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Make and shape of the eyes – Prosthetics Occlurar

The manufacture of prosthetic eye *

When the surgical site has healed and good dimensional stability, making an ocular prosthesis can begin. Before you begin, a thorough review of the decision should be taken to ensure adequate enucleated healing and the absence of infection. The location of the implant, the movement of the bed of tissue and the size and scope of the socket must be taken into account.

Impressions

An impression may be taken with irreversible hydrocolloid. A tray can be manufactured with hard base warming wax in the fire and are adapted to the contour of the area around the eye. A wax handle is attached to the handling. The side of the fabric is marked with a hot spatula to allow retention media. The patient sits upright, invited to view a remote location, and instructed to keep their eyes on a direct position with eyes open during printing is made. This procedure will ensure that the back surface of the enucleated and making the muscles of the rectum in the same position relative to the rest of the eye.

The irreversible hydrocolloid is mixed into a half-measure extra heat water, providing a smooth and fluid mixing nasal quickly define. The media is placed in a large syringe. The enlargement of the opening of the tip of the syringe will facilitate the expression of the media. The patient's eyelids open, irreversible hydrocolloid mixture is injected into the outlet, taking care to completely cover the capture takes little pockets of air. Covers are then released, and some print materials expressed in the eyelids. The plateau, which has been coated with printing equipment, is placed in the eye and helped defined. When activated, the material in the manufacture and eyelids can be removed in one piece. The patient is asked to open their eyes as wide as possible, and the impression is carefully removed. Care must be taken not to break the impression of a thin sheet tray is opening the lid. Before pouring the plaster, this section Printing can be improved by placing a pin through the back. The print is inspected and verified making any irreversible hydrocolloid residual.

Formulation distribution:

The impression is poured in two sections. A picture is formed around the container with duct tape 3 inches. The first half of the iron is cast with dental plaster mixed with water slurries to accelerate the setting time. This procedure will prevent excessive water loss of printing. The mixture is vibrated in the box and feel around the widest part of the printing outlet. The impression is then placed in a basement while the stone. At least two slots are cut into the surface of the first aid casting a large round bur vulcanite. The stone is then lubricated with a separating medium and the second half of the impression is cast and returned in the basement.

Manufacture of the sclera:

After the stone has set, the mold can be separated by removing the wax tray and print media. With the help of a laboratory knife to open the lid of the mold is expanded to allow the wax melted is poured in without having to freeze the wax before the mold is filled. Dip mold in warm water for a few minutes and remove excess wax allowing water to flow fill the mold without adhering to the stone.

After the wax cooled, the mold is opened and the wax pattern is recovered. The wax layer represents the opening cap is cut, the anterior surface of the model is outlined in a soft hemispheriod. The subsequent take into account the topography of the tissue bed of the orbit. Close adaptation posterior tissues of the bed produces a corresponding movement in the prosthetic eye in harmony with the natural eye. Close adaptation also reduces the accumulation of fluid behind the prosthesis, which could cause irritation and promote bacterial growth.

The wax pattern is now in orbit and the contours of the roof was evaluated. To insert wax prosthesis, the upper lid is lifted and the upper edge of the prosthesis, the upper lid is lifted and the upper edge of the prosthesis is placed above and below the lid. Then, while pulling the lower lid down and the bottom edge of the prosthesis in place. The wax model should be comfortable for the patient, but may cause mild irritation and tearing. The wax does not flow as freely as the finished denture acrylic resin. The openings of the eyes and the top are checked several angles.

When the contours have been adequate to point the wax is ready to be invested. Consider a balloon or prosthetic crowns and bridges can be used flask. Orthodontic Stone White preferable to avoid the possible contamination of the sclera white or clear acrylic yellow stone plaster with pigments. After completing the lower half of the mold with plaster, which forms part of the mix of the stone is vibrated on the back surface of the wax. Gently mock the wax is placed in the top of the stone on the ball, taking care not to trap air. After the stone has set, the exposed stone is lubricated with a means of separation and the upper half of the balloon is filled. When the stone has set, the ball can be separated by gently prying the other. It is not necessary boilout. The wax pattern is removed from the mold and the mold is washed with soap and water to remove residual medium separation. A replacement sheet layer is applied and the mold is ready to be packaged by compression method.

