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Implant-retained auricular prostheses offer better retention than conventional adhesive retentive methods. Peri-implant skin inflammation, which results from improper substructure design, poor hygiene, skin thickness, and the hot and moist environment around abutments, however, is a common complication of craniofacial implants. This article describes a technique for fabricating an acrylic resin housing design with an extended arm to improve ventilation around implants and to reduce the risk of the silicone prosthesis tearing away from the acrylic resin housing.

Large maxillofacial defects from malignant tumor treatment are rarely rehabilitated by surgical reconstruction alone. Ameloblastic carcinoma, a rare aggressive odontogenic malignant tumor, requires wide surgical excision to gain a tumor-free margin. In the post-surgical defect, prosthetic rehabilitation is the treatment of choice to restore function and esthetics. Moreover, an intra-oral prosthesis such as an obturator restores speech, mastication and deglutition. Retention of the obturator is a major problem while rehabilitating large defects. The existing anatomical structures from the defect with the help of magnet attachments are suitable to enhance retention, stability and support of the prostheses. This case report presents a patient with an intraoral and extra-oral combination defect following surgical resection of ameloblastic carcinoma and describes the prosthetic techniques and design considerations for a magnet-retained obturator and mid-facial prosthesis. An implant-retained mid-facial prosthesis was fabricated. The retention of combined prostheses was obtained from the remaining right posterior teeth only. The patient had an unfavorable defect due to the large size and presence of scar contracture that vertically tends to dislodge the obturator. Magnet attachments were used to combine the facial and oral prosthesis, minimize the vertical dislodging forces and enhance retention. In addition, the retention was also gained from the scar band at lower border of mid-facial defect that avoided the need for more implants surgery. Magnet attachment with anatomical structure of the mid-facial defect provides an acceptable means of retention in large extraoral-intraoral combinations defects, improving the function, esthetic and the patients’ quality of life. Key words:Mid-facial prosthesis, obturator, magnet attachment, maxillectomy.

A 61-year-old male patient reported with a chief complaint of loss of left eye [Table/Fig-1a]. The patient had a history of squamous cell carcinoma involving the left orbit. Patient consent was obtained prior to treatment. Surgical treatment was conducted by orbital exenteration and external beam radiotherapy, with a total dose of 4000 cGy delivered at a dose of 200 cGy in 20 daily fractions. Thereafter, the patient was referred for fabrication of an orbital prosthesis. The patient did not present with any systemic diseases and no evidence of known allergies or recurrence of tumor was evident.