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Orbital defects due to congenital causes, cancer, and trauma can compromise appearance and function, creating a deep psychological impact on an individual's life. The prosthetic rehabilitation of such patients is challenging. The objective of prosthetic treatment of an ocular defect is to provide a well-fitting ocular prosthesis that closely resembles the original eye, restoring the patient's self-confidence and social acceptance. Ocular prostheses can be customized or prefabricated. The challenge encountered with prefabricated eye prostheses is a poor fit. Customized prostheses exhibit better fit, aesthetic outcome, and comfort to the patient in the long term. The article describes a technique to fabricate an ocular prosthesis with a stock iris and customized sclera that is both functional and aesthetically pleasing.

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Introduction: the present study aimed to establish an epidemiological profile of patients consulting the unit of maxillofacial prosthodontics in Rabat. Results deriving from this study will help enhance the quality of patient care in our center and can also serve as a comparison tool with other maxillofacial teams around the world. Methods: during 11 months all patients consulting the unit of maxillofacial prosthodontics in our center were included. We opted for a questionnaire with 3 variables: socio-demographics, clinical examination data, and the type of prosthetic treatment adopted. The study was conducted in the Department of Removable Prosthodontics in the Center of Consultation and Dental Treatment of Rabat Morocco (CCDTR) from September 2020 to July 2021. Results: the study population consisted of 91 patients, with a majority of male patients at 53% (n=48). During our study period, the proportion of patients under one-year-old was predominant, accounting for 38.4% (n=35) of the total sample. Among the patients in the sample, 72.5% (n=66) had no profession, while 66% (n=60) had a low income. Regarding medical insurance, the majority of our patients, 85.5% (n=78), were covered by Public Health Insurance for the Low-income Population (PHILP). Among the total sample, 57.1% (n=52) consulted for a combination of pain function and aesthetics. Additionally, 61.5% (n=56) were referred by teaching hospitals. For the type of oro-facial defect, 52.7% (n=48) of the sample consisted of newborns with congenital facial cleft. Out of the 91 patients, 36 had maxillofacial tumors, with 47.6% (n=17) of them presenting squamous cell carcinoma. Furthermore, 63.7% (n=58) of the prosthetic treatments adopted involved presurgical orthopedic treatments for newborns with facial cleft. Conclusion: the study on the epidemiological profile of patients attending the maxillofacial prosthodontics unit at Ibn Sina University Hospital in Rabat, Morocco provides important insights. The findings highlight the predominance of male patients and the prevalence of oro-facial defects in newborns. Socioeconomic factors, such as low income and lack of profession, are significant considerations. The majority of patients are covered by the PHILP, indicating the importance of medical insurance. These findings contribute to improving healthcare planning and specialized care for this patient population.

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This clinical report summarizes a workflow that introduces two approaches for fabricating a metal framework removable partial denture for a marginal mandibulectomy patient. First, the pre-existing denture was adjusted according to the piezographic technique to determine the optimal configuration for adhering to the available denture space. Second, computer-aided design-computer-aided manufacturing (CAD-CAM) technology was used to fabricate a new removable partial denture by digitally scanning the oral condition and the well-adjusted denture and then using the obtained data to design and fabricate the new denture. These two approaches can help to reduce chair time not only for maxillofacial prosthetic treatment but also for other denture cases.