The material used in packaging, scleral white acrylic mold. It is commercially available or can be made by combining powder * 1.5gm 100gm zinc oxide transparent acrylic resin. The processing of the resin to 150 ° F for 9 hours and 212 ° F for two hours, the possibility of porosity is reduced.

The sclera acrylic resin is recovered the ball and the flash removed with a rotary instrument and polished wet flour of pumice. The wet milling with a low speed to prevent burning the resin from the resin. The whites should be brought to a very bright and lava with soap and water. The sclera acrylic resin is inserted and the contours and the opening of the lid are checked again. Adjustments are made at this time. If grinding is carried out, the sclera must be polished before being returned to the eye.

Iris Place. The location of the iris is determined the sclera in place and the situation of the patient in relaxed position. Again ask the patient to look at a distant point. Compared with the natural eye, the center of the pupil of the prosthesis is located and marked with a rod is dipped in waterproof ink. The sclera is removed. By placing a compass point architect at the center of the pupil, a circle is drawn up the same diameter as the natural iris. A waterproof ink used for this circle. The size and location iris must match the rest of the eye. This is easily verifiable by sight and measuring with a millimeter rule with the inner corner and the inner edge of the blade as points reference. Another factor to consider at this point is the location of the iris opening the lid. Usually, the upper eyelid covers part of the upper half of iris while the bottom edge of the iris is equal to or slightly above the lower eyelid.

The sclera is then reinvested in the same way as wax. Reinvestment facilitates handling, the sclera should be cut to the incorporation of the iris. The front is also reduced to allow the shade of the sclera. The material extracted for these purposes is easily replaced with sclera acrylic resin.

Before re-invest the sclera, a piece of casting 28 gauge wax is placed in the circle represents the iris. A spatula in the hot wax is used to remove excess wax from the circle and at the same time, to seal the wax to the sclera. When vials, wax leaves a depression in the stone ball in the position of the iris. This depression is approximately 2 mm deep in the center then tapered to the sides to form a concavity smooth and rounded. This period produced the evidence in the cornea completed prosthesis. This area can be profiled to capture highlights of the reflected light to match the natural eye and produce a more realistic appearance.

The following procedure is denudation "character of the painting of lilies. A wheel mounted diamond or a square stone carries out this work smoothly and easily. acrylic resin is withdrawn a depth of 3-5 mm thickness of the sclera. Reverse cone carbide bur will stabilize the soil of the denudation and also limit the walls around the edges. When painted, the body will show through the sclera and the effect of the leaf. A leaf can also be made with care to color the surface sclera or iris.

Sclera is again introduced at the start *** check the soil of the denudation is parallel to the plane of the body and is perpendicular the line of sight. When the soil of the denudation is a good alignment, the front of the sclera is reduced by at least 1 mm. sclera is significantly reduced at all the location of the iris which allows a depth of 1-1 ½ mm above the floor of the denudation. The edge of the denudation of the iris remains an acute angle.

The sclera is ready to be tagged. A cotton swab with a ball of wax at each end accounts serves as a handle for dyeing. A sclera in children is usually blue. In adults with fair skin, is light blue or green. With sclerotic skinned individuals tends to be dark dark, showing shades of brown-orange. A yellow pigment is applied to the canthal region, except in children. Blood vessels is a rayon fiber or the painted red Simulated cotton or applied to the sclera and held in place with a stream of clear acrylic resin. If necessary, denudation of the iris is painted to represent to the sheet.

The sclera is returned to the lower half of the flask and the iris is placed in paint stripping. Now, the eye prosthesis is ready for be packed with transparent acrylic resin. Precautions should be taken to prevent entry of air between the painting of irises and acrylic sealant. A mixture of good clear self-curing acrylic resin is poured over the iris and sclera and cured in a pressure cooker before the resin, heat cured acrylic is full.

After the curing process of the eye recovers the ball, finishing and polishing. Upon delivery, the denture should be checked for proper size, opening the lid, and outlines. At that time, it is important to note the great natural light in the eye and the prosthesis. Highlights should correspond as closely as possible. If not, selective grinding on the surface of the cornea of the prosthesis is going to change the position of strength.

