[Teeth as prostheses materials for reconstruction of disrupted ossicular chain]

Since 1988 we have routinely used prostheses made from teeth for ossicular reconstruction and have now done more than 400 implants. Short-time results with at least 1 year implantation were studied in a retrospective analysis of 319 cases with a review of 88 patients. Eighty percent of the implants were covered by an intact tympanic membrane, while in 10% the prosthesis was completely uncovered. This apparent perforation was not due to a material-related extrusion, but was caused by persistent ventilation dysfunction of the middle ear. This was associated with a progressive retraction of the tympanic membrane, which could be seen in all of these cases. The overall acoustic results were disappointing and hearing gain was only 8.7 dB. However, these results were due to the unsolved problems of chronic middle ear inflammation and were not influenced by the dental material. We have been very satisfied with the teeth as implant material, as they can be autoclaved (eliminating problems due to infection) without any loss of mechanical strength. Furthermore, their practically cost-free production has a definite financial advantage over the expensive, commercially-available implants. The prostheses can be sculptured by the young resident during his otologic training, with this experience then resulting in better and faster tympanoplasties.