State of the Art Care in Computer-Assisted Facial Prosthetic Rehabilitation

Autologous reconstruction for major facial defects is primarily considered for patient's lifetime care. There are situations, however, when autologous reconstruction is not ideal or feasible, and prosthetic reconstruction is necessary to reconstruct missing anatomy or to complement surgical reconstruction. The history of facial prosthetic reconstruction can be traced for millennia. At our craniofacial center, craniomaxillofacial prosthetic rehabilitation has been incorporated in the care provided to our patients since the center's inception, more than 70 years ago.The purpose of this review is to present the evolution of our current thinking based on our long experience since the implementation of computer-assistive technologies over 15 years ago, to further improve our patients' overall rehabilitation.These applications include all stages of prosthetic care from planning, design through device delivery, and for lifetime maintenance. The collaboration among surgeons and anaplastologists is fundamental to achieving optimal patient outcomes and in the success of our technology-based practice. Such collaboration starts with the patient's decision to proceed with prosthetic rehabilitation and continues with postoperative care and lifetime management of the patient's prosthetic device and prosthesis-bearing soft tissue.Although computer-assistive techniques often represent a substantial financial investment, the benefits of using them demonstrate clear advantages to both the clinician and patient. These benefits include: Improved predictability of outcomes, surgeon preparedness, reduction in operating room time, reduction in overall treatment times, improved precision and anatomical accuracy, improved treatment efficiencies, and overall treatment experience, particularly for those patients traveling great distances for access to care.Representative examples will be presented.