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The aim of this study was to assess the perceptibility and acceptability thresholds of maxillofacial silicones for light and dark skin colors and to evaluate the effect of gender and professional experience on these thresholds. Two different sets of specimens (as light and dark) each, consisting of 14 (25 × 25 × 6-mm3) silicone skin replications, were produced. Four specimens of each set were produced from the same silicon mixture of the relevant set and polymerized simultaneously to provide standardized fabrication conditions. These 4 light/dark specimens were assigned as "baseline color specimens (BCs)" in each set, while the other 10 specimens were produced with a color difference level that increased gradually from BC. These stepped levels were obtained by controlled increasing of the pigment concentration in the relevant baseline silicon mixture. Color difference levels of specimens were calculated by using the CIELAB and CIEDE2000 formulas. Observers comprised of 3 different professional experiences as first-year dental students, interns, and dentists (n = 30/group, gender-balanced) were included. Combinations consisting of 5 specimens with 4 BCs and 1 different color were shown to the observers to assess whether the color difference was perceptible or acceptable. Perceptibility and acceptability percentages were regressed with color difference levels to estimate the best fit curve and confidence intervals were calculated (α = 0.05). The highest estimation of the coefficient of determination (R2) was found in the cubic curve for all parameters. A significant difference was found between the light and dark colors. The perceptibility thresholds (ΔE*ab/ΔE00) were 0.8/0.59 and 2.63/1.75 for light and dark colors, respectively. The acceptability thresholds (ΔE*ab/ΔE00) were 3.35/2.25, 10.07/7.04 for light and dark colors, respectively. No significant differences were found between gender and among experience groups concerning visual thresholds. Regardless of gender and experience, observers could perceive color differences more easily in light skin colors.

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It is a well-known saying that the eyes are "windows to the soul." The absence or loss of any facial part, particularly the vision, can lead to severe physical as well as emotional trauma. Losing any part of the face causes the patient societal, physical, and psychological anguish. An ocular prosthesis aims to improve social acceptance and boost self-confidence by restoring the facial appearance. A pediatric dental specialist should be a part of the maxillofacial prosthesis team since maxillofacial prosthetic rehabilitation in young children can be challenging, especially with the less cooperative ones. The following case report describes these challenges in relation to a 5-year-old boy who had his eye enucleated due to trauma. The purpose of the case was to provide custom-built, acrylic ocular prostheses in as comfortable and atraumatic manner as possible by the maxillofacial prosthetic team. How to cite this article: Bansod AV, Pisulkar S, Beri A, et al. Rehabilitation of an Ocular Defect Using a Custom Ocular Prosthesis in a Pediatric Patient. Int J Clin Pediatr Dent 2024;17(4):479-482.

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The repair of hemimandibulectomy defects involving the temporomandibular joint (TMJ) is challenging. This study compared the functional outcomes and reconstruction accuracy using a deep circumflex iliac artery (DCIA) flap with and without a virtually planned stock TMJ prosthesis (TMJP) after hemimandibulectomy. Ten patients were assessed: five with a TMJP (TMJP group) and five without (control group). A three-dimensional comparison revealed a mean deviation of 0.11 ± 0.04 mm between the planned and actual DCIA flap with TMJP. The planned and actual TMJP positions differed by 0.56 ± 0.57 mm in height, 0.33 ± 0.24 mm ventrally/dorsally, and 1.18 ± 0.42 mm medially/laterally. Mouth opening, laterotrusion, and midline deviation were significantly greater in the control group than in the TMJP group (P = 0.024, P = 0.008, P = 0.024). The deviation in ventral to dorsal translation for the DCIA flap was slightly higher than reported values in the literature, while height deviation was comparable. Lower deviations in the literature were due to the DCIA flap being used where both TMJs were intact. The in-house virtually planned DCIA flap with stock TMJP yielded results comparable to more expensive patient-specific prostheses.

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the aim of this paper, is to propose a new reference line: the Frontozygomatic-Infraorbital Line (FZ-IOL). This reference line can guide the surgical team planning mandibular angle harmonization, based on the patient's skeletal proportion. The Frontozygomatic-Infraorbital Line has been adopted for symmetrization surgery, masculinization surgery, and in unsatisfactory results of previous orthognathic surgery. From March 2021 to December 2022, 3 patients were treated for severe facial asymmetry affecting mainly the lower third of the face. All cases were planned with the reference FZ-IOL. Patients were treated in the same center, at the Orthognathic Surgery Department of the Instituto Portugues da Face, Lisbon, Portugal. The Frontozygomatic-Infraorbital Line is designed virtually using software to reconstruct a 3D image from a digital imaging and communications in medicine (DICOM) file obtained from a cone beam computer tomography (CBCT). , connecting the two orbital rims. Then, a vertical line, the frontozygomatic line perpendicular to the IOL and passing through the outmost lateral portion of the frontozygomatic suture is drawn. The proposed line demonstrated how establishing appropriate reference lines is crucial for the success of the surgery. The selection of reference lines should be based on the patient's anatomy, the symmetrization process's complexity, and the surgery's desired outcome. The Frontozygomatic-Infraorbital Line represents an adequate reference line for managing mandibular angle lateral projection, improving lower third of the face symmetrization.

