Çene-Yüz Protezlerinde Güncel Yaklaşımlar: Rehabilitasyon Prensipleri, Biyomateryaller ve Klinik Uygulamalar
Özet
Maksillofasiyal defektler; konjenital anomaliler, travmalar, onkolojik rezeksiyonlar ve enfeksiyonlar sonucunda ortaya çıkabilen ve bireylerin fonksiyonel kapasitesi, estetik görünümü ve psikososyal yaşam kalitesi üzerinde önemli etkiler yaratan kompleks klinik durumlardır. Maksillofasiyal protezler, bu tür defektlerin rehabilitasyonunda cerrahi rekonstrüksiyona alternatif veya tamamlayıcı bir yaklaşım olarak önemli bir rol oynamaktadır. Bu bölümde, maksillofasiyal protez rehabilitasyonunun temel prensipleri güncel literatür ışığında kapsamlı biçimde ele alınmaktadır. Öncelikle maksillofasiyal defektlerin etiyolojisi ve sınıflandırılması incelenmiş; ardından yüz protezlerinde kullanılan biyomalzemeler, özellikle silikon elastomerler ve nanoteknoloji destekli materyaller açısından değerlendirilmiştir. Bunun yanı sıra yüz tarama sistemleri, CAD-CAM tasarım süreçleri ve üç boyutlu baskı teknolojileri gibi dijital üretim yöntemlerinin klinik uygulamalara katkıları ele alınmıştır. Protezin stabilitesini ve klinik başarısını doğrudan etkileyen retansiyon yöntemleri ve klinik uygulama protokolleri ayrıntılı olarak açıklanmıştır. Ayrıca nanoteknoloji, yumuşak doku mühendisliği, artırılmış gerçeklik ve sanal gerçeklik gibi gelişmekte olan teknolojilerin maksillofasiyal protez rehabilitasyonunun geleceğine yönelik potansiyel katkıları tartışılmıştır. Bu bölüm, klinisyenler ve araştırmacılar için güncel yaklaşımları bütüncül bir perspektifle sunmayı amaçlamaktadır.
Maxillofacial defects caused by congenital anomalies, traumatic injuries, oncologic resections, or severe infections represent complex clinical conditions that can significantly affect patients’ functional capacity, aesthetic appearance, and psychosocial well-being. Maxillofacial prostheses play a crucial role in the rehabilitation of these defects, serving either as an alternative or as a complementary approach to surgical reconstruction. This chapter provides a comprehensive overview of the fundamental principles and contemporary developments in maxillofacial prosthetic rehabilitation. The etiology and classification of maxillofacial defects are first discussed, followed by an evaluation of biomaterials used in facial prostheses, with particular emphasis on silicone elastomers and nanotechnology-enhanced materials. Furthermore, the integration of digital technologies—including facial scanning systems, CAD-CAM design processes, and three-dimensional printing techniques—into clinical workflows is examined. Retention methods and clinical application protocols that directly influence prosthetic stability and treatment outcomes are also addressed. Finally, emerging innovations such as nanotechnology, soft tissue engineering, augmented reality, and virtual reality are explored in terms of their potential contributions to the future of maxillofacial prosthetic rehabilitation. This chapter aims to provide clinicians and researchers with an up-to-date and multidisciplinary perspective on current approaches and future directions in the field.
Referanslar
Goiato MC, Pesqueira AA, Ramos G, Zuccolotti BC. Maxillofacial Prosthesis: A Comprehensive Review. International Journal of Research Publication and Reviews. 2024;5(1):1–12. Available from: https://ijrpr.com/uploads/V5ISSUE1/IJRPR21913.pdf [Accessed 12 Jan 2025].
Reddy N, Kumar P, Reddy S, et al. Retention in maxillofacial prosthetics: A review. International Journal of Applied Dental Sciences. 2021;7(2):516–521. Available from: https://www.oraljournal.com/archives/2021/vol7issue2/PartI/7-2-116-361.pdf [Accessed 12 Jan 2025].
