Epithetics

An introduction

Deformities in the head and neck area are usually the result of tumor disease, accident or congenital malformations and usually lead to severe psychological stress for the patient.

As an alternative to surgical reconstructive measures, it is possible to replace the missing areas with epitheses.

Epitheses are artificially made facial parts (facial prostheses) and are individually manufactured for each patient and designed to closely match the skin color.

There are various methods of attachment that can be used to anchor epitheses to the defect.

  • Mechanical attachment, e.g., to a pair of glasses
  • Fixation of the epithesis using skin adhesive
  • The epithesis is secured using clamping techniques (anatomical undercuts in the defect).
  • The epithesis is attached to an intraoral prosthesis.
  • Bone-anchored implants provide support for the prosthesis.
  • Combinations with each other

Epitheses and ocular prostheses are made of alloplastic material as artificial replacements in the head and neck area and therefore must be regularly checked, corrected if necessary, and renewed after a certain period of wear.

Epitheses are made of silicone; their lifespan is approximately 1.5-2 years.

This lifespan = wearing time has been proven in clinical studies.

The color and edges of silicone prostheses change over time; they fade and tear.

Over time, colonization with germs, e.g. fungi and bacteria, also occurs.

This is another reason why epitheses need to be remade after 1.5-2 years.

Acrylic ocular prostheses have an approximate lifespan of 2 to 3 years.

During this time, they should be regularly polished (1-2 times per year). This removes micro-germs and reseals the surface roughened by micro-dust and blinking.

Glass prostheses, on the other hand, must be replaced after just one year due to irreversible changes in their surface texture.

According to the current state of science, implant fixation of the epithesis should be the method of choice whenever possible.

In implant-supported epithetics, titanium implants are inserted into the bone by the surgeon and, after several weeks of healing, are used to attach the epithesis.

There are two different types of extraoral bone anchors:

Into these bone anchors, corresponding superstructures are inserted into a thread, which hold the epithesis in place.
Either a bridge-rider construction can serve as a fastening, or one or more spherical magnets.

Magnetic fastening technology is the most widely used nowadays.