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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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Loss of a sense organ, such as an eye in situations of orbital involvement, or any other bodily part, such as the maxilla or palate, might make one more dependent on others for care and affect how they perceive themselves in society. The prosthetic rehabilitation of large mid-facial defects is a challenging task due to the varied size and shape of the defect. Confluent maxillary and orbital abnormalities are best restored with prosthetic means by creating a comfortable, aesthetically pleasing prosthesis that allows for the restoration of speech, deglutition, and mastication. The retention of any prosthesis is must for it to be successful. The hollow orbital conformer described in this case presentation aids in reducing the weight of the prosthesis, thereby enhancing the retention of the prosthesis. This clinical case presentation highlights the aesthetic and functional rehabilitation using a combined obturator-orbital prosthesis connected using intraoral magnets.

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Anophthalmic patients suffer from social, functional, and emotional agony. The role of a maxillofacial prosthodontist is to restore this loss and to restore the self-esteem of such patients. Fabrication of a prosthesis for the anophthalmic cavity can be successful with the judicious use of the materials, the vision, and the skill of the prosthodontist. This article describes various techniques used for iris replication and a novel method to locate the iris, which is the most crucial step to fabricate a natural gaze.

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@#Post-surgical orbital defects pose a severe effect on patient, psychologically and physically, especially in the eventual return to the society and daily routine. In cases where reconstructive surgery is not possible, prosthetic rehabilitation is crucial in addressing this issue. Implant-supported orbital prosthesis provides superior retention, however, it is not economically acceptable for some cases. Various modes of retention are available to cater to each patient’s diagnosis, treatment need and economical status. This article describes the procedures in the construction of a customized silicone orbital prosthesis using adhesive and spectacles for retention. This technique is cost-effective and simple while providing comfort and satisfaction for the patient.

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AIM: To investigate the biocompatibility and therapeutic effects of polyetheretherketone (PEEK) on recovery of a rabbit orbital defect. METHODS: Totally 16 New Zealand rabbits were used to establish an orbital bone defect model and then randomly divided into two groups. PEEK was implanted in the experimental group. The control group was blank, and no substance was implanted. The model rabbits were sacrificed at 4 and 8wk, and examined by general observations, histology, electron microscopy, Western blotting, and real-time polymerase chain reaction. RESULTS: No infection or rejection occurred after PEEK implantation, and biocompatibility was good. The relative expression of vascular endothelial growth factor (VEGF) protein in the experimental group was significantly higher than that in the control group postoperatively (P<0.05). Bone defect repair in the experimental group was significantly better than that in the control group in the same period and some osteogenesis was observed. CONCLUSION: PEEK has good biocompatibility and efficacy for the treatment of orbital bone defects in a rabbit model.

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Repairs of orbital post-traumatic and extensive malignant defects remain a major surgical challenge, in view of follow-up outcomes. Incorrect surgical management of injured facial structures results in cosmetic, ophthalmic, and social aftereffects. A custom-made knitted TiNi-based mesh (KTNM) endograft was employed to overcome post-surgical complications and post-resected lesions of the orbital area. Preoperative high-resolution computed tomography (CT) imaging and CAD modelling were used to design the customized KTNM in each case. Twenty-five patients underwent surgery utilizing the suggested technique, from 2014 to 2019. In all documented cases, resolution of the ophthalmic malfunction was noted in the early period. Follow-up observation evidenced no relapsed enophthalmos, hypoglobus, or diplopia as late complications. The findings emanating from our clinical observations allow us to claim that the KTNM indicated a high level of biocompatibility. It is simply modified intraoperatively to attach any desired shape/size for implantation and can also be screw-fixed, providing a good supporting ability. The KTNM precisely renders orbitozygomatic outlines and orbital floor, thus recovering the anatomical structure, and is regarded as an attractive alternative to Ti-based meshes and plates. Additionally, we report one of the studied cases, where good functional and cosmetic outcomes have been achieved.

