Computed tomographic study of bone availability for facial prosthesis-bearing endosteal implants

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Science
• Medical Imaging

Background:

• Facial defects often necessitate reconstructive surgery, with osseointegrated implants offering a viable solution for prosthesis support.
• Assessing bone availability is crucial for successful extraoral implant placement in patients with complex facial anatomy.

Purpose of the Study:

• To evaluate bone availability for extraoral Brånemark implants in patients with facial defects using computed tomography.
• To determine the success rates of implants used to support facial prostheses.

Main Methods:

• Computed tomographic scans of 56 patients with facial defects were analyzed.
• Bone depths were measured in key facial regions: auriculotemporal, infraorbital, lateroorbital, supraorbital, medioorbital, and nasal skeleton.
• Implant survival rates and complications were tracked over three years.

Main Results:

• Bone availability varied across facial regions, with limitations noted near the frontal and maxillary sinuses and in the nasal region.
• The auriculotemporal region consistently offered sufficient bone width.
• Three-year implant survival rates were 100% for auricular defects and 85.8% for orbital defects, with few serious complications.

Conclusions:

• Extraoral Brånemark implants are a successful option for supporting facial prostheses, especially in auricular reconstructions.
• Careful pre-operative assessment of bone dimensions is essential, particularly in the infraorbital and supraorbital areas.
• While generally safe, some patients may require secondary corrective surgery.