Maxillofacial prosthetics

Surface rubber
Stephen and

characterization prosthesis
0. Bartlett, J. Moore, Captain (DC)

of the silicone

USN,* (DC)

levy

Y. Pineda,

Chief,

USN,**

Dorsey

Commander

USN***

Bethesda,

Md.

.Lh e prosthesis that replaces facial tissues must meet stringent standards with respect to appearance and physical properties. Various materials and fabrication methods have been used throughout the history of maxillofacial prosthetics. Currently, silicone rubber, either heat vulcanizing or room-temperature vulcanizing, is, frequently used. Vinyl plastisol preparations have the advantage of being easily cured with varied coloration intrinsically incorporated in the prosthesis to simulate the natural appearance of the skin. Silicone rubber can also be intrinsically colored but only in a single base color, without variations. Regardless of the material used, it. is an advantage to be able to alter the color of the finished prosthesis. Even the most talented operator occasionally needs to make such changes. For several years, room-temperature-vulcanizing silicone rubber? has been used at the United States Naval Dental School, National Naval Medical Center, for fabricating prostheses. Until recently, we were extrinsically altering the color of the prosthesis by adding a new layer of the same type of rubber to the surface and then by spraying the material with a catalyst. All too frequently, as described by Schaaf,l the bond between the prosthesis and the extrinsic material was weak. The patient would peel away the outer layer of silicone rubber when cleaning and handling the prosthesis. Owing to a lack of translucency and depth of coloration, the prosthesis did not always appear as natural as was desired. Because of these experiences, we developed a modification of the technique for extrinsic coloration. We now use silicone medical adhesiveg rather than the ordinary silicone rubber for the additional layer of material. -The opinions and assertions contained herein are those of the authors and are not to be mnstrued as official or as reflecting the views of the Navy Department or the Naval Service at large. *Head, **Senior ***Formerly tSilastic :Silastic Prosthodontics Laboratory Department. Technician, Maxillofacial Prosthetics Prosthetics Division. Mich. Mich. 69 Division.

Chief, Maxillofacial

382 or 502, Dow Corning, Adhesive

Inc., Midland,

Type A, Dow Corning,

IIK.~ Midland,

70

Bartlett, Pineda, and Moore

J. Prosth. Dent. January, 1971

Fig. I

MATERIALS AND METHODS The prosthesis is constructed in the base shade employing the technique of Firtell and Bartlett.* After it is found to be satisfactory in contour and shade, it is thoroughly cleaned with chloroform to remove all contaminants from the surface. The portion of the surface to be characterized should not be touched with the fingers. A convenient handle for holding the prosthesis while it is being cleaned and tinted can be made. Acrylic resin is poured into a disposable plastic syringe, and the heads of straight dressmaker pins are embedded in the resin. The prosthesis is speared on its inner surface by the projecting pin points (Fig. 1) . The tinting material is prepared by first thinning silicone Type A medical adhesive with xylene to the consistency of paint (approximately equal parts of silicone and xylene are used). Small amounts of the thinned adhesive are placed in individual medicine cups, and each is tinted with a different inorganic pigment, which is mulled into the mix with a spatula (Fig, 2). The adhesive is applied to the surface of the prosthesis with cotton swabs (Fig. 3) . Brushlike strokes are sufficient where light shades are required. To obtain deep shades, as for freckles, a buildup can be achieved without fear that the material will not be cured. The reason is that the Type A adhesive is autocatalytic as it comes from the manufacturer. Therefore, it does not need to be sprayed with a separate catalyst, which might not permeate the thickest parts of the material. Colored flocking can be added if indicated. The entire tinting process takes about 15 to 20 minutes.

p1grg u

Surface

characterization

of rubber

prosthesis

71

Fig. 3. The tinted adhesive is being applied to the surface of the prosthesis.

After several minutes, when the surface has reached the tacky stage, a skinlike texture can be obtained by dabbing a patch of lint-free gauze over the area. Once the desired characterization is obtained, the prosthesis is set aside for 30 to 45 minutes to complete the cure. During the process, the xylene will volatilize, leaving a desirable dull surface. As the Type A adhesive is translucent, the effect will be quite lifelike.

LIISCUSSION
This tinting procedure requires less time and effort than the various methods previously used. The strength of the prosthesis is improved by the inherent qualities of the Type A adhesive. There is a complete cure of the surface and no buildup of catalyst to be concerned about. Also, there is no tendency for the extrinsic coloration to peel free, because the adhesive is bonded to the base prosthesis very tenaciously. Limited experimentation has shown that the adhesive can be used with equal success for tinting the prosthesis fabricated of heat-vulcanizing silicone rubber.

C:ONCLUSION
A modification of the technique prostheses has been described. This coloring the silicone prosthesis. for tinting is a simple, silicone extraoral maxillofacial effective means of realistically

References
1. Schaaf, N. G.: Color Characterizing 24: 198-202, 1970. 2. Firtell, D. N., and Bartlett, S. 0.: PROSTH. DENT. 22: 247-252, 1969. Silicone Maxillofacial Rubber Facial Prostheses, J. PROSTH. Reproducible
DENT.

Prostheses:

Fabrication,

J.