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Exenteration surgery greatly affects a person in terms of function, esthetics, and psychological trauma. In such cases, restoration by silicone orbital prosthesis is a well-accepted treatment option. However, this is a difficult task, necessitating personalized design of method for each patient. This case report describes the technique for fabrication of a silicone orbital prosthesis for a male patient with left orbital defect due to exenteration of a Grade 3 squamous cell carcinoma of the left eye and surrounding tissues. The patient was delivered with a satisfactory silicone orbital prosthesis having good retention and finish. Multidisciplinary management and team approach are crucial in providing precise and effective rehabilitation for improving the patient's quality of life and help them return to their normal social life.

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To evaluate the clinical results of reconstruction orbital defect with craniomaxillofacial implant. Three patients with orbital defect were treated with ten implants. The magnetic abutments were attached six months after one stage operation and the prostheses were fabricated. Within 11 to 47 months of follow up, all implants were stable with successful osseointegration. The prosthesis fit the orbital defects well. Reconstruction of orbital defect with craniomaxillofacial implant can be considered as a viable alternative treatment.

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To evaluate the clinical results of reconstruction orbital defect with craniomaxillofacial implant. Three patients with orbital defect were treated with ten implants. The magnetic abutments were attached six months after one stage operation and the prostheses were fabricated. Within 11 to 47 months of follow up, all implants were stable with successful osseointegration. The prosthesis fit the orbital defects well. Reconstruction of orbital defect with craniomaxillofacial implant can be considered as a viable alternative treatment.

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An orbital defect causes severe facial asymmetry and disfigurement that result in an immense emotional trauma to the patient and is also associated with economic, esthetic, and psychological problems. A prosthetic replacement is the treatment of choice in helping individual to return to his normal life by producing an acceptable and lifelike appearance. This case report describes the critical areas of fabrication of ocular prosthesis for a patient with missing right eye due to trauma to eye ball in an accident. Patient had given a history of surgical enucleation of the eye 15 days after ocular trauma. A polymethyl methacrylate ocular prosthesis was planned. The technique described in this case report presents the use of both custom-made and stock eye shell in an attempt to include the benefits of both. A novel attempt was made to simulate eye movements and exact color matching to that of contralateral eye to provide a better and functional ocular prosthesis to the patient.

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Eye is a vital organ not only for vision, but also an important component of facial expression, and over-all personality of a person. Loss of eye, apart from leading to impaired vision has a crippling effect on the psychology of the patient. Prosthodontic rehabilitation of such cases includes fabrication of prosthesis by acrylic resin, silicone and implants. However, not all patients are willing to use implants for maxillofacial rehabilitation. Therefore, a custom made orbital prosthesis serves as an affordable and satisfactory alternative.

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BACKGROUND: Endoscopic endonasal orbital surgery may result in large orbital defects that mandate reconstruction to minimize the risk of diplopia and enophthalmos. The purpose of this study is to determine whether the nasoseptal flap can provide adequate coverage of maximal orbital defects. METHODS: This was an anatomic cadaveric study. Morphometric measurements were completed in 5 cadaveric orbits to determine the dimensions of an orbital defect comprising the entire lamina papyracea and the orbital floor. The dimensions of a planned nasoseptal flap were then calculated and an appropriately sized flap was harvested to verify complete coverage of the defect. RESULTS: The mean ± standard deviation (SD) medial orbital defect was a depth of 47.3 mm ± 2.52, height of 13.67 mm ± 2.73, and width of 13.33 mm ± 1.03 for the orbital floor. The mean flap dimensions were a width of 55 ± 6.16 mm, height of 48 ± 4.47 mm, and depth of 70 ± 3.54 mm. In all cases, the harvested flap adequately covered the orbital defect. These dimensions correlated with flap incisions subtending the mucocutaneous junction anteriorly, the inferior meatus laterally, the attachment of the middle turbinate superiorly, and the choanal arch posteriorly. CONCLUSION: Endoscopic orbital approaches may result in large orbital defects with significant orbital fat herniation and extraocular muscle exposure. Immediate vascularized flap reconstruction of the orbit may help to limit the attendant morbidity including diplopia and enophthalmos. This study is the first to demonstrate the feasibility of the nasoseptal flap for the reconstruction of maximal orbital defects.