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The absence of any organ of the facial region causes an asymmetrical appearance. This asymmetrical appearance can cause social dilemmas for the patient. The maxillofacial technician, the prosthodontist, and the patient must work closely together to fabricate an epithesis. On the implants, a superstructure is first constructed. Most of it is made up of rings and a bar that joins the implants. The firm acrylic resin base of the epithesis is equipped with clips that serve as the epithesis's retention mechanism. The actual epithesis is made of silicone rubber. The epithesis has to be shaped and colored with extreme caution. An appropriate substitute is an auricular prosthesis that is implant-retained. Microtia, deformity, malformation, and loss of the external ear, either partially or completely, can result from a variety of inherited genetic conditions. To evaluate the symmetry of both ears, artificial intelligence (AI) software is used. An Instagram lens Gridset by crystalwavesxx was used to correct and verify the bilateral symmetry of the patient. This case report primarily focuses on the fabrication of implant-supported auricular prostheses using AI.

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In a rare condition known as vaginal agenesis, the uterus (womb) may develop only partially or not at all, while the vagina fails to develop altogether. It is common to diagnose vaginal agenesis, when a female does not start menstruation at puberty. This is a prenatal disorder that may also be linked to bone or kidney issues. Mullerian agenesis, Mullerian aplasia, and Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome are other names for the illness. Treatment modalities encompass surgical and nonsurgical interventions, including the utilization of prefabricated or customized vaginal stents for neovagina reconstruction and maintenance. This case report describes the development of a neovagina in a 27-year-old female diagnosed with vaginal agenesis, a characteristic of MRKH syndrome. A customized clear acrylic stent, designed to provide a resilient surface, serves as a straightforward and cost-efficient alternative for managing this condition. Significantly, it enhances patient's compliance and comfort during treatment, addressing both the physical and psychological ramifications of this congenital anomaly. This customized vaginal stent not only provides a practical solution but also contributes to enhancing the quality of life for individuals grappling with vaginal agenesis, thereby offering a promising avenue for addressing the multifaceted challenges associated with this condition.

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PURPOSE: To evaluate in situ the influence of sweat, oil, sunscreen, and disinfectant solution on the color stability, hardness, and roughness of elastomer for facial prostheses. MATERIALS AND METHODS: Standardized and intrinsically pigmented specimens remained in contact with human skin from the same person for 30 days, considering exposures (n = 36 per group), absent of exposition (Control, C); sweat and oiliness contact (SO); sweat and oiliness associated with sunscreen (SOS); 0.12% chlorhexidine digluconate immersion (CD0.12%); and all agents exposed (SOSCD). The main variables were color change (CIELab and National Standard Bureau system, NBS), Shore A hardness, and surface roughness, measured at baseline and 30 days. Qualitative analyses were performed by atomic force microscopy (AFM) and scanning electron microscopy (SEM). The data were analyzed by Kruskal-Wallis tests (color) and two-way ANOVA (hardness and roughness) with Sidak post-test (α = 0.05). RESULTS: CD0.12% (1.54 ± 0.49) and SOSCD (2.10 ± 1.03) had similar effects and caused the smallest color changes, considered mild and noticeable (NBS), respectively. SOS promoted the greatest color change (6.99 ± 1.43, NBS: large) and hardness (17.97 ± 0.56); SOS promoted intermediate roughness (3.48 ± 1.05) between SOSCD (2.25 ± 0.53), and two similar groups: C (4.46 ± 0.95), and CD0.12% (4.39 ± 1.26). The qualitative analysis showed an irregular, dense, dry, and whitish layer on the surface of the specimens exposed to sunscreen, which was reduced when in contact with 0.12% chlorhexidine digluconate. CONCLUSIONS: Endogenous and exogenous factors are capable of altering elastomer properties. The 0.12% chlorhexidine digluconate minimized the changes caused by sweat, oil, and sunscreen.

