An 18-year-old female patient reported to the Department of Prosthodontics for prosthetic rehabilitation of her lost left eye. On eliciting history, it was found that the patient had sustained a shrapnel injury to her left eye, which necessitated a surgical evisceration of the eye. Clinical examination revealed a completely healed left eye socket. Her right eye had normal vision. The patient had no other relevant medical history [].\nA custom ocular tray was made by pouring autopolymerizing resin into an alginate mold made with a stock ocular prosthesis. Perforations were made in the custom ocular tray to aid in retention of the impression material, and a tunnel was cut out at the center of the custom tray to which a disposable impression tip was attached to deliver the impression material[] The impression was made by injecting light bodied addition silicone material (Aquasil Dentsply) through the prepared tunnel[] []. The patient was asked to move her eyes in all directions to facilitate flow of impression material into all aspects of the socket. Then, the patient was asked to look directly at a fixed point six feet away at the level of eye allowing impression of the site with the muscles in neutral gaze position The impression was invested first in dental stone till the height of contour and when set a second pour to create a two piece split cast mold[] [] A wax conformer was fabricated by pouring molten baseplate wax into the two pieces split cast, after which it was retrieved and the sharp edges were removed.[] The rubber stopper from a plunger tip of a tuberculin syringe was used as a removable cap which was fitted into an opening made in the posterosuperior aspect of the wax conformer A bevel was placed around the margins of the cap to help in easy removal and placement []. The wax conformer was then adjusted for the satisfactory fit, contours, and comfort An iris disk cut out from a stock eye was attached to the wax conformer using a transparent grid[] [] A needle cap was attached with cyanoacrylate adhesive to the iris disk []: To assess orientation of visual axis To stabilize and secure the iris disk during dewaxing and packing. A wire was attached to the rubber cap so that the rubber cap was retained in the same position during dewaxing and packing [] The prosthesis was invested in a dental flask. Upon separation of the flask after dewaxing, the rubber cap was retained in position by the attached wire and iris disk was retained in position by the needle cap which was attached to it [Figures and ] A mixture of clear heat cure acrylic resin and zinc oxide eugenol was packed to achieve a white scleral color.[] Lost salt technique was used to create a reservoir for the lubricant in the superior aspect of body of the ocular prosthesis[] [] A modified curing protocol (reverse curing cycle) was followed to minimize the monomer content of acrylic eye.[] In this technique, the flask was placed in water at 95°C × 20 min and thereafter in boiling water for additional 20 min The ocular prosthesis was acrylized, retrieved, and finished. All residual salt crystals were flushed out through the opening for the removable cap The prosthesis was tried to check for the extent, fit, comfort, and iris position. Characterization of the scleral part of the prosthesis was done with the help of (SR Adoro) light cure stains and (Targis Power) light curing unit so as to match the natural eye. Optiglaze protective coating agent (GC America) was applied to protect the characterization [] A 0.5 mm diameter exit hole for the lubricant was created on the anterior surface of the ocular prosthesis into the limbus with the help of a suitable bur which connected the reservoir containing the lubricant The prosthesis was disinfected in cidex :2% glutaraldehyde cidex (surgikos, Johnson & Johnson co.), and it was delivered to the patient with instructions as to how to load the lubricant (carboxymethylcellulose eye drops IP 0.5%, extralube).[] [Figures –]. The removable cap is to be replaced if there is deformation or tear such that it does not fit into the access passage or there is a leakage of lubricant. Patient was instructed to clean the prosthesis with ophthalmic irrigation solution.[] The chamber was cleaned by removing the removable cap and injecting ophthalmic irrigation solution through a syringe Patient was followed up after 24 h, 1 week, 1 month, 3 months, and then every 6 months. The removable cap was replaced after 6 months due to deformation.
A 42-year-old male patient reported to Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh, India requesting replacement of his missing teeth. On intraoral examination, the patient had completely edentulous maxillary and mandibular arches. He had lost his teeth over a period of 3 years because of periodontal problems and was edentulous for the past 2 years. The patient was conscious about his sunken cheeks and desired a prosthesis that would make his face look fuller and healthier. He was leading a socially isolated life due to the psychological stress of his appearance. Treatment plan was formulated, keeping the patient’s demand in mind. It was decided to give the patient maxillary and mandibular complete dentures with intraoral closed faced magnet retained cheek plumpers for the maxillary denture. Primary impressions of maxillary and mandibular arches were made using impression material (Y Dents, MDM Corporation, Delhi). Custom trays were made using autopolymerizing acrylic resin. Border molding was done using low fusing impression compound (DPI Pinnacle, The Bombay Burmah Trading Corporation Limited, Mumbai, India) and wash impression was made with medium body addition silicone impression material (Aquasil, Dentsply/ caulk). Jaw relations were recorded. For the try-in appointment waxed denture was first tried for occlusion and esthetics. At the same appointment, cheek plumpers were made in wax and were attached to the upper waxed-up denture. Then it was evaluated to give the patient a fuller appearance. A dramatic change in the appearance with and without wax-up cheek plumper was observed and it was immediately accepted by the patient. The waxed plumper was separated from the waxed-up denture. After that flasking and dewaxing procedures were completed separately for the final pros-thesis and cheek plumpers. The mold space was packed with heat-polymerizing acrylic material (DPI, Mumbai, India) and curing procedures were performed according to the manufacturer’s instructions. After deflasking, the cured final prosthesis and plumpers were retrieved. Trimming, finishing, and polishing procedures were performed. Then a pair of commercially available magnets (cobalt-samarium, Ambika Corporation, New Delhi, India), 5 mm in diameter and 2 mm in thickness was employed to retain the cheek plumper with final prosthesis (). Provision for placement of magnets in the flange of the final prosthesis and in the cheek plumper was made and positioned with the help of autopolymerizing resin (, & ). Complete polymerization was ensured by placing in a pressure pot and finishing and polishing was then carried out. The attachment of plumper to the prosthesis was first checked outside the patient’s mouth ( & ). The prosthesis along with the plumper was then checked in the patient’s mouth for comfort, function and esthetics ().\nThe patient was educated about the positioning of the plumper to the prosthesis. The patient’s demands were fulfilled ( & ). He was called for regular check up to evaluate any soreness or looseness of dentures.