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Prefabricated silicone subdermal mandibular implants: observations and problems related to their application
Journal of Biomedical Materials Research
|July 1, 1976
Summary
Custom silicone implants effectively reconstruct mandibular defects, evolving from basic to K-wire reinforced designs. Careful patient selection is crucial for successful outcomes in alloplastic mandibular reconstruction.
Area of Science:
- Plastic Surgery
- Biomaterials Engineering
- Oral and Maxillofacial Surgery
Background:
- Facial contour defects have been successfully treated with custom Silastic implants.
- Mandibular reconstruction presents unique challenges due to continuous stress and motion.
- Alloplastic materials are difficult to use in mandibular reconstruction.
Purpose of the Study:
- To evaluate the efficacy of custom-fabricated silicone implants for mandibular reconstruction.
- To describe the evolution of mandibular implants from commercially available to K-wire reinforced designs.
- To assess the outcomes of prefabricated silicone implants in various mandibular defect scenarios.
Main Methods:
- Utilized custom-fabricated Silastic implants for mandibular reconstruction.
- Developed K-wire reinforced, prefabricated silicone implants.
- Implant fabrication based on preoperative X-ray measurements for immediate reconstruction.
- Implant placement for defects resulting from tumor resection, trauma, or congenital malformations.
- Approximately 30 subdermal implants were inserted over several years.
Main Results:
- Successful reconstruction of facial defects and functional abnormalities like drooling and deviation.
- Implants were used for immediate reconstruction after tumor resection and delayed reconstruction for trauma or deformity.
- Implants failed in patients with severe congenital malformations due to associated soft tissue deficiency.
- Prefabricated silicone implants demonstrated effectiveness in specific patient groups.
Conclusions:
- Custom-fabricated silicone implants are a viable option for mandibular reconstruction.
- The evolution towards K-wire reinforced, prefabricated implants improved outcomes.
- Meticulous patient selection is paramount for successful alloplastic mandibular reconstruction.
- Implants are not suitable for patients with severe congenital malformations and soft tissue deficiency.