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A technique for changing the shade of a custom-made ocular prosthesis Manish Goutam, MDS,a G. S. Chandu, MDS,b Siddharth Gupta, MDS,c Ambika Shrivastava, MDS,d and Madhvi Singh, MDSe Digital imaging1-3 is simple, decreases treatment time, and requires minimal artistic skills compared to the irispainting technique for making custom-made artificial eyes. However, the reproducibility of the iris shade may vary as a result of the quality of the paper used, the printer inks, and the amount of monopoly syrup added. A mismatched iris shade will require repeating the entire treatment procedure, including custom tray preparation, impression making, cast fabrication, and wax pattern evaluation. This technique provides a method to correct a mismatched iris shade in the same appointment without the need to repeat the entire procedure. The technique
also preserves the previous characterization of the sclera part of the prosthesis. PROCEDURE 1. Evaluate the mismatched shade (Fig. 1A) of a custom-made artificial left eye made with digital imaging. 2. Carefully remove the round iris part of the prosthesis with a tungsten carbide bur (Bur No. HP 557; S. S. White Burs Inc) without touching the remaining part of the sclera (Fig. 1B).
Figure 1. A, Left custom ocular prosthesis with poor iris shade match. B, Removal of iris part of prosthesis without touching remaining sclera part.
a
Postgraduate student, Department of Prosthodontics, Rishiraj College of Dental Science and Research Centre, Bhopal, India. Professor and Head, Department of Prosthodontics, Rishiraj College of Dental Science and Research Centre, Bhopal, India. Reader, Department of Prosthodontics, Rishiraj College of Dental Science and Research Centre, Bhopal, India. d Reader, Department of Prosthodontics, Rishiraj College of Dental Science and Research Centre, Bhopal, India. e Postgraduate student, Department of Periodontics, People’s Dental Academy, Bhopal, India. b c
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Figure 2. A, Printed iris paper attached to sclera. B, Definitive insertion and evaluation of shade match.
3. Make an image of the iris of the contra lateral natural eye with a digital camera (Nikon D40; Nikon Corp). Attach close-up lenses 1, 2, and 3 and set the camera to ASA 400, film sharpness 3008×2000 fine, and Auto mode. Make necessary adjustments with imaging software (Photoshop 7.0; Adobe Systems Inc), if required. 4. Print the image on 130 g/m2 white paper with a laser printer with Xerox digital copier 600 DPI laser printer with CREOFIERY (ImageCLASS MF8580Cdw; Canon India Pvt Ltd) with a color ink cartridge. 5. Evaluate the photograph and compare it to the patient’s iris. 6. Adapt a layer of spacer wax (MP Sai Enterprise Private Ltd) onto the top half of the hollow iris part. Flask and eliminate the wax from the mold. 7. Cut the iris from the printed photograph exactly the size of the hollow iris part, and fix it on the round hollow part of prosthesis with monopoly syrup (J-305 Monopoly Syrup; Factor II Inc) (Fig. 2A). 8. Pack the flask with clear methyl methacrylate resin (DPI-Heat cure; Dental Products of India Ltd) over
THE JOURNAL OF PROSTHETIC DENTISTRY
the prosthesis and place in a water bath at 100 C to polymerize for 1 hour. 9. Carefully pumice and polish the polymerized ocular prosthesis and insert it (Fig. 2B). 10. Repeat the procedure if the shade match is not satisfactory. REFERENCES 1. Artopoulou I, Montgomery PC, Wesley PJ, Lemon JC. Digital imaging in the fabrication of ocular prostheses. J Prosthet Dent 2006;95:327-30. 2. Jain S, Makkar S, Gupta S, Bhargava A. Prosthetic rehabilitation of ocular defect using digital photography: a case report. J Indian Prosthodont Soc 2010;10:190-3. 3. Jayaswal GP, Dange SP, Khalikar AN. Restoration of an atrophic eye socket with custom made eye prosthesis, utilizing digital photography. Indian J Dent Res 2011;22:482-5. Corresponding author: Dr Manish Goutam Main Road, Barganda, Giridih Jharkhand INDIA Email: [email protected] Acknowledgment The authors thank Dr Anisha Maria, Dean, RCDS, for her support during the procedure. Copyright © 2015 by the Editorial Council for The Journal of Prosthetic Dentistry.