Iris Enlightenment acrylic paints on watercolor paper discs. The colors used are titanium white, ultramarine blue, burnt sienna, yellow ocher, cadmium yellow, alizarin crimson y. Greens should be avoided because they become very bright when included in acrylic resin. To simulate shades of green, olive to use. Black ink is required purple. The paint mixed with water to obtain a heavy consistency. If mixture is too thin, a true color will not be achieved and the paintings tend aa flow together. Only a small amount of paint must be mixed at any time since the paint dries quickly.

Cold-pressed watercolor paper grade Imperial used. paper discs were cut into 0.5 mm graduations, ranging from 10.0 to 12.0mm. paper discs are cut in increments of 0.5 mm, ranging from 10.0 to 12.0mm. tour blows on the right is desirable to avoid the jagged edges in the complete denture. A disk of the correct size band is attached to a type of paper on which the disc was cut. This band manage and simplify the management of small disk in the paint. It also provides a convenient place to test paint mixture.

There are five basic elements a painting of the iris: the student, the base color, detail, collar and the blade. Students first painted and located in the center of the disc of the iris. A circle of correct size is important to keep the disk with the black and then filled in. The size of the pupil is considered by the shadow of the eyes with natural hand and observing the change in size as they are exposed to light. In general, the average of the extremes there is a student at an acceptable size.

The first step in painting iris color base. The base color is the darkest color that can be seen in the natural iris is usually blue, brown, olive, gray, or a combination of these colors. This layer is applied in a thick brush strokes to make sure that the disc is completely transformed. The iris is developed in layers ranging from darker colors to lighter colors. Thin shots form the radial grooves and give an illusion of depth. The point must be very thin brush for delicate stripes can be produced. A small area around the pupil is left unpainted. Next, adjust paint to the flange. Once dried, the shade of paint used for the iris should be darker than the iris, which was matched as these paintings have a tendency to lighten and brighten following treatment. Viewing the painting when wet or covered with a drop of water will help walking shadows. The collar is then painted and is usually a bit lighter than the base color. Finally, the sheet is added. This can be painted on the side of the iris, but more often painted on the bottom of the cup to the iris of the sclera. The color used to paint the contact is normally a tone that mixes paint the iris to the sclera.

Although acrylics are the most popular. You can also use watercolors. However, watercolors are longer, as the drying time must elapse between each step of the painting to prevent the colors run together. In addition, the watercolors are not as stable as the color, or long as the acrylics.

SAIC oil paintings with an illustration on acetate discs, the colors of oil paint is used abroad, sky blue, cadmium red, cadmium yellow, bright orange, cadmium, sienna, umber, black and titanium white. There are two methods of oil paint to paint the iris disk. The first monomer solution uses a mono-poly (acrylic thickened with a polymer transparent) thinning and hardener. The paints are applied in the black disc of acetate, which is covered by a button on the cornea transparent acrylic resin. The second method uses linseed oil as a paint thinner.

Iris mono poly-painting. Mono-poly is obtained by combining ten parts part heat cured acrylic monomer by weight acrylic polymer. To combine the monomer and the polymer a pan with hot water and boil lightly. The monomer is poured into a Pyrex beaker. The glass is placed in the pot of boiling water and when it is hot the monomer, the polymer is slowly sifted into the monomer, stirring continuously with a glass rod. Two viscosity of this solution are necessary. After about 10 minutes, the solution reaches the viscosity of an oil light. Most of this solution is poured into a dark glass bottle and stored. The rest is returned to the boiling water until the mixture reaches about twice the viscosity of the mixture. The second mixture is also stored in a dark glass bottle. Thin the two solutions is used as the thinning and hardening agents oil paint, while the thickest is used to join the painted iris disk in the corneal button.

In this method, the student is the button of the cornea. Therefore, any consideration of pupil size or location is required during the painting of the iris. The paint is applied on a disc similar to the method described above. Paint the base coat is mixed and diluted with mono-poly and applied to the disc with strong strokes that cover the entire disk. Several layers of apply paint until the disc is well covered and a striped effect is achieved. The painting of the iris is completed in the same manner, using light colors to match the iris is maintained. The last necklace is painted and applied in a star around the center of the disc. The corneal button is placed on top of the disc painted for check the size and location of the neck. The adjustments to their size or location can be done here. The blade is painted on the edge of the disc in a tone properly mixing paint the iris in the sclera. The iris is painted disk verified the accuracy of the natural eye color by placing a drop of water cons in the iris painted.