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Diminution of the orbital contents post-surgical removal of a malignant tumor can have a severe psychological impact on the patient in terms of function and esthetics. Therefore, esthetic remedy should be planned subsequently, since tumor obliteration precedes cosmetic concern. A convenient option for successful rehabilitation in such patients is a simple, user-friendly, removable orbital prosthesis. Retention of the prosthesis is one of the key factors for the successful rehabilitation. Spectacle frame, conformers, adhesives, osseointegrated implants, magnets or buttons have been used to impart retention to the prosthesis. The use of semi precision attachments in maxillofacial prostheses is limited to the osseointegrated prostheses. This case report describes a conventional spectacle frame technique, to retain the silicone orbital prosthesis using two different types of stud attachments viz., dalla bona and O-ring attachment systems.

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Mutilation of a portion of a face can cause a heavy impact on the self image and personality of an individual. Surgical removal of an eye is a severe handicap to a patient because the most important sensory organ of communication is lost. Depending on the severity of the defect Ocular/Orbital prosthesis are required in these patients for rehabilitation. This case report details the clinical management of a patient following enbloc removal of an eye. Fabrication of a sectional two piece orbital prosthesis has been detailed. The importance of meticulous treatment planning to tackle the challenges faced in fabricating an orbital prosthesis is explained with relevant literature.

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Objective:To build 3D digitized face model of unilateral orbital defect and to realize imitating design of defect section.Methods:Phase measuring profilometry was employed to acquire a 3-D digitized face model with open eyes.By Geomagic software,the image of normal orbit was extracted and mirrored with the image of the deformed side of the orbit.Results:A 3-D digitized face model of unilateral orbital defect was successfully reconstructed and 3-D normal orbit data of defect section was acquired.Conclusion:The use of phase measuring profilometry and RE software is a convenient and effective method to the computer-aided design for the restoration of unilateral orbital defect.

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Objective: To develop a computer-aided three-dimensional design software and laser scanning technique for the restoration of unilateral orbital defect. Method: By laser scanning apparatus plaster face model and the acquired primitive face point data were scanned; with the three-dimensional design software the point data were reconstructed to one smooth face surface image and the data of the defect of the orbital tissue were obtained from the normal contralateral tissue data by software. Results: The face-model data obtained by laser scanning apparatus was distinct and precise; the Digisurf retrograde engineer software succeeded to fulfill the computer-aided design for restoration of unilateral orbital defect. Conclusion: The laser scanning technique and three-dimensional design software can be used in the computer-aided design of the unilateral orbital defect restoration.

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BACKGROUND AND OBJECTIVES: Among the various alloplastic materials which are used in reconstruction of the traumatic orbital defects, porous polyethylene sheets (PPSs) are increasingly used due to their improved biocompatibility, easy malleability, and minimal complication. We report our experience with PPSs in reconstruction of the traumatic orbital defects. MATERIALS AND METHODS: PPSs (0.85 mm or 1.5 mm) were used in 23 patients with significant traumatic orbital defects. Twenty patients were treated for orbital floor defects, 2 for medial wall defects, and 1 for both floor and medial wall defects. Their surgical results and postoperative complications were studied. Their mean follow-up period was 18 months. RESULTS: Postoperatively, diplopia or limitation of eye movements were resolved in 11 of 17 patients and enophthalmos in 6 of 9 patients. No patients had induced diplopia or exacerbation of preoperative symptoms. There were no complications like graft extrusion, infection, clinically detectable graft distortion, or resorption. CONCLUSION: PPS appears to be an excellent material for reconstruction of the traumatic orbital defects.

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Objective To discuss the accuracy of 3DSS three-dimensional scanning system, which was used to reconstruct the 3D digital model of unilateral orbital defect patients. Methods By using 3DSS spectrometer on the case of patients with unilateral orbital defect, the related scan dates of facial structure were collected, and the reconstructed digital models were processed wax pattern by SLS prototyping machine. Results The digital solid model of three-dimensional reconstruction was smooth and complete, and border over the natural. The designed resin prosthesis can be inosculated with the orbital defect tightly and symmetrically. Conclusion To adopt the system can be successfully completed unilateral orbital defect restoration design and production, and ultimately satisfied the clinical requirement of prosthesis production.