Goutam et al
A technique for changing the shade of a custom-made ocular prosthesis Manish Goutam, MDS,a G. S. Chandu, MDS,b Siddharth Gupta, MDS,c Ambika Shrivastava, MDS,d and Madhvi Singh, MDSe Digital imaging1-3 is simple, decreases treatment time, and requires minimal artistic skills compared to the irispainting technique for making custom-made artificial eyes. However, the reproducibility of the iris shade may vary as a result of the quality of the paper used, the printer inks, and the amount of monopoly syrup added. A mismatched iris shade will require repeating the entire treatment procedure, including custom tray preparation, impression making, cast fabrication, and wax pattern evaluation. This technique provides a method to correct a mismatched iris shade in the same appointment without the need to repeat the entire procedure. The technique
also preserves the previous characterization of the sclera part of the prosthesis. PROCEDURE 1. Evaluate the mismatched shade (Fig. 1A) of a custom-made artificial left eye made with digital imaging. 2. Carefully remove the round iris part of the prosthesis with a tungsten carbide bur (Bur No. HP 557; S. S. White Burs Inc) without touching the remaining part of the sclera (Fig. 1B).
Figure 1. A, Left custom ocular prosthesis with poor iris shade match. B, Removal of iris part of prosthesis without touching remaining sclera part.
a
Postgraduate student, Department of Prosthodontics, Rishiraj College of Dental Science and Research Centre, Bhopal, India. Professor and Head, Department of Prosthodontics, Rishiraj College of Dental Science and Research Centre, Bhopal, India. Reader, Department of Prosthodontics, Rishiraj College of Dental Science and Research Centre, Bhopal, India. d Reader, Department of Prosthodontics, Rishiraj College of Dental Science and Research Centre, Bhopal, India. e Postgraduate student, Department of Periodontics, People’s Dental Academy, Bhopal, India. b c
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Figure 2. A, Printed iris paper attached to sclera. B, Definitive insertion and evaluation of shade match.
3. Make an image of the iris of the contra lateral natural eye with a digital camera (Nikon D40; Nikon Corp). Attach close-up lenses 1, 2, and 3 and set the camera to ASA 400, film sharpness 3008×2000 fine, and Auto mode. Make necessary adjustments with imaging software (Photoshop 7.0; Adobe Systems Inc), if required. 4. Print the image on 130 g/m2 white paper with a laser printer with Xerox digital copier 600 DPI laser printer with CREOFIERY (ImageCLASS MF8580Cdw; Canon India Pvt Ltd) with a color ink cartridge. 5. Evaluate the photograph and compare it to the patient’s iris. 6. Adapt a layer of spacer wax (MP Sai Enterprise Private Ltd) onto the top half of the hollow iris part. Flask and eliminate the wax from the mold. 7. Cut the iris from the printed photograph exactly the size of the hollow iris part, and fix it on the round hollow part of prosthesis with monopoly syrup (J-305 Monopoly Syrup; Factor II Inc) (Fig. 2A). 8. Pack the flask with clear methyl methacrylate resin (DPI-Heat cure; Dental Products of India Ltd) over
THE JOURNAL OF PROSTHETIC DENTISTRY
the prosthesis and place in a water bath at 100 C to polymerize for 1 hour. 9. Carefully pumice and polish the polymerized ocular prosthesis and insert it (Fig. 2B). 10. Repeat the procedure if the shade match is not satisfactory. REFERENCES 1. Artopoulou I, Montgomery PC, Wesley PJ, Lemon JC. Digital imaging in the fabrication of ocular prostheses. J Prosthet Dent 2006;95:327-30. 2. Jain S, Makkar S, Gupta S, Bhargava A. Prosthetic rehabilitation of ocular defect using digital photography: a case report. J Indian Prosthodont Soc 2010;10:190-3. 3. Jayaswal GP, Dange SP, Khalikar AN. Restoration of an atrophic eye socket with custom made eye prosthesis, utilizing digital photography. Indian J Dent Res 2011;22:482-5. Corresponding author: Dr Manish Goutam Main Road, Barganda, Giridih Jharkhand INDIA Email: [email protected] Acknowledgment The authors thank Dr Anisha Maria, Dean, RCDS, for her support during the procedure. Copyright © 2015 by the Editorial Council for The Journal of Prosthetic Dentistry.
Goutam et al