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Trauma, cancer, and congenital abnormalities are the three main causes of eye loss. A person's personal and professional life is left with functional, aesthetic, and psychological problems when they lose one eye. A customized ocular prosthesis made of heat-cured polymethylmethacrylate can be used to restore an eye defect. Fabrication of the customized ocular prosthesis has multiple steps including scleral plank fabrication, iris positioning, and characterization. This article's primary goal is to explain a novel method for iris positioning for better cosmetic outcomes.

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Objectives: The purpose of this comparative study in vitro was to evaluate the effect of organic and inorganic nanoparticles on colour stability, tear strength and hardness of maxillofacial silicone elastomer at baseline and when subjected to outdoor weathering for 6 months. Material and Methods: A total of 240 specimens were fabricated using M511 platinum silicone which were divided into total 4 groups (n = 60) based on the type of nanoparticles (control, polytetrafuoroethylene [PTFE], titanium dioxide [TiO2], zinc oxide [ZnO]) added and each group was further divided into 3 subgroups (n = 20) for colour, tear strength (TS) and hardness (H) testing. The tests were conducted and data was obtained both before and after outdoor weathering of 6 months. Results: Minimum colour change after weathering was observed in PTFE group (∆E = 2.23). TiO2 group showed maximum TS (12.01 N/mm) followed by PTFE group (10.85 N/mm) before weathering. After weathering, maximum TS was shown by TiO2 group (12.9 N/mm) and PTFE group (12.54 N/mm). TiO2 group showed maximum hardness (24.15 shore A) before weathering and PTFE group showed maximum hardness (33.43 shore A) after weathering. Conclusions: Within the limitations of this study, it can be concluded that the addition of polytetrafuoroethylene nanoparticles to the polymer enhances both the optical as well as mechanical properties and can be considered favourable for the extended life of the prosthesis.

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Squamous cell carcinoma (SCC) is the type of cancer that most frequently affects the oral cavity, mainly in men older than 50 years of age. Treatment for oral SCC often involves surgical excision of the affected margins, resulting in mutilation that affects the patient's quality of life. The objective of this case report is to describe the prosthetic treatment of a 56-year-old man who underwent total glossectomy, resulting in speech and swallowing difficulties. The proposed treatment was a tongue prosthesis retained by orthodontic clasps on the mandibular first molars. After maxillary and mandibular complete-arch impressions were performed and casts were prepared for prosthetic planning, an acrylic resin plate and 3 tongue prototypes were fabricated. Esthetic and functional tests were carried out, and 2 tongue models (1 for speech and 1 for eating) were selected for acrylization, finishing, and polishing. After placement of the prostheses, the patient was referred for follow-up with a speech therapist to improve his adaptation with the prostheses. The patient was satisfied with the prostheses and able to perform the functions of chewing, swallowing, and speech production, which helped in his social reintegration and improved his quality of life.

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PURPOSE: This study investigated the color stability of different commercially available silicone materials for facial prostheses upon exposure to everyday beverages. It was hypothesized that the beverages would not alter the color of the silicone under conditions simulating daily exposure. METHODS: Sixty specimens were fabricated using two materials - VST-50 and Silfy - and exposed to commercially available cold mineral water, tea, or coffee. Specimen color was evaluated on days 1 and 15. The color was measured with a spectrophotometer based on CIELab system and color differences were calculated as ΔE. Statistical analysis was performed using the Kruskal-Wallis test and Mann-Whitney U test. RESULTS: The mean ΔE values after 15 days of exposure to mineral water, cold green tea, and coffee were 1.016, 3.480, and 3.636 for VST-50 and 0.440, 0.798, and 1.425 for Silfy, respectively. Both materials showed significant differences in color, and VST-50 showed a greater color change than Silfy, especially for coffee. CONCLUSION: Pigmented silicone elastomers have low color stability, leading to an overall color change in silicone prostheses when exposed to pigmented beverages. Color changes in such prostheses can be mitigated by selecting materials with better color stability to extend their longevity.

