Evolution of Facial Prosthetics: Conceptual History and Biotechnological Perspectives

The reconstruction of cephalic defect and more precisely from the face is not a recent issue. Indeed, the use of facial masks in a symbolic perspective was reported in ancient Egypt. Few references to facial prostheses are then found. It is really only with the work of the French surgeon Ambroise Paré that the first surgical techniques concerning facial epithetics are described. Techniques and materials tend to evolve over the centuries. But then came WWI, which marked a major turning point and brought to light the broken faces and the impact of maxillofacial trauma. Rehabilitation became a major issue in society. The war was a driving force for change from both a surgical and prosthetic point of view, revealing in particular such brilliant designers as the American sculptor Anna Coleman Ladd. Today, the profession is undergoing a major upheaval, linked to the growing development of biotechnological constructions. This historical review aims to retrace the evolution of the rehabilitation of facial substance loss over the ages and to outline the prospects for the foreseeable future. (Int J Maxillofac Prosthetics 2021;4:2-8

Surface Electromyography and Mandibular Motion Recording Input in Prosthetic Rehabilitation of Segmental Mandibulectomy: the MAC2 Protocol

Lateral segmental mandibulectomy can be associated with sequelae, such as mouth opening limitation and mandibular deviation, that lead to altered oral functions (chewing, swallowing, speech) and complex prosthetic management. The authors present a new protocol for surface electromyography (sEMG) and mandibular motion recording to help clinicians with decision-making and dental prosthetic treatment planning for segmental mandibulectomy. The clinical case of a patient with a reconstructed titanium endoprosthesis is presented. The MAC2 protocol is used and consists of chronologically performing various recordings by using a device for sEMG and mandibular tracking. During the orofacial reeducation and dental prosthetic reconstruction, three therapeutic steps can benefit from the MAC2 protocol: to analyze the initial muscular imbalance, to provide guidance in the choice of maxillomandibular relationship and to quantify the functional improvement. sEMG of masticatory muscles is a useful diagnostic tool in a context of mandibular kinematic disorders and the MAC2 protocol adds some guidance for dental prosthetic rehabilitation in the context of segmental mandibulectomy. (Int J Maxillofac Prosthetics 2021;4:47-54

Replacement of missing lateral incisors for patients with cleft lip and palate: A decision-making tree based on a systematic review of the literature

Statement of problem: Cleft lip and palate are the most frequent congenital anomalies of the face and are often linked with lateral incisor agenesis. The therapeutic decision on whether and how to replace the lateral incisors is not straightforward, and a decision-making tree is needed. Purpose: The purpose of this systematic review was to evaluate the available literature reporting on treatments for the replacement of missing lateral incisors in cleft areas. By analyzing the success and survival rates of these treatments, a decision-making tree was developed. Material and methods: The literature search was performed on the PubMed (MEDLINE), Web of Science, Cochrane, EMBASE, Dentistry of Oral and Science Source, and Google Scholar databases and was based on the question: Which treatment for patients with lateral incisor agenesis and cleft lip and palate has a good success rate? Results: Twenty-six articles were included in this systematic review. A meta-analysis was performed on 14 articles (20 case series, 6 case controls). The estimated overall 5-year survival rates were 96.4% for implant-supported prostheses. Conclusions: Different treatment options are available, depending on the clinical situation. If the patient meets the conditions for implant placement, this treatment remains a preferred solution. If the prosthetic space is reduced, orthodontic space closure and composite resin restorations are possible. When these options are not possible, a resin-bonded fixed partial denture is the preferred option. If the teeth adjacent to the edentulous area require extensive restorations, a fixed partial denture may be a suitable alternative