PMC5494075_01
Patient's face with large size nasal defect (frontal and profile view).
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fig1
(a) Preoperative panoramic radiograph showing partially edentulous maxillary and mandibular arches. (b) Patient's face with O-ring post over implants in anterior nasal floor.
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Now the healing caps were removed and the selected O-ring posts were screwed over the implants (Figure 2(b)).
(a) CT image of defect area. (b) Polyamide acrylic substructure.
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Patient's nasal defect area was scanned by CT to obtain the geometric data (Figures 3(a) and 3(b)).
Evaluation of wax pattern on patient.
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Following this try-on of wax pattern (Figure 4) and acrylic substructure try-in were done and verified for shape, extension, air way, and esthetics.
Acrylic resin substructure on dewaxed master cast.
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After the wax boil-out procedure, the acrylic substructure was positioned on the master cast (Figure 5). The substructure was made hollow (as seen in Figure 5 and care was taken to maintain the space for metal encapsulator during packing of silicone) so that the silicone engages it from all around and adhesives were also applied on its surface to bond with silicone.
Definitive nasal prosthesis with metal encapsulator of O-ring attachment incorporated in resin substructure.
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The prosthesis was removed and evaluated for the incorporation of metal encapsulator with O-ring in acrylic resin substructure (Figure 6).
Definitive nasal prosthesis on patient.
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Now the completed nasal prosthesis was delivered to the patient (Figure 7).
Postoperative PNS water's view radiograph showing implant in position.
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Patient was observed regularly for 6 months which was found satisfactory and verified by radiograph (Figure 8).