TEETH AS PROSTHETIC MATERIAL OF OSSICULAR RECONSTRUCTION

Since 1988 we have routinely used prostheses made from teeth for ossic ular reconstruction and have now done more than 400 implants. Short-ti me results with at least 1 year implantation were studied in a retrosp ective analysis of 319 cases with a review of 88 patients. Eighty perc ent of the implants were covered by an intact tympanic membrane, while in 10% the prosthesis was completely uncovered. This apparent perfora tion was not due to a material-related extrusion, but was caused by pe rsistent ventilation dysfunction of the middle ear. This was associate d with a progressive retraction of the tympanic membrane, which could be seen in all of these cases. The overall acoustic results were disap pointing and hearing gain was only 8.7 dB. However, these results were due to the unsolved problems of chronic middle ear inflammation and w ere not influenced by the dental material. We have been very satisfied with the teeth as implant material, as they can be autoclaved (elimin ating problems due to infection) without any loss of mechanical streng th. Furthermore, their practically cost-free production has a definite financial advantage over the expensive, commercially-available implan ts. The prostheses can be sculptured by the young resident during his otologic training, with this experience then resulting in better and f aster tympanoplasties.