The painting of the iris is inserted into the corneal button by applying a thicker layer of mono-poly for surfaces glide smoothly and together, being careful not to trap air bubbles between the surfaces. When in proper alignment, two sections are pressed together and let dry.

For the buttons of the cornea with the student including, transparent resin Acrylic is packed and processed in a specially prepared ball touches iris. After treatment, iris buttons should not be removed the ball. Using round cutters of different sizes that correspond to the sizes of the students, drilling a hole in the surface the touch of a button. The top button is visible from the bottom and is used as a guide to locate the center of the disc. The holes should be about 2 mm deep. This depth is sufficient to create a black student that the button has not been finished and polished, but not deep enough to provide students with a statement or a rounded appearance when the prosthesis is viewed from the side. The holes should be moistened with monomer and filled with an acrylic resin that has been soiled. Black returned the ball must be reassembled and processed. The ball is placed in cold water and boil slowly. Should be boiled for 30 minutes. It then must be removed from the flask and the bottom surface Button must be crushed by milling a flat surface covered with a fine emery cloth. Milling remove any black acrylic resin outside the area of the pupil.

Figure Iris oil painting and linseed oil. The method of oil painting and illustration iris only flaxseed oil differs slightly from the method of mono-poly. The disk used in this method is transparent with a hole in the center of the disc. The hole can be enlarged pupil with a tail rat small file to match the size of the pupil of the eye naturally. The easiest way to organize this type of disc inserted the spout of a pair of cotton I had a small cut on his way through the pupillary aperture. The voltage clamp on disc in the slot in the process of painting. The colors are selected and mixed with linseed oil as a thinning agent. The interior and exterior surfaces the disc is completely covered with the base color, leaving an area around Unpainted the pupil by the throat. After the base coat is applied the album ends with the methods described above.

After the painted iris disk should be placed in an oven 125 to 1400F for a period of 4-6 hours. The corneal button is now filled with transparent acrylic resin ball hits the iris. Painting button the cornea is placed over the mass and the acrylic resin is full of trial. The flash is removed and then a black acetate disc is placed behind the iris image. The black disk provides students in the complete denture. The corneal button was processed recovered and the flash is off. The knob is polished, the maintenance of the stem.

Training sclera. A wax model is obtained and profiled in the same manner as described above. When you are satisfied with the size and shape of the whites of the wax, the iris is located. The wax inside the circle is removed to a depth of 3-3 mm and iris button is inserted into the cavity. The wax pattern with the corneal button in place is inserted into the cavity of the eye. Using the handle of the rod, the iris is adjusted to correspond to the position and appearance natural iris. After removal of the white wax and care of iris, the iris is waxed position and returned to the assembly outlet to check its position. The wax is invested and processed as described above. Stem corneal button is held the button in the upper half of the ball and is the correct relationship of the sclera. After the white acrylic recovers the ball, with the built-in button, the rod is removed and the prosthesis is polished. At that time the sclera is reinvested in a balloon. This allows reducing the anterior surface and color. We must prevent the paint on the surface where the color of the iris. The sclera is returned to the ball and treated transparent acrylic resin.

Patient Education. The method of insertion and removal of the prosthesis and treatment is shown to the patient. The prosthesis must be removed at least once a day for cleaning. The prosthesis should not be allowed contact with alcohol or solvents of any kind which may lead to malfunctioning of acrylic. If the eye should be removed must be returned to polishing.

Modification a stock ocular prosthesis. An eye of values is selected with the correct size of the iris, sclera color and approximate shape. Surfaces peripheral and later reduced by 2-3 mm and retaining slots are cut in the back. A thin, straight stick together with sticky wax in the Ward perpendicular to the plane of iris. This stick will act as a handle and as a guide for alignment of the prosthesis in relation to the natural right of the eye.

