID: 31610244 DOI: 10.1016/j.jormas.2019.10.003
    A systematic review was conducted in early 2019 to evaluate the articles published that dealt with digital workflow, CAD, rapid prototyping and digital image processing in the rehabilitation by maxillofacial prosthetics. The objective of the review was to primarily identify the recorded cases of orofacial rehabilitation made by maxillofacial prosthetics using computer assisted 3D printing. Secondary objectives were to analyze the methods of data acquisition recorded with challenges and limitations documented with various software in the workflow. Articles were searched from Scopus, PubMed and Google Scholar based on the predetermined eligibility criteria. Thirty-nine selected papers from 1992 to 2019 were then read and categorized according to type of prosthesis described in the papers. For nasal prostheses, Common Methods of data acquisition mentioned were computed tomography, photogrammetry and laser scanners. After image processing, computer aided design (CAD) was used to design and merge the prosthesis to the peripheral healthy tissue. Designing and printing the mold was more preferred. Moisture and muscle movement affected the overall fit especially for prostheses directly designed and printed. For auricular prostheses, laser scanning was most preferred. For unilateral defects, CAD was used to mirror the healthy tissue over to the defect side. Authors emphasized on the need of digital library for prostheses selection, especially for bilateral defects. Printing the mold and conventionally creating the prosthesis was most preferred due to issues of proper fit and color matching. Orbital prostheses follow a similar workflow as auricular prosthesis. 3D photogrammetry and laser scans were more preferred and directly printing the prosthesis was favored in various instance. However, ocular prostheses fabrication was recorded to be a challenge due to difficulties in appropriate volume reconstruction and inability to mirror healthy globe. Only successful cases of digitally designed and printed iris were noted.
    Matched MeSH terms: Maxillofacial Prosthesis*
  12. B Jamayet N, J Abdullah Y, A Rajion Z, Husein A, K Alam M
    Bull. Tokyo Dent. Coll., 2017;58(2):117-124.
    PMID: 28724860 DOI: 10.2209/tdcpublication.2016-0021
    The wax sculpting of a maxillofacial prosthesis is challenging, time-consuming, and requires great skill. Rapid prototyping (RP) systems allow these hurdles to be overcome by enabling the creation of a customized 3D model of the desired prosthesis. Geomagic and Mimics are the most suitable software programs with which to design such prostheses. However, due to the high cost of these applications and the special training required to operate them, they are not widely used. Additionally, ill-fitting margins and other discrepancies in the final finished products of RP systems are also inevitable. Therefore, this process makes further treatment planning difficult for the maxillofacial prosthodontist. Here, we report the case of a 62-year-old woman who attended our clinic. Initially, she had presented with a right facial defect. This was later diagnosed as a squamous cell carcinoma and resected. The aim of this report is to describe a new technique for the 3D printing of facial prostheses which involves the combined use of open-source software, an RP system, and conventional methods of fabrication. The 3D design obtained was used to fabricate a maxillofacial prosthesis to restore the defect. The patient was happy with the esthetic outcome. This approach is relatively easy and cheap, does not require a high degree of non-medical training, and is beneficial in terms of clinical outcome.
    Matched MeSH terms: Maxillofacial Prosthesis*
  13. Abdullah AM, Rahim TNAT, Hamad WNFW, Mohamad D, Akil HM, Rajion ZA
    Dent Mater, 2018 11;34(11):e309-e316.
    PMID: 30268678 DOI: 10.1016/j.dental.2018.09.006
    OBJECTIVE: To compare the mechanical and biological properties of newly developed hybrid ceramics filled and unfilled polyamide 12 (PA 12) for craniofacial reconstruction via a fused deposition modelling (FDM) framework.

    METHODS: 15wt% of zirconia (ZrO2) as well as 30, 35, and 40wt% of beta-tricalcium phosphate (β-TCP) were compounded with PA 12, followed by the fabrication of filament feedstocks using a single screw extruder. The fabricated filament feedstocks were used to print the impact specimens. The melt flow rate, tensile properties of fabricated filament feedstocks, and 3D printed impact properties of the specimens were assessed using melt flow indexer, universal testing machine, and Izod pendulum tester, respectively. The microstructure of selected filament feedstocks and broken impact specimens were analysed using a field emission scanning electron microscope and universal testing machine. Human periodontal ligament fibroblast cells (HPdLF) were used to evaluate the cytotoxicity of the materials by (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromid) (MTT) assay.

    RESULTS: Hybrid ceramics filled PA 12 indicated sufficient flowability for FDM 3D printing. The tensile strength of hybrid ceramics filled PA 12 filament feedstocks slightly reduced as compared to unfilled PA 12. However, the tensile modulus and impact strength of hybrid ceramics filled PA 12 increased by 8%-31% and 98%-181%, respectively. A significant increase was also detected in the cell viability of the developed composites at concentrations of 12.5, 25, 50 and 100mg/ml.

    SIGNIFICANCE: The newly developed hybrid ceramics filled PA 12 filament feedstock with improved properties is suitable for an FDM-based 3D printer, which enables the creation of patient-specific craniofacial implant at a lower cost to serve low-income patients.

    Matched MeSH terms: Maxillofacial Prosthesis*
  14. Abdulhadi LM
    Eur J Prosthodont Restor Dent, 2012 Jun;20(2):81-5.
    PMID: 22852525
    A 72-year-old man was referred from the surgery department for rehabilitation following surgical resection of Basaloid carcinoma. The first surgical intervention involved the anterior palatal region and was restored with a simple obturator. Two years later further surgery was undertaken to excise a recurrent tumor in the nose and part of the cheek. This resulted in an exposed nasal cavity and maxillary sinus. In addition, there was a small oral aperture composed of thin tissue that stretched to its maximum due to scar formation. The defect was restored with a full thickness skin flap but it subsequently broke down leaving the midface exposed with limited mouth opening due to tissue contraction and scar formation after the flap operation. The defect was rehabilitated with Co-Cr obturator intraorally and a silicone nose retained to the naso-palatal extension of the obturator by a magnet extraorally. This resulted in practically good retention, placement, and adaptation of the two parts of the prosthesis.
    Matched MeSH terms: Maxillofacial Prosthesis*
  15. Abdulhadi LM
    Chin J Dent Res, 2010;13(1):61-6.
    PMID: 20936194
    A 70-year-old man who suffered from extensive extra and intraoral defects was rehabilitated with a prosthesis using multiple retaining means. The treatment was performed in two parts: externally involving the construction of an episthesis supported only by the remaining intact boundaries of the defect and retained by mini-dental implants and spectacle frame with a modified ear hook; and intraorally by an acrylic resin obturator to restore the function of the hemi-sectioned hard and soft palate. The episthesis was securely retained with minimal movement and/or dislodgment of the prosthesis during function. Multiple retentive techniques may be used to fix heavy external prostheses as an alternative to conventional implants or biological adhesives.
    Matched MeSH terms: Maxillofacial Prosthesis*; Maxillofacial Prosthesis Implantation*
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