MAXILLOFACIAL

PROSTHESIS MATERIALS
Composition
• Silicones – used to fabricate bulk of the prosthesis.
• Acrylic resins – incorporated to provide strength and rigidity.
• Polyurethanes – provide a thin transparent junction with the skin.
Features of ideal material
• Excellent tissue receptivity.
• Nontoxic and nonallergic.
• Accurate forming, retention of fine details and without introduction of
obvious parting lines.
• A degree of translucency is required.
Features of ideal material
• The material must be essentially colorless so that it can be tinted to
simulate pastel skin tones.
• It must be durable and should have resistance to outdoor weathering.
• Should remain flexible over a range of ambient temperatures.
• Must adhere securely and comfortable and exhibit a fine line marginal
contact.
Materials available
1. Metals
Usually Co–Cr is used in the fabrication of framework of the definitive
prosthesis.
2. Nonmetals
• Acrylic resin and copolymers.
• Polyvinyl chloride and copolymer derivatives – realistic, mediplast,
prototype II.
• Silicone elastomers
Silicone elastomers
• HTV silicones ( high temperature vulcanized)
• Silastics 370, 372, 373, 4-4514, 4-4515
• PDM siloxane
• Q4635, Q7-4650, Q7-4735, SE-4524
• RTV silicones ( room temperature vulcanized)
• Silastic 382, 389
• MDX 4-4210
• SILASTIC 891
• Cosmesil
• A-2186
Acrylic resins
• These are used in the fabrication of both intraoral and extraoral
prostheses.
• Facial prosthesis made of this material remains serviceable for up to 2
years.
• Successfully employed for specific types of facial defects (e.g.
fabrication of orbital prosthesis).
Acrylic resins
• Intrinsic and extrinsic colouration can be utilized.
• Compatible with most adhesive systems.
• Heat polymerizing methyl methacrylateis preferred to the
autopolymerizing resin.
• Colour stability is better.
Disadvantages of hard acrylic prosthesis
• Rigid.
• Trauma to the defect area.
• Inferior aesthetic result due to lack of reproduction of skin.
Vinyl polymers and copolymers
They are copolymers of vinyl chloride and vinyl acetate.
• Polyvinyl chloride
• Clear hard resin, tasteless and odourless.
• Hardens when exposed to ultraviolet light and heat.
• Requires heat and light stabilization to prevent
discolouration during fabrication and use.
Vinyl polymers and copolymers
• Polyvinyl acetate
• Stable to light and heat.
• Abnormally low softening point (35–40°C)
• Flexible
• Adapt to intrinsic and extrinsic coloration
• Present an acceptable clinical appearance
Disadvantages
• Discoloration and hardening of prosthesis particularly at the margins.
• Edges tear easily if thin and require reinforcement with nylon fibres.
• Easily stained and degrade when exposed to ultraviolet light,
peroxides and ozone.
• Lack life like appearance.
• Metal moulds are required for curing.
• Can be used from 1 to 6 months
Chlorinated polyethylene
• The processing involves high heat curing of pigmented sheets of the
thermoplastic polymer in metal moulds.
• Colouration using oil soluble dyes and repeated moulding is possible.
Silicones
Advantages
• Soft and comfortable to the patients.
• Allow good color matches to be achieved.
• The process of cross-linking the polymer is referred to as
vulcanization.
• Vulcanization occurs both with and without heat and
depends on the catalytic or cross-linking agents utilized.
Types

• Heat temperature vulcanization silicones (HTV)

• Room temperature vulcanization silicones (RTV)
HTV silicones
• A white opaque material with highly viscous, putty-like consistency; it
is available as 1 component or 2 component putty.
Properties
• Exhibit excellent thermal stability.
• Color stable when exposed to ultraviolet light.
• Biologically inert.
• Do not posses sufficient elasticity to function in movable tissue beds.
Disadvantages of HTV

• Opaque and lifeless appearance.

• Do not readily accept extrinsic coloration, the internal colorants must
be incorporated into the gum stock with a milling device.
• Because high temperatures are required for vulcanization, metal
moulds are necessary.
RTV silicones
• Color stable.
• Biologically inert.
• Retain their physical and chemical properties at wide temperature
ranges.
• Clear solutions are available that enable the fabrication of translucent
prostheses.
Disadvantages

• Poor edge strength.

• Difficult to colour.
• The cosmetic appearances of these materials are much lesser than
acrylics, polyurethanes and polyvinyl chlorides.
Adhesives
• They are commonly classified by the method in which they are
dispensed – pastes, liquid emulsions, spray on and double sided tapes
Removers

• These are used to clean the adhesive form the skin. The various
adhesive removers available are
• Trichloroethane
• Acetone
• Kryolan medical sprit gum remover
Disadvantages
• Sebum acts as a barrier between skin and adhesive.
• Moisture reduces adhesive nature of the adhesive.
• Solvents used to remove adhesive from the skin act as irritants.
• Allergy.
• Trauma to the skin at the time of removal
Tissue conditioners

• It consists of ethoxyethyl acid copolymer ethyl acetate.

• It provides an elastic protective barrier that prevents skin damage