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This case study delineates the proficient creation of a silicone finger prosthesis, tailored for a patient contending with partial digit amputation. The prosthesis was devised with the overarching goal of reinstating not only the physiological dexterity of the hand but also its aesthetic integrity and the patient's psychological equilibrium. The crafting process entailed a meticulous technique to replicate the intricate texture of the skin in order to guarantee a near normal appearance. Post-prosthesis integration, the patient exhibited enhancements in manual functionality and articulated a heightened self-assuredness because of the indiscernible prosthesis. This illustrative case underscores the efficacy of silicone finger prosthetics in conferring both functional and aesthetic restitution to those afflicted with partial digit amputations.

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PURPOSE: Digital technologies are continuously improving the accuracy and quality of maxillofacial prosthetics, but their impact on patients remains unclear. This cross-sectional study aimed to analyze the impact of facial prosthetics service provision, patients' perception, and digital technology on prostheses construction. MATERIALS AND METHODS: All patients who presented for evaluation and management of facial defects between January 2021 and December 2021 at the ENT clinic were eligible for study enrollment. Patients requiring prosthetic reconstruction of their missing facial parts were included in the study. Forty-five questionnaires were delivered, inquiring about the patients' prosthetic demographics, prosthesis manufacture using 3D technologies, and their perceptions and attitudes. RESULTS: A total of 37 patients responded (29 males, eight females; mean age 20.50 years). The congenital cause was the highest among other causes (p = 0.001) with auricular defects being the highest (p = 0.001). A total of 38 prostheses were constructed and 17 prostheses were retained by 36 craniofacial implants (p = 0.014). The auricular and orbital implants success rates were 97% and 25%, respectively. The implant locations were digitally planned pre-operatively. Digital 3D technologies of defect capture, data designing, and 3D modeling were used and perceived as helpful and comfortable (p = 0.001). Patients perceived their prosthesis as easy to handle, suited them, and they felt confident with it (p = 0.001). They wore it for more than 12 h daily (p = 0.001). They were not worried that it would be noticed, and found it comfortable and stable during various activities (p = 0.001). Implant-retained prosthesis patients were more satisfied with it, and found it easy to handle and stable (p = 0.001). CONCLUSIONS: Congenital defects are the main cause of facial defects in the study country. The overall acceptance of maxillofacial prostheses was good, showing high patient perception and satisfaction. Ocular and implant-retained silicone prostheses are better handled, more stable, and the latter is more satisfying than traditional adhesive prostheses. Digital technologies save time and effort invested in manufacturing facial prostheses.

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Purpose To assess the accuracy of scanning technologies for constructing facial prostheses on human faces.Study selection Our systematic search was performed on five databases. Studies reporting on human volunteers (P) whose faces were scanned with a scanning technology were eligible. The anthropometrical interlandmark distances (ILDs) were used as indicators of accuracy; the ILDs are measured on the virtual models (I) and directly on the faces (C). The virtual models deviated from their true values (O). Studies reporting the measurements on patients with or without facial deformities were included, but cadavers or inanimate objects were reasons for exclusion. We performed a mean difference (MD) / standardized MD analysis with a random effect model. The difficulties regarding the scanning procedure mentioned in the articles were also assessed.Results We found 3723 records after duplicate removal. Twenty five articles were eligible for the qualitative review, and ten articles were included in the quantitative synthesis. Eight different ILDs were compared in MD analyses. The differences were between -0.54-0.43 mm. We also performed a regional three-dimensional analysis to compare scanning technologies in each major region. No significant differences were found in any of the regions and axes. The most mentioned difficulties were artifacts due to motion or blinking.Conclusions The results suggest no systematic skew in linear dimensions neither between direct caliper measurements nor between measurements on the scanned models, scanning technologies, or facial regions.

