Thesis (M.Sc.) - Cairo University - Faculty of Oral and dental medicine - Department of Prosthodontics

This study was conducted to compare virtually fabricated ear prosthesis to the conventional prosthesis, concerning patient satisfaction and adaptation in patients with auricular defects. Methodology: 15 patients were recruited for auricular prosthetic reconstruction; 5 with bilateral defects and 10 with unilateral defects, total of 20 prostheses were fabricated. Preoperative data was collected including personal and medical history, plain photographs and CT scans. Pre-operative prosthetic and implant planning was carried out and surgical stent was fabricated. Three endosseous implants were placed in a two-stage surgical technique. Patients were assigned into two groups with allocation ratio 1:1. In control group, Implant level impression was recorded and a stone model with lab analogues was cast for the defect site. In intervention group, CT scanning was done for the full head and optical scanning was done to the defect site with scan bodies screwed to the implants. Using Bluesky and Exocad softwares a model of the defect site with implant analogues was planned and printed using SLA printing technology. For both groups, bar-clip attachment system was fabricated. to retain the silicone prostheses. For primary outcome assessment, patients were allowed to answer a 17 items questionnaire, each question was given a score from 1-5, total score was recorded for each patient to assess total satisfaction. For the secondary outcome assessment, acrylic ear models were fabricated. In the control group, waxing up of the ear was done on the stone cast followed by flasking, wax elimination, packing of heat cured acrylic resin and curing. In the intervention group, ear model was planned for using Meshmixer and Exocad soft wares to produce ear model with abutment extensions in relation to the implant positions. A placement jig was done for ear models of both groups and adaptaional accuracy was measured on the patient using silicon replica technique. The silicone replica was sectioned into 12 sections and the gap, represented in light consistency polyvinyl siloxane impression material was measured using digital microscope

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