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Adhesives /orthodontic straight wire technique
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Adhesives /orthodontic straight wire technique Presentation Transcript

  • 1. ADHESIVES IN MAXILLOFACIAL PROSTHESIS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. Adhesion: • 1) The property of remaining in close proximity, as that resulting from the physical attraction of molecules to a molecular attraction existing between the surfaces of bodies in contact.(GPT-8) • 2) The stable joining of parts to each other, which may occur abnormally. (GPT-8) www.indiandentalacademy.com
  • 3. Maxillofacial prosthetic adhesive:: A material used to adhere external prosthesis to skin and associated structures around the periphery of an external anatomic defect.(GPT-8) www.indiandentalacademy.com
  • 4. INTRODUCTIONINTRODUCTION www.indiandentalacademy.com
  • 5. The form of a prosthesis is thought to be created by Egyptians in the belief that whatever they took to the grave with them they brought to their after life. www.indiandentalacademy.com
  • 6.  The field of maxillofacial prosthetics, a subspecialty of prosthetic dentistry, restores lost or compromised facial anatomy caused by cancer,trauma,or birth defects with the use of artificial substitutes such as silicone elastomers.  Trauma patients are also treated with extra oral prostheses made to rehabilitate compromised facial anatomy that results from automobile accidents, gunshot wounds, and so forth. www.indiandentalacademy.com
  • 7.  Despite advances in plastic surgery, there is still the need to rehabilitate small and large portions of the face with alloplastic materials. maxillofacial prosthetics provides the skills,methods,and materials to satisfy the extra oral prosthetic needs of afflicted patients. www.indiandentalacademy.com
  • 8.  The success of facial prosthesis depends partly on retention. A prosthesis can be retained either by mechanical means, with the use of available undercuts, skin adhesives, both undercuts and adhesives or, more recently, by the extra oral placement of Osseo integrated implants. www.indiandentalacademy.com
  • 9. Early facial prosthesis relied only on mechanical retention, such as - wires - eyeglass frames - springs - straps. Such methods are less popular because of their unsightliness. www.indiandentalacademy.com
  • 10. Attaching the prosthesis to the skin with a skin adhesive is an effective and most commonly used method. Various types of skin adhesives are available and include - interfacing pastes - liquids - sprays - double coated tapes www.indiandentalacademy.com
  • 11. TAPES Available in various types. They are clear tape silicone adhesive cloth tape with silicone heat resistant silicone adhesive tape pressure sensitive adhesive tape double coated tapes silicone rubber coated tapeswww.indiandentalacademy.com
  • 12. PASTES Amount of adhesive required will be less It can be applied using a brush, on the borders of the prosthesis. They are available in various shades and forms like White, clear, black, red etc-based on the heat resistant capacities. They posses excellent bond strength. www.indiandentalacademy.com
  • 13. Silastic medical adhesive Dow corning medical adhesive paste RTV red silicone Permatex black adhesive Clear silicone adhesive paste www.indiandentalacademy.com
  • 14. Liquid dab on silicone Silicone matte lace adhesive Medical silicone adhesive Silicone skin adhesive Liquid tape adhesive silicone Silicone hair piece adhesive LIQUIDS www.indiandentalacademy.com
  • 15. Medical adhesive spray on Spray on silicone adhesive SPRAY-ON www.indiandentalacademy.com
  • 16. Self adhesive tape Self adhesive strip Self adhesive SELF ADHESIVE www.indiandentalacademy.com
  • 17.  With the rapid development of adhesive technology. it would be expected that highly specialized adhesives would have been developed for applications to compromise tissues. However ,adhesives marketed for medical use are generally materials that have been adopted from nonmedical applications. www.indiandentalacademy.com
  • 18.  An ideal adhesive should be one that provides firm functional retention under flexure or extension during - speech - facial expression - eating - inadvertent gestures - splash of water or rain - accumulation of moisture - perspirationwww.indiandentalacademy.com
  • 19.  Because these adventures induce local dislodgement by pushing or pulling away of the prosthesis from attachment to the contacting tissue or skin, the basic adhesive chemical component is variously modified with - Emollients - Hygienic agents - Pleasant scent www.indiandentalacademy.com
