Summary:

This presentation describes the prosthetic rehabilitation (using an epithesis) of a female patient (born in 1974) following multiple surgical interventions and radiation therapy for an adenoid cystic carcinoma of the left side of the face, first diagnosed in August 2011. The course of treatment was complicated by complex wound conditions, severe wound healing disturbances, and the loss of a significant portion of the inserted grafts and full-thickness skin grafts.

An implant-supported restoration was ruled out due to the extensive size of the defect, the lack of suitable bony structures, and the significantly elevated risks associated with the previously irradiated tissue.

Capturing the defect anatomy posed a particular challenge, as conventional impression-taking was not feasible. Using high-resolution CT imaging, the anatomical situation was digitally visualized and printed as a 3D model.

The epithesis was secured using a two-part retention system with magnetic attachment, incorporating additional materials from the field of orthotics.

By mirroring the healthy side of the face following a facial scan, the missing facial contours were digitally reconstructed, establishing a crucial foundation for the subsequent design of the epithesis.

The presentation outlines the entire clinical and technical workflow, demonstrating how digital 3D technologies, traditional epithesis fabrication methods, and customized retention concepts can be combined within a hybrid workflow.