The Computer Aided Design and Fabrication of Facial Prostheses

Maxillofacial prosthetics is a specialised profession that seeks to meet the needs of patients with various degrees of facial deformity by restoring aesthetic and functional portions of missing tissue using artificial materials. The maxillofacial prosthetics specialty is relatively small compared to other healthcare professions and technological developments are often denied to them, as commercial companies cannot recoup the investment required from such a small market. Therefore many of their practices are inherently labour intensive, requiring inordinate amounts of skill and training to become competent.

Faced with increasing case numbers and a reduced number of new prosthetists entering the profession, there is urgency to update techniques in order to improve efficiency. The need to embrace technological development is clear.

The profession has a long and well-documented history of adopting, adapting and improving on existing technologies found in industry. For example, Computer Aided Design (CAD) and Rapid Prototyping (RP) have been successfully used for many years to assist maxillofacial surgery. However, the application of these technologies for soft tissue prostheses has proved more complicated and very few people have concentrated research efforts in the area.

This research critically evaluates and develops the current capabilities of technologies that may be used to assist in the production of soft tissue facial prostheses. Case study, action research methods were used to critically evaluate technologies in terms quality, economics and clinical viability. Technological limitations have been challenged and case studies in this thesis incorporate gradually more complex aspects of prosthesis design, such as implant retention mechanism design and fabrication and texture creation. Conclusions on the current capabilities, limitations and required future developments are made. The research culminates in a specification, against which developers may measure their technologies and towards which they may develop them to meet the needs of the profession and UK health service.