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This clinical report describes the use of a glass fiber-reinforced composite (FRC) substructure to reinforce the silicone elastomer of a large facial prosthesis. The FRC substructure was shaped into a framework and embedded into the silicone elastomer to form a reinforced facial prosthesis. The prosthesis is designed to overcome the disadvantages associated with traditionally fabricated prostheses; namely, delamination of the silicone of the acrylic base, poor marginal adaptation over time, and poor simulation of facial expressions.

Surgery for cancer of the floor of the mouth often results in alteration of the muscles of the tongue and floor of the mouth. Both primary and secondary surgical procedures often result in scar formation with reduced mobility of the tongue during speech and deglutition. Speech is often used as a diagnostic tool in the placement of the anterior teeth during fabrication of a prosthesis. Speech can similarly be used to help determine the proper placement of a speech portion of the prosthesis. The prosthetic rehabilitation approach described lowers the palatal vault with a false palate to enable the tongue to function against it during speech (Fig. 15). Group studies have shown that the design and fabrication of speech prostheses for partial glossectomy patients have significantly improved speech and swallowing for these patients. A speech pathologist is helpful during diagnosis, and speech therapy is necessary for significant speech improvement. Prosthetic rehabilitation alone cannot be expected to improve speech.