Prosthetic rehabilitation of a geriatric patient with squamous cell carcinoma of the buccal mucosa: A report of clinical challenges

OBJECTIVE: This article aims to highlight the rehabilitation of a geriatric patient with an orofacial cheek defect by an extraoral silicone prosthesis. METHODOLOGY: Structured extra- and intra-oral examination of tissues coupled with a justified choice of impression materials, techniques, and prosthetic rehabilitation with a high-temperature vulcanizing silicone was done. RESULTS: The presence of compressible tissues, static appearance of the prosthesis during patient's facial movements, variability in complexion of the skin around the defect, and manipulating heat-vulcanized silicone were the challenges faced during clinical procedures. Rehabilitation of orofacial defects is a challenge to the maxillofacial prosthodontist due to limited material properties, soft-tissue mobility, compromised retention of prostheses, and poor patient acceptance. The fabrication of a facial prosthesis is as much an art as it is science. Prosthetic form, coloration, and texture of the prosthesis must be indiscernible from the surrounding tissues. Prosthetic reconstruction helps in restoring functional disability and aids in raising the morale of the patient. Prosthetic options of rehabilitation include interim and definitive conventional adhesive-retained or implant-retained prostheses. Initially, vulcanite rubber and acrylic resins were used for reconstruction. CONCLUSION: We report clinical challenges during extraoral rehabilitation of orofacial tissues with a silicone cheek prosthesis such as impression making and shade matching during restoration in a geriatric patient. The use of silicone maxillofacial elastomers allowed intrinsic, extrinsic coloring and ease of construction.