  • 20.  Thus adhesives for maxillofacial prosthesis require a substantial amount of supportive ingredients properly formulated so as to provide lasting viscoelasticity with a high degree of tack while accumulating metabolics that can decrease the effective tackiness. www.indiandentalacademy.com
  • 21. COMPOSITIONCOMPOSITION www.indiandentalacademy.com
  • 22.  Precedently, over the years of nondescript formulations, the most prominent chemical configurations withstanding these adhesive experiences comprise basically  1) Other siloxanes of low molecular weight intermediate to that of siloxane fluids and solid elastomers,the most common being silastic medical adhesives which is also used as vehicle base for extrinsic coloring. www.indiandentalacademy.com
  • 23.  2) Polyisobutylene,a configuration noted for its tackiness and self-sealing attribute and as the active component in oral bandages.  3) Special acrylics in emulsion form.  A unique structural variant of acrylic polymers in the last-named connection are the alkyl cyanoacrylates,well known for cohesive bonding to skin but inordinately toxic; its use in orofacial prosthetic retention is highly prohibitive. www.indiandentalacademy.com
  • 24. FACTORS AFFECTING ADHESIVE JOINT STRENGTH IN USE OF MAXILLOFACIAL PROSTHETIC ADHESIVE www.indiandentalacademy.com
  • 25.  The adhesive joint strength at the skin surface may be influenced by numerous factors. They are:  Properties of the adhesive  Properties of the skin  Environment factor  Nature of dislodging forces  Repeated application by patient www.indiandentalacademy.com
  • 26. Properties of the adhesive: - constituents - thickness of layer - viscosity/wetting - permeability - absorptiveness - glass transition temperature www.indiandentalacademy.com
  • 27. Properties of skin: - surface topography - wettability - physiology - biochemistry - histology www.indiandentalacademy.com
  • 28. Environmental factors: - temperature - humidity - contaminants www.indiandentalacademy.com
  • 29. Nature of dislodging forces: - tensile - shear - peel - composite - soft machine - hard machine - dead weight www.indiandentalacademy.com
  • 30. Repeated application by patient: - correct application - adhesion - ease of cleansing substrate www.indiandentalacademy.com
  • 31.  Facial prosthetic adhesives are commonly used on skin surfaces compromised by surgery, chemotherapy and radiotherapy. The use of adhesives on skin surfaces of patients who have had adjunctive therapy presents a particular problem because the skin is subject to insult and change. www.indiandentalacademy.com
  • 32.  The interaction of adhesive material with skin presents problems, such as  - longevity of the bond  - dermatologic {sensitivity} problems  - ability to completely remove adhesive residue  maintenance of the skin and prosthesis requires considerable daily effort and dexterity by the patient www.indiandentalacademy.com
  • 33.  Skin-prep protective dressing {isopropyl alcohol, butyl ester of polyvinyl methacrylate/methyl methacrylate copolymer, acetyl tributyl citrate} is used where skin needs protection from - adhesive - trauma - abrasion - chafing - irritation. www.indiandentalacademy.com
  • 34.  This skin-prep protective dressing creates a physical, water proof barrier that is nonirritating and allows the skin to breath.  Improves retentive properties of adhesives www.indiandentalacademy.com
  • 35. PROSTHESIS APPLICATIONPROSTHESIS APPLICATION && REMOVALREMOVAL www.indiandentalacademy.com
  • 36. Equipment :Equipment : The relevant Prosthetic A Prosthetic adhesive or Latex liquid rubber A specific adhesive Remover - For removing specialist Prosthetic adhesives from the skin. Latex does not require a Remover as it will simply peel off (except from hair where an oil based remover will help) www.indiandentalacademy.com
  • 37. Liquid Latex One or two medium sized soft flat artists paint brushes One or two pieces of Sponge or Foam Rubber (or specialist foam latex make-up sponges) Cotton wool and cotton buds www.indiandentalacademy.com
  • 38.  The thin irregular edges should be left on the Prosthesis. They are designed to allow the Appliance to be blended in properly and realistically with the skin. Check that the item fits you comfortably before adhering it. If some of the edges are restricting the fitting, and/or feel uncomfortable, you will have to trim them. DO NOT USE SCISSORS unless the edge is not going to be seen (such as behind ears etc). PRIOR TO APPLICATION www.indiandentalacademy.com