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@#The identification of suitable seed cells represents a critical scientific problem to be solved in the field of oral and maxillofacial bone tissue regeneration. The application of adipose-derived stem cells (ASCs) in tissue and organ repair and regeneration has been studied extensively. In recent years, dedifferentiated fat (DFAT) cells have also shown broad application prospects in the field of bone tissue engineering. DFAT cells express stem cell-related markers and have the potential to differentiate into adipocytes, osteoblasts, chondrocytes, nerve cells, cardiomyocytes and endothelial cells. In addition, DFAT cells also have the advantages of minimally invasive acquisition, strong proliferation and high homogeneity. Currently, all studies involving the application of DFAT cells in scaffold-based and scaffold-free bone tissue engineering can confirm their effectiveness in promoting bone regeneration. However, cytological research still faces some challenges, including relatively low cell culture purity, unclear phenotypic characteristics and undefined dedifferentiation mechanisms. It is believed that with the continuous development and improvement of isolation, culture, identification and directional induction of osteogenic differentiation methods, DFAT cells are expected to become excellent seed cells in the field of oral and maxillofacial bone tissue engineering in the future.

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A prótese obturadora (PO) permite o restabelecimento estético e funcional de indivíduos maxilectomizados. Os objetivos deste estudo foram: 1. avaliar pelo método de elementos finitos (MEF), o comportamento biomecânico de infraestruturas metálicas de próteses parciais removíveis obturadoras (PPRO) para uma maxila com ressecção do tipo Classe II de Aramany, variando o tipo de conector maior; 2. realizar uma revisão sistemática com meta-análise em rede sobre a eficácia da PO, e outros tratamentos na qualidade de vida de seus usuários. No primeiro estudo, um modelo virtual simulando uma maxila Classe II de Aramany com ressecção óssea do lado esquerdo, e ausência dos dentes 24, 25, 26 e 27 foi construído no programa Rhinoceros® 7.0, a partir de duas tomografias. Em seguida, três infraestruturas de PPRO digitais foram confeccionadas variando o tipo de conector maior: grupo controle com conector maior tipo placa palatina com extensão reduzida (GC), conector maior tipo placa palatina com extensão total (ME), e conector maior tipo barra anteroposterior com extensão reduzida (AP). A análise de elementos finitos foi realizada no software Optistruct 2022, e os resultados analisados no HyperView 2022. Os resultados foram avaliados de forma qualitativa por meio da observação visual das imagens gráficas com variação dos gradientes de cores, de acordo com a distribuição de tensão, e quantitativa por meio da tensão de von Mises (σVM), tensão máxima principal (σmax), tensão mínima principal (σmin) e deslocamento (mm). No segundo estudo foi realizada uma revisão sistemática com meta-análise em rede (PROSPERO #CRD42023430827). Foram incluídos ensaios clínicos randomizados (ECRs) e estudos de intervenção não randomizados (EINRs) com pacientes reabilitados com prótese obturadora como um dos tratamentos de reabilitação. Sete desfechos reportados pelos pacientes foram analisados separadamente para cada desenho de estudo, de acordo com os questionários de QV: aparência, mastigação, dor, contato social, fala, deglutição e QV geral. Os dados foram convertidos para o questionário UW-QOL v4, exceto o contato social que foi convertido para o EORTC QLQ-H&N35. Foi usada meta-análise em rede Bayesiana modelo randômico para calcular as diferenças médias, e intervalos de credibilidade de 95% (Crl) para cada comparação entre tratamentos. A interpretação seguiu a certeza da evidência por meio da abordagem GRADE para meta-análise e a diferença mínima importante (DMI). A revisão incluiu 4 ECRs e 9 EINRs. Sete tratamentos foram avaliados: pré-cirúrgico (considerado sem tratamento), obturador pós-cirúrgico, obturador provisório, obturador convencional, obturador suportado por implante, obturador magnético e retalho, totalizando 120 comparações de tratamentos em todos os sete desfechos. Verificou-se pelos resultados do primeiro estudo que CG e AP apresentaram comportamentos semelhantes, já ME apresentou maiores valores de tensão para praticamente todos os componentes do sistema. Nenhum dos grupos apresentou valores de deslocamento significativos. Para a revisão sistemática, observou-se que a estimativa de efeito de alguns tratamentos alcançou a DMI, entretanto, o intervalo de credibilidade cruzou a linha de efeito nulo, com certeza da evidência muito baixa, portanto, nenhum tratamento foi mais eficaz que o outro. Para ambos os estudos, mais estudos laboratoriais e ensaios clínicos randomizados são incentivados para confirmar as evidências encontradas.

