Use of 3-dimensional imaging and manufacturing for bilateral auricular prostheses: A case series of six patients with congenital auricular defects

Elsevier

Available online 18 November 2022

The Journal of Prosthetic DentistryAbstract

The prosthetic reconstruction of unilateral ear deformity is a straightforward procedure which relies on copying the details, position, and symmetry of the existing contralateral ear. However, reconstructing bilaterally missing ears is challenging. The use of 3-dimensional (3D) technology in the prosthetic reconstruction of the bilaterally missing ears of 6 patients is described. The deformity site was created directly by segmenting the patient’s digital scan or indirectly via a desktop scanner. Adequate bone quantity and quality for implant retention and optimal implant locations were also identified virtually. The use of 3D technologies has made it more straightforward to accomplish ear symmetry, as well as to validate the orientation and location of the ears reliably with the minimum subjectivity. The printed ears were matched in shape, surface texture, and anatomy. The skin color was straightforward to record and store so that it could be reproduced at a future time. Overall, the digital manufacture of the ears was controlled, consistent, and reproducible.

Section snippetsClinical report

The 6 patients presented with bilaterally missing ears of congenital etiology as shown in Table 1. The patients were treated with auricular prostheses that were retained by craniofacial implants or medical adhesive. For implant retention, two 4-mm-long craniofacial implants (Brånemark; Cochlear Europe Ltd) were installed in each side. The implant locations were specified by segmenting skull computed tomography (CT) images using a planning software program (CMF Pro Plan; Materialise). Digital

Discussion

Replacement of missing ears can be achieved via surgical or prosthetic routes, and treatment preferences vary among countries, clinician expertise, and patient inclination. The 6 patients presented were treated via the prosthetic route. Patient 3 received surgical treatment first but did not proceed, having received a suboptimal reconstruction. All patients and their parents found the prosthetic route to be enjoyable and interactive, and the ear outcome met with their expectations. Turnaround

Summary

Digital technologies of 3D virtual designing, preoperative planning, and physical prototyping helped optimize the prosthetics of bilaterally missing ears. They enhanced reconstruction applicability, reproducibility, and accuracy and made reliable results broadly obtainable.

CRediT authorship contribution statement

Muhanad M. Hatamleh: Conceptualization, Supervision, Software, Methodology, Writing – review & editing. Heba Mohammad Hatamlah: Writing – original draft preparation, Project administration. Amjad Nuseir: Investigation, Resources, Writing – original draft preparation.

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© 2022 by the Editorial Council for the Journal of Prosthetic Dentistry.

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