Indian Dental Academy: will be one of the most relevant and exciting training
center with best faculty and flexible training programs for dental
professionals who wish to advance in their dental practice,Offers certified
courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,
Prosthetic Dentistry, Periodontics and General Dentistry.
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)
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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.
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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.
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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.
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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.
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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
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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.
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13. Silastic medical
adhesive
Dow corning medical
adhesive paste
RTV red silicone Permatex black
adhesive
Clear silicone
adhesive paste
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14. Liquid dab on
silicone
Silicone matte
lace adhesive
Medical silicone
adhesive
Silicone skin
adhesive
Liquid tape
adhesive silicone
Silicone hair piece
adhesive
LIQUIDS
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15. Medical adhesive spray on Spray on silicone adhesive
SPRAY-ON
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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.
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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
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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.
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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.
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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.
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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
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26. Properties of the adhesive:
- constituents
- thickness of layer
- viscosity/wetting
- permeability
- absorptiveness
- glass transition temperature
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29. Nature of dislodging forces:
- tensile
- shear
- peel
- composite
- soft machine
- hard machine
- dead weight
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30. Repeated application by patient:
- correct application
- adhesion
- ease of cleansing substrate
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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.
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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
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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.
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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
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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
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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
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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-
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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
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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
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