Use of prostheses in the past

The use of facial prostheses such as wax ears has been reported in Ancient Egypt. The first historically documented evidence comes from the sixteenth century when the French surgeon Ambroise Paré describes the first nose prostheses from gold, silver, and “papier mâché,” which were held to the face by a string tied around the head. In the late 19th century, Claude Martin conceived an idea of an immediate prosthesis using tissue excised from the maxilla and mandible as a template for fabricating complex appliances. In the 20th century, while the quality of lifelike craniofacial prostheses was considerably improved with the introduction of silicone materials, the problem of their retention, which is essential for aesthetics, function, and comfort, was not entirely solved. With increasing aesthetic requirements, conventional fixation tools such as skin adhesives, skin pockets, skin loops, and glasses became unsuitable. It was Brånemark who first placed a modified extraoral implant for a bone-anchored hearing aid in 1977 and for a bone-anchored auricular prosthesis in 1979. These events changed concepts of prosthetic maxillofacial reconstruction. Since then, osseointegrated extraoral implants have been widely used to retain orbital, ear, and nose prostheses. Their usage diminishes adhesive-related problems like discoloration and deterioration of the prosthetic material. The skin and mucosal surfaces are less subjects to mechanical and chemical irritation from intrinsic mechanical retention, adhesives, or adhesive solvents. Maintenance of acceptable feathered margins and simple positioning of an implant-retained craniofacial prosthesis significantly increased their aesthetic qualities. Many scientific and clinical studies confirm the success of their practical application and improvement of patient’s quality of life.

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