The obturator prosthesis (OP) allows the restoration of speech, aesthetics, and oral function in patients with maxilectomized individuals. The objectives of the study were: 1. to evaluate, using the finite element analysis (FEA) methodology, the biomechanical behavior of metallic infrastructures of removable partial denture obturator (RPDO) for a maxilla with Aramany Class II resection, varying the type of major connector; 2. carry out a systematic review with network meta-analysis on the effectiveness of the OP and other treatments on the quality of life of its users. In the first study, a virtual model simulating an Aramany Class II maxilla with bone resection on the maxillary left side and absence of teeth 24, 25, 26 and 27 was developed using the Rhinoceros® 7.0 program based on two tomography scans. After obtaining the virtual model, three infrastructures digital RPDOs were created varying the type of major connector: major connector with reduced coverage (RPDO1), major connector with extensive coverage (RPDO2) and major connector with anteroposterior bar (RPDO3). The FEA analysis was carried out using the Optistruct 2022 software, and the results were analyzed using the HyperView 2022 software. The results were evaluated qualitatively through visual observation of graphic images with variation of color gradients according to the stress distribution and quantitative von Mises stress (σVM), maximum principal stress (σmax), minimum principal stress (σmin) and displacement (mm). For the second study, the systematic review with network meta-analysis (PROSPERO #CRD42023430827). Randomized controlled trials (RCTs) and non-randomized studies of intervention (NRSIs) with obturator prosthesis as one of the treatments were included. Seven patient-reported outcomes were analyzed separately for each study design, according to the QOL questionnaires: appearance, chewing, pain, social contact, speech, swallowing and general QOL. Data were converted to the UW-QOL v4 questionnaire, except social contact, which was converted to the EORTC QLQ-H&N35. Network meta-analysis (NMA) Bayesian random model was used to calculate mean differences (MD) and 95% credibility intervals (Crl) for each treatment comparison. Interpretation followed the certainty of evidence through the GRADE approach for NMA and the least important difference (DMI). The review included 4 RCTs and 9 NRSIs. Seven treatments were evaluated: presurgical (considered no treatment), surgical obturator, interim obturator, obturator, implant-supported obturator, magnet obturator, and flap, totaling 120 treatment comparisons in all seven outcomes. The results of the first study indicate that RPDO1 and RPDO3 showed similar behaviors, while RPDO2 presented the highest stress values for all system components. None of the groups presented significant displacement values. In the systematic review, it was observed that the effect estimates of some treatments reached the DMI, however, for all treatment comparisons, the credibility interval crossed the null effect line with very low certainty of evidence. No treatment showed superiority compared to another for any outcome. For both studies, further laboratory studies and RCTs are encouraged to confirm the evidence.

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Aim: This study aimed to review the scientific literature to describe the main care and hygiene protocols for different types of maxillofacial prostheses (MFP). Methods: A bibliographic search on the PubMed / Medline database using the following keywords: ["maxillofacial prosthesis" OR "ocular prostheses" OR "palatal obturators"] AND ["Cleaning" OR "disinfection"] AND ["care"] AND ["color stability"] OR ["denture cleansers" OR "cleansing agents"]. Articles addressing materials, cleaning and disinfection protocols, and care related to MFP were included. The following exclusion criteria were applied: no adequate methodology, incompatibility with the area of interest, and unavailability for reading in full. Results: The papers were grouped into the following topics: facial prostheses, ocular prostheses, maxillofacial intraoral prostheses, and retention systems. Conclusion: Despite the MFP changes over time, its degradation decreases upon following the recommendations and post-adaptation care. The guidelines for cleaning and disinfection must be individualized to guarantee the longevity of the prosthesis and the patient health

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