PMC5098757_01
Pre- and post-prosthetic treatment photos of the patient fitted with an implant-retained orbital prosthesis.
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A 48-year-old woman with a right orbital defect who underwent exenteration and cranioplasty for fibromyosarcoma with a history of wearing an adhesive-retained orbital prosthesis was treated with surgical placement of implants in the right orbit, followed by fabrication of a custom, magnet-retained right oculoorbital silicone prosthesis (Figure 1). The prosthesis was finished in customary fashion and fitted with optimal prosthetic outcomes and patient satisfaction (Figure 1).
The views in Mimics, including coronal, axial, sagittal, and three-dimensional reconstruction.
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The coronal, axial, and sagittal views (Figure 2) were used to evaluate the available bone at the selected locations, and implant positions were adjusted as needed, taking into account the prosthetic design requirements.
Virtual (left) and physical (right) computer-generated models of the patient's skull with surgical guide and implants.
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A Boolean operation was also used to create the bone fitting surface of the guide (Figure 3). The surgical guide was test fitted on the 3D-printed model of the patient's anatomy to ensure a precise fit in the area for surgical placement of the implants (Figure 3).
(Left to right) Surgical guide seated onto the orbital rim in situ for placement of five osseointegrated implants at 7:00, 8:00, 10:00, 11:00, and 12:00 o'clock positions in the right orbit; followed by stage 2 abutment connection at 8:00, 11:00, and 12:00 o'clock positions.
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With subperiosteal exposure of the orbital bone, the surgical guide was seated directly onto the orbital rim without the need for external fixation (Figure 4). Three implants were connected at the 8:00, 11:00, and 12:00 o'clock positions, and 7.5 mm healing abutments were attached (Cochlear; Figure 4).