  • 39.  To trim edges, hold the edge of the Prosthetic firmly with one hand, just inboard of the area to be removed, and carefully pull the excess material off with the other hand. Only remove a small amount at a time, and ensure that you hold firmly to prevent tearing off more of the edge than is required. Take the time to understand exactly how the item fits so that you will be able to apply it correctly first time. www.indiandentalacademy.com
  • 40. APPLICATIONAPPLICATION www.indiandentalacademy.com
  • 41.  Ensure that none of the thin edges are curled or folded under each other, as this will make the blending in process later, far more difficult. For large (e.g. Facial) Appliances, using a brush, paint the inside edges (which touch the skin) with adhesive or Latex. Take special care to paint up to the very edge. Paint the corresponding body area and allow both to touch dry. Line the Prosthetic up carefully with the body area and press firmly into position, and be careful with your positioning as you do not get a second chance! www.indiandentalacademy.com
  • 42.  For small or complex items such as Ears, simply paint the inside edges as above, and position carefully on the relevant body area whilst the adhesive is still wet. Press gently into place and allow to dry. After a few minutes press again firmly into place, and the Prosthesis should adhere to the skin in the same manner as above. Many Prosthetic adhesives and Latex either dry clear or change to a darker color when dry. The drying process may be speeded up by the gentle application of heat from a hair dryer or similar warm air source. www.indiandentalacademy.com
  • 43.  Whatever method is being employed, when the item is in position, ensure that all the edges are fully glued down to allow the blending process to be achieved. Keep all brushes in the Adhesive or Latex during use. Latex may be washed out of brushes in cold water, as too may "Pros-Aide" or "Pro-Stik" Adhesives. Spirit Gum and other Prosthetic Adhesives must be cleaned out in the appropriate Remover. www.indiandentalacademy.com
  • 44.  DO NOT ALLOW ADHESIVE OR LATEX SOAKED BRUSHES TO DRY! If this occurs, allow the brush to stand for an hour or so in the relevant Remover or white spirit, and brush out the softened Adhesive/Latex if necessary with a wire brush. Wash the brushes in hot soapy water and rinse in warm water. www.indiandentalacademy.com
  • 45. BlendingBlending  When the Prosthesis is in position, take a small piece of clean dry sponge, and stipple a small quantity of Latex around the Appliance where the edges meet the skin, adding a subtle texture as you work...Allow to dry. www.indiandentalacademy.com
  • 46. RemovalRemoval  If Latex was used as an Adhesive, the Prosthesis may be simply peeled from the skin. If an alternative Adhesive was used, soak around the edges of the Appliance with a piece of Cotton wool soaked in the appropriate Remover and leave for a minute or two. www.indiandentalacademy.com
  • 47.  Next, carefully work under and around the edges with a cotton bud or paint brush soaked in the same Remover and gently work the Prosthetic Appliance off the skin. Leave the Appliance face down on a working surface. Clean off any remaining Adhesive and other make-up from the skin with appropriate Removers, and wash thoroughly with soap and warm water. www.indiandentalacademy.com
  • 48.  The use of a good quality moisturizer may be advisable to prevent the skin from being dried out by the make-up materials used earlier. Clean the back of the Prosthesis with Remover or peel if Latex Adhesive was used, and also peel excess Latex from around the edges. Allow the item to dry out if necessary, and then de-tack the back with powder or Talc. -Store carefully for future use- www.indiandentalacademy.com
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  • 54. DISADVANTAGES  Despite of providing adequate means of retention, adhesives does have several problems.  The application of the adhesive may be a messy and time-consuming process.  The edges of the prosthesis must often be thickened or reinforced with fabric to resist tearing as the adhesive is cleaned from the prosthesis on a daily basis. This detracts from the appearance of the prosthesis www.indiandentalacademy.com
  • 55.  The adhesive may cause skin irritation, particularly in those patients who have under- gone radiation therapy.  Retention by the skin adhesive maybe unreliable especially if the prosthesis is large, if the weather is humid, or if the patient has oily skin. Proper positioning of the prosthesis is difficult in the absence of anatomical structures to orient its placement or if the patient has compromised manual dexterity or visual acuity www.indiandentalacademy.com
  • 56. www.indiandentalacademy.com
  • 57. For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com