A small amount of irreversible hydrocolloid is mixed with warm water and placed in the back of the prosthesis. With the patient looking straight ahead at a remote location, the prosthesis printing material and mounted between the eyelids and sat on the socket. Precautions must be taken to prevent entry of air between the media and the fabric surface. The handle is used to move the implant into alignment with the natural eye and lids are audited by the openness and contour.

Printing is deleted excess printing equipment and cut properly. The stick handle is removed from the anterior surface of the prosthesis. The prosthesis and the feeling invested in the bottom half of the ball. After the stone has two small projections of self-curing acrylic resin canthal areas are attached to the prosthesis. These projections are maintained prosthesis in the upper half of the ball and keep the good relationship between the prosthesis and the mold during packing and processing procedures. The use of a separating medium on all exposed surfaces of stone, the upper half of the globe is done. The packing, processing and finishing of the prosthesis is carried out as described above.

Complications *

Ptosis. Ptosis can be divided into two main categories for the resolution ocular prosthesis: pseudoptosis and true ptosis. Pseudoptosis occurs when the upper eyelid is not well supported by the artificial eye. This problem is usually solved by changing the contour of the artificial eye to properly maintain and replace the lid.

A more difficult situation occurs when a true ptosis exists. Due to poor muscle tone or lack of tissue, lower the upper eyelid over the prosthesis. Ptosis correction can often be achieved by reducing a surgical muscle or reduce the volume of tissue. However, in many special situations contour of the prosthesis would alleviate the problem. Allen describes a method of contour ptosis overcome prosthesis. First, the upper face of the importance of the cornea is enlarged to lift the lid. Then the top surface of the prosthesis is reduced to form a shelf or depressed area in which the lid to rest and sleep. A small bump is placed behind the cover to make it appear full.

minor drop cap. downfall of the lower lid can sometimes be solved in a similar manner. By eliminating some of the bottom of the front overhang of the stent, the pressure to force the cover is reduced. The material is added to the prosthesis behind the cover, in an attempt to push the cover off and let ferment. A second solution is to reshape the bottom of the teeth and the pressure out internally and the sides with the lower lid has more support. aspect medial side and the bottom edge are elongated and the core is thinned and shortened.

Other problems. Other situations that can cause problems that can be corrected surgically (Reen and Beyer, 1976) are entropion and ectropion. When the bottom edge of the deck or the position tabs leave an unsightly, gently contouring wax or relieve pressure on the lid and increase their support sometimes correct the situation without surgery.

Aging occurs, patients lose their tone and elasticity of tissues in many areas of the body. The upper and lower eyelids are also affected. Attention should be special attention to the contours of a prosthesis for the geriatric patient to overcome these problems in its web. Blepharosulcus is not rare and special configurations to minimize aesthetic problems in aging patients may be needed (Guibor, 1976).

Sometimes bands or adhesions are scar connect the plug wall eyelids (symblepharon). These bands of scar reducing the mobility of the prosthesis or to prevent its manufacture. Surgical revision of the decision in relation to the pressure vessel is sometimes able to eliminate these bands scars. In some patients, ocular prosthesis can be used a slot placement strip in which the scar can rest, but the mobility of the prosthesis is compromised.

Having a contract may occur after trauma or infection or when the patient does not use a prosthesis for an extended period. The result is the loss of a way sufficient to retain the prosthesis. To compensate for this loss, expansion of the sleeve can be obtained by applying pressure with a prosthetic enlargement. progressive enlargements can be made as time passes. A simple culture surface-de-sac can be accepted by the bottom contour of the prosthesis as suggested for the cover falling lower.

Evisceration is increasingly popular as a treatment modality. In gutting the content of the planet instead of the entire planet are eliminated. An implant may or may not be used, but the application is recommended. Cornea is often left intact. To reduce the incidence of elceration and abrasion of the cornea or the possible loss of the implant, a prosthesis Stock should not be used. Instead, the eye must be custom made. A print allows the fabrication of ocular prostheses intimate contact with the bed of tissues and also distributes pressure more make a stock of the eyes.

RESTORATION OF ORBITAL DEFECTS

Manufacture of orbital implants are aesthetically more challenging. As the conversation the other starts with eye contact, small differences in eye position, the contour of the lid, and the color of the prosthesis immediately noticed by the observer. In some patients, may not be possible to reproduce the look and shape of the eye remains normal and adjacent orbital structures. In orbital defects in particular creates a psychological trauma unsightly prosthesis the prosthesis at all.