Javaid M, Haleem A. 3D printing of maxillofacial prosthesis materials: Challenges and opportunities. Materials Today: Proceedings. 2023;62(Part 3):2253–2260. doi:10.1016/j.matpr.2022.10.532
Rumsey N, Harcourt D. Psychosocial impact and quality of life in facial prosthesis wearers. Body Image. 2021;36:215–223. doi:10.1016/j.bodyim.2020.11.008
Tavakolizadeh S, Hasani-Sadrabadi MM, Ghaffari M, et al. Recent advances in maxillofacial silicone elastomers. Materials Science and Engineering C. 2021;118:111544. doi:10.1016/j.msec.2020.111544
Kiat-Amnuay S, Gettleman L, Jacob RF. Color stability and mechanical performance of modern silicone prosthetic materials. The Journal of Prosthetic Dentistry. 2022;127(6):953–960. doi:10.1016/j.prosdent.2021.02.010
Ciocca L, Mazzoni S. Three-dimensional printing for maxillofacial prosthodontics. The International Journal of Prosthodontics. 2021;34(2):180–192. doi:10.11607/ijp.6664
Tran NH, Scarfe WC, Maniyar N, et al. Photogrammetry vs optical scanning for facial prosthesis fabrication. The Journal of Prosthodontics. 2021;30(3):235–242. doi:10.1111/jopr.13317
Hohne KH, Abdelrahman M, Przysiezny PE, et al. Digital workflows in facial prosthetics: Current concepts and future directions. Clinical Oral Investigations. 2023;27(2):489–501. doi:10.1007/s00784-022-04715-3
Goto M, Nagai H, Matsumura H, et al. Long-term outcomes of extraoral implants for facial prostheses: A retrospective study. The International Journal of Oral & Maxillofacial Implants. 2021;36(4):875–883. doi:10.11607/jomi.8912
Chrcanovic BR. Survival and complications of craniofacial implants: A systematic review. Journal of Cranio-Maxillofacial Surgery. 2020;48(9):911–922. doi:10.1016/j.jcms.2020.06.016
Ciocca L, Scotti R. Workflow optimization for orbital and nasal prostheses. The Journal of Prosthetic Dentistry. 2021;125(6):889–896. doi:10.1016/j.prosdent.2020.04.007
Alghazzawi TF. Clinical considerations and challenges in maxillofacial prosthetic rehabilitation. Saudi Dental Journal. 2022;34(4):185–193. doi:10.1016/j.sdentj.2022.02.003
Behroozian A, Ghaffari M, Mirhadi S, et al. Nanotechnology in improving maxillofacial prosthetic materials. Nanomedicine. 2021;16(12):957–972. doi:10.2217/nnm-2021-0052
Patel N, Singh P, Nair LS. Soft tissue engineering approaches for facial reconstruction: Emerging concepts and future directions. Tissue Engineering Part B: Reviews. 2023;29(3):423–438. doi:10.1089/ten.TEB.2022.0194
Lee JH, Kim YE, Park M, et al. Virtual and augmented reality applications in maxillofacial prosthodontics. Journal of Prosthodontic Research. 2022;66(2):247–256. doi:10.2186/jpr.JPOR_2021_160
Referanslar
Goiato MC, Pesqueira AA, Ramos G, Zuccolotti BC. Maxillofacial Prosthesis: A Comprehensive Review. International Journal of Research Publication and Reviews. 2024;5(1):1–12. Available from: https://ijrpr.com/uploads/V5ISSUE1/IJRPR21913.pdf [Accessed 12 Jan 2025].
Reddy N, Kumar P, Reddy S, et al. Retention in maxillofacial prosthetics: A review. International Journal of Applied Dental Sciences. 2021;7(2):516–521. Available from: https://www.oraljournal.com/archives/2021/vol7issue2/PartI/7-2-116-361.pdf [Accessed 12 Jan 2025].
Javaid M, Haleem A. 3D printing of maxillofacial prosthesis materials: Challenges and opportunities. Materials Today: Proceedings. 2023;62(Part 3):2253–2260. doi:10.1016/j.matpr.2022.10.532
Rumsey N, Harcourt D. Psychosocial impact and quality of life in facial prosthesis wearers. Body Image. 2021;36:215–223. doi:10.1016/j.bodyim.2020.11.008
Tavakolizadeh S, Hasani-Sadrabadi MM, Ghaffari M, et al. Recent advances in maxillofacial silicone elastomers. Materials Science and Engineering C. 2021;118:111544. doi:10.1016/j.msec.2020.111544
Kiat-Amnuay S, Gettleman L, Jacob RF. Color stability and mechanical performance of modern silicone prosthetic materials. The Journal of Prosthetic Dentistry. 2022;127(6):953–960. doi:10.1016/j.prosdent.2021.02.010
Ciocca L, Mazzoni S. Three-dimensional printing for maxillofacial prosthodontics. The International Journal of Prosthodontics. 2021;34(2):180–192. doi:10.11607/ijp.6664
Tran NH, Scarfe WC, Maniyar N, et al. Photogrammetry vs optical scanning for facial prosthesis fabrication. The Journal of Prosthodontics. 2021;30(3):235–242. doi:10.1111/jopr.13317
Hohne KH, Abdelrahman M, Przysiezny PE, et al. Digital workflows in facial prosthetics: Current concepts and future directions. Clinical Oral Investigations. 2023;27(2):489–501. doi:10.1007/s00784-022-04715-3
Goto M, Nagai H, Matsumura H, et al. Long-term outcomes of extraoral implants for facial prostheses: A retrospective study. The International Journal of Oral & Maxillofacial Implants. 2021;36(4):875–883. doi:10.11607/jomi.8912
Chrcanovic BR. Survival and complications of craniofacial implants: A systematic review. Journal of Cranio-Maxillofacial Surgery. 2020;48(9):911–922. doi:10.1016/j.jcms.2020.06.016
Ciocca L, Scotti R. Workflow optimization for orbital and nasal prostheses. The Journal of Prosthetic Dentistry. 2021;125(6):889–896. doi:10.1016/j.prosdent.2020.04.007
Alghazzawi TF. Clinical considerations and challenges in maxillofacial prosthetic rehabilitation. Saudi Dental Journal. 2022;34(4):185–193. doi:10.1016/j.sdentj.2022.02.003
Behroozian A, Ghaffari M, Mirhadi S, et al. Nanotechnology in improving maxillofacial prosthetic materials. Nanomedicine. 2021;16(12):957–972. doi:10.2217/nnm-2021-0052
Patel N, Singh P, Nair LS. Soft tissue engineering approaches for facial reconstruction: Emerging concepts and future directions. Tissue Engineering Part B: Reviews. 2023;29(3):423–438. doi:10.1089/ten.TEB.2022.0194
Lee JH, Kim YE, Park M, et al. Virtual and augmented reality applications in maxillofacial prosthodontics. Journal of Prosthodontic Research. 2022;66(2):247–256. doi:10.2186/jpr.JPOR_2021_160
