Orbital prosthesis fabrication: current challenges and future aspects

Abstract

Orbital defect, arising from tumor-related resections, trauma, and congenital anomalies, can lead to negative functional and psychological effects in the patients. Rehabilitation with an orbital prosthesis can provide satisfactory aesthetic outlook and can be combined with surgical reconstruction to improve the retention. Despite less than ideal properties, silicone elastomer is the most commonly used material to fabricate orbital prosthesis. Several studies have been conducted on developing newer materials and improving the properties of silicone elastomer. Craniofacial implants offer greater retention compared to adhesives, but they have been observed to have a higher risk of implant failure and related side effects when placed in irradiated bone. This review gives a scope on understanding the current challenges faced during fabrication of orbital prosthesis and the future directions of this field.

Post exenteration surgery rehabilitation with orbital prosthesis – A case report

“…An ideal maxillofacial prosthesis material should have ideal mechanical and physical properties, such as dimensionally stable, high resistance to abrasion, high tear and tensile strength, no water sorption, odorless, it should also be biocompatible with the surrounding tissues without release of any allergenic or toxic by-products after curing [4].…”

“…Methyl methacrylate, polyurethanes, and silicone have gained the most popularity as prosthesis materials as they can be intrinsically and extrinsically tinted using oil-based or dry earth pigments to match the patient's skin [4]. Silicone type room temperature vulcanizing (RTV) has better cosmetic outlook because the margins can be made thin and translucent to blend with surrounding skin [4].…”

“…These prostheses mimic the patient's missing structures and have acceptable aesthetic outlook. They also permit hygiene maintenance around the defect and observation for tumor recurrence [4].…”

“…Various types of medical grade adhesive systems are commercially available, such as spray-on adhesives, pastes, double-sided adhesive tapes, and liquid emulsions to retain the prosthesis [4]. Many studies have demonstrated the benefit of implants for retention of the orbital prostheses in providing increased retention, comfort, safety of use, and handling, compared to adhesive or other retention.…”

“…Silicone may not be as durable but it is easy to color and has better cosmetic outlook. The major drawbacks of silicone are their low tear and edge strengths and relatively low elongation [4].…”