Preoperative Consultation is useful to inform patients of the malfunction and the options available to restoration. Unfortunately, many patients have the impression that the prosthesis moves and works together with the eye remains. Photographs of the prosthetic Similar defects are useful in eliminating this misconception. In most patients, it is not necessary to obtain preoperative photographs or impressions because they are of little value in making the prosthesis after surgery.

Surgical resection of tumors of the orbit depends on the nature and extent of the tumor. Resections which are limited to the removal of orbital contents cause defects that are easier to restore aesthetically. Since the margins beyond surgical orbital implants are less aesthetic limits due to the impossibility of concealing the connection cables between the skin and the prosthesis. In addition, as the prosthesis extends beyond the orbit, the beds can be found more furniture exposure connecting lines.

The surgeon must be charged to the line of the bony walls of the orbit and skin. In most cases attempts should be made to obstruct the orbit Flap local or distant tissues. After these reconstructions, there is little room for the placement of a prosthesis adapted orbital. Furthermore, recognition recurrence the tumor may be delayed because the margins of resection are not clearly visible.

Impressions

Impressions precise orbital defects are difficult to obtain because the periorbital tissues are easily displaced. Move the tissues is particularly difficult to avoid when dealing with patients who had a total maxillectomy and orbital exenteration in the cheek region is no longer supported by bone. In these patients, The final shot should be properly and placed before the output from the orbital region.

Initially taking a face is obtained and the result is a tray main factory. Unless cons of the orbit bone retention is made, the tray is not necessary to expand significantly in the orbital cavity. The purpose printing is to save the bed of orbital and periorbital tissues as accurately as possible. For this, the patient should be placed in an upright position and extreme careful not to move the bed of tissue. Before printing, then unwanted areas should be blocked with Vaseline gauze. media with irreversible hydrocolloid is adequate, but other materials such as silicone or reversible hydrocolloid, are also suitable. The syringe of print material in the folds of the skin and small areas of difficult access and the tray loaded with impression material in place gently. The plate is suspended in the appropriate position, taking care do not compress the tissue. When irreversible hydrocolloid and used additional water is added to the mixture, the viscosity of material decreases due to less tissue compression bed. During the procedure, the patient should keep their eyes open and remain fixed on a distant point squarely to come. This will prevent muscle contraction and prevent distortion unwanted residual defect coverage. After extraction, part of the impression may need support. This support can be done with nails or wire, which may be necessary. A cast is then made in stone. A hole must be drilled in the posterior orbital wall to facilitate movement and adjustment of the portion of the ocular prosthesis.

Sculpture

An action is selected that ocular prosthesis approximates the color and size of the iris and sclera of the eye is maintained. Typically, the artificial eye should be small to fit easily top anomaly in the proper orbital position. Aluminum foil is so adapted to the stone jetty. Clay or wax is used as the medium of sculpture. The artificial eye is mounted on the medium chosen and the whole apparatus is transferred to the patient. The artificial eye is able to simulate the eye position is maintained with patients, focusing on a distant point to forward. The patient should be standing in a relaxed position with a colleague's operation of the prosthesis in place while the clinician assesses the eye positioning. A reference mark is placed in the midline and a tongue or a Boley gauge can be used to confirm the position modiolateral. Students may be used as reference points in this evaluation. Middle-lateral, anterior-posterior, and inferior-superior position of the ocular prosthesis should reproduce the exact position of the normal eye, if a prosthesis must be successfully manufactured. The slightest deviation in the position of the eye is immediately noticed by the casual observer. Before accepting what appears to be an appropriate position of the eyes, the verification must be made by additional observers.

In the next round sculpting periorbital tissues takes place. To ensure adequate coverage usually around the eyes, the sculpture should be carried out for half the day. The patient should be rested and relaxed for fatigue and anxiety affect the contours of the deck dramatically in many patients. edges of the lid and periorbital tissues are similar to those in the normal eye extent possible. All information must be faithfully reproduced. The lines connecting must be completed with pen and glasses or the shadows cast by them. Without the use of frames connection lines are pretty obvious. The best results were obtained in patients age with a lot of cracks and periorbital tissues. If possible, lines connection should not extend beyond the area covered by spectacle frames, for the margins are difficult to camouflage. Plastic eyeglass frames are generally preferable to metal frames and shoot higher than shadows in which the connection lines can be placed. Also, if you want the orbital prosthesis can be more easy to bound with plastic frames than metal.

Team selection and treatment

The manufacture of molds in the usual way, except that the artificial eye should be removed. If the prosthesis is processed in acrylic resin is made by pouring a layer of stone on the outer surface of complete dentures carved. The artificial eye is then carefully removed and the hole in the wall back of the master model. This task must be carried out without altering the roof and canthal areas. Only the material of the sculpture directly behind the ocular prosthesis should be eliminated. Dental stone is then gently vibrates so by closing the back previously occupied by the eye of acrylic resin. If a flexible material is used for part the face of the artificial eye should be duplicated and inserted into the appropriate position in the mold (Challis et al, 1971; Bulbulian, 1973).

Selection of equipment for treatment depends on physician preference. Mehacrylate methyl simply prefer a prosthesis the orbital region. Acrylic resin is the longest of the materials available and allows the installation of the prosthesis to the frames. Moreover, the bed of tissue rarely mobile, the rigidity of the acrylic resin is often confusing for the patient. In our experience, the materials become soft tissue beds advantageous when the defect extends beyond the orbital area and mobile games.

The prosthesis is treated in the material of choice and that is intrinsic or extrinsic stained or both. denture tabs are attached to the upper eyelid before reintegration of acrylic eyes. In general, the cilia, which are commercially available, should be diluted to make a normal appearance. From the tabs are rare chorus lower their presence can be simulated with a few vertical lines of paint on the lower eyelid to extrinsic. The eyebrows, if any, can be replaced Eyebrow pencil or eyebrow or prosthesis to the measure. If the prosthesis has been transformed into methyl methacrylate, acrylic eyes are fixed in position by the self-curing acrylic resin. Following the accession of the Acrylic resin eyes, a small amount of resin self-curing acrylic is added inner and outer edge. The transition can canthal mixes easily be stained and the adjacent sclera.

Retention. Retention of the orbital prosthesis can be achieved in several ways. adhesives on the skin are more common and work well. In some patients, withholding commitment orbital cons with a flexible material is sufficient to retain the prosthesis.

The above methods work well in defects confined to orbits. However, when one patient underwent a total maxillectomy with orbital exenteration in combination, maintenance performed by the prosthesis spectacle frames can be advantageous. The spectacle frames to simplify the placement of the prosthesis and orbital positioning ensuring reproducible precision of the restoration. precise positioning is particularly difficult in the orbital tissue defects compressible beds as seen in patients with total maxillectomy defects. It is clear that the smallest error is the position will attract attention to the prosthesis. If frames are used for retention, an orbital band custom implant or a duplicate must be made for patient. When the frames are worn, care must be taken by the optometrist to prepare the lens on the prosthesis so that the lens is identical to the asymmetric normal eye or distortion of the prosthesis will be perceived.

Benefits acrylic plastic eye glass eye.

1. It guarantees freedom of fragility and etduing area resulting from the dissolution by secretions outlet.

2. Since the replacement is made to measure, adjust the size and shape is more feasible to compensate the irregularities are so frequent socket.

3. Several other features can be adapted to different aesthetic imperatives, such as the leaf, the anterior chamber depth, the diameter of the cornea, the pupil, and episderat cyclical and boats. This is possible because the assembly strictly anatomical parts everywhere.

4. There is a real effect in three dimensions is construction after the suspension of transparent resin transparent perforated disc was painted on both sides. This effect is reinforced by the placement of a student reaction black disk at some distance from the back of the iris disk.

Five. prefabricated iris button to be stored, so that the operator know from principle the exact color of the rainbow in a complete denture.

6. The plastic eye eliminates the time to take steps such as the use of multiple molds precision grinding angle of the camera.

7. The method is easy to education, dental personnel can be trained in a relatively short for all stages of manufacture.

8. Glass Eye has the disadvantage of being extremely fragite.

9. A glass eye (prosthesis) to Sometimes it can explode spontaneously in the eyes and laborious solvent will remove heavy fragment by an ophthalmologist.

10. In addition, the surface glass is affected when the fluids from the wall cause itching can be very irritating to the taking of the membranes.

11. glass restorations are also difficult to fit correctly in relation to defects and variations, so that very often, the prosthesis is too small, which gives the user the appearance of evophihalmos.

The prosthesis CARE

Proper maintenance of the prosthesis is of vital importance for reasons hygiene and aesthetic

1. The prosthesis must be removed at least once a day to clean.

2. The tail should be removed with a finger roll the ball or thumb to the borders of the device.

3. All surfaces of the prosthesis should be cleaned with mild soap and a brush.

4. The thin contact with the prosthesis should be carefully cleaned and care.

Five. The patient is carefully done to remove and stop using the prosthesis should not cause irritation contacts and the prosthetic tissue to see the prosthetist as soon as possible for treatment.

MODE gives the patient

The daily placement of the prosthesis will succeed the patient follows the instructions given to him, are:

1. To keep the area clean and dry and without oil.

2. To keep teeth clean.

3. To replace the prosthesis as shown.

4. Adhesive should not be taken until the prosthesis is replaced.

Five. Membership when used should be as sparing as possible and not too often.

6. For support, see one or more mirrors in the placement of the prosthesis.

This will allow the patient is placed in its proper relationship to the spaces surrounding anatomy.

7. To keep the unit in place with finger pressure for 5 minutes.

8. To check all the edges by the use of ice to adapt fully to all surfaces.

The surfaces of the prosthesis were made to accommodate the support areas, so it must match exactly.

9. To avoid too much has been exposed to direct sunlight.

10. Attention daily cleaning will help prevent hardening of the prosthesis the presence of residues of the nose sections of the skin.

11. The patient should be revoked at any time that a prosthesis is exposed to the resulting changes in its basic color.

The basic color surroundly areas may also change as a result of sunlauning, exposure Diners etc.

In this case it may be necessary to replace the prosthesis with a color correction.

Facilities laboratory

Outside supplies (wax, investment, metal mold making, etc) Main laboratory equipment is as follows.

1. Double boiler and the Bunsen burner with tripod and asbestos notes:

This equipment is used to prepare material used to make reversible hydrocolloid impression that failure of the patient and duplication procedures for the manufacture of molds.

2. Galunized large investments Rings sheet:

They are used in models of investment has been the construction of molds.

3. A dry heat oven Large:

This is used to drive the moisture from the investment after the elimination has been and the heat of the investment and ensure the thermal expansion before issuing appropriate procedures.

4. Square-jawed pliers

These are used to manipulate the molds.

Asbestos teeth. 5:

These are essential to enable rapid processing Models invested before, during and after the costs actual molds.

6. Casting Melting Pot with large burner and tripod:

This setting is used in smelting Linotype Metal and metal and bring it to the desired temperature before casting molds.

7. large bathroom.

8. Sierra and blades

9. Vice

10. Lalthe bank

  Ocular Prosthesis

The authors found ocular prostheses to win their increased retention of neodymium magnets housed in a cage superstructure in the orbit. The superstructure is made of implants placed in each lateral half of the superior orbital ridge or side of the third sub-orbital ridge where the bone becomes thicker as it merges with the infraorbital ridge where the bone becomes thicker as it merges into the zygomatic arch. In some cases, both sites are used, especially if the prosthesis includes a facial skin and orbital therefore, requires more and heavier. Because the orbit is circular, pillars of coverage to the center of the orbit. Therefore, the risk of contact with abutments and the superstructure is limited to this. It is recommended that the implant space at least 1 cm away and consider their appearance in the angle of the orbit.

In such cases, the implant diameter of 4.0 mm "4.5 mm length are more common. However, sometimes a bone may be thin enough for '3 0.5 mm 4.0 mm implants and bone more anatomical 6.0 mm thick with a capacity of lengths. To evaluate the thickness of the bone at a time to choose the best site for implants and best length of the implant, a scan is needed.

About the Author

i m prosthodontist. working as assisatnt professor t GOVT. DENTAL .ROHTAK INDIA.

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