Innovations at RSDM: Building a Better Prosthesis
Dr. Louis DiPede hopes CAD/CAM technology can help him design a lightweight prosthesis for oral cancer patients.
When patients lose their upper jaw to oral cancer, they can’t eat, drink, or speak. “That’s because you’re missing the separation between your mouth and nose,” explains Dr. Louis DiPede, director of RSDM’s Postgraduate Prosthodontics.
The solution is an obturator prosthesis, which replaces the roof of the mouth. For a custom fit, it must be molded by hand so that it’s thin yet strong enough to fit into the mouth without moving too much or becoming an impediment. But the acrylic material that’s normally used to make this kind of prosthesis isn’t always ideal. “It’s the material of choice because you can add to it and subtract to it,” says DiPede, a doctor at Rutgers Health University Dental Associates, RSDM's faculty practice. “But it’s not always lightweight enough for the best fit.”
When DiPede was searching for a material that was both strong and light enough to make the best obturator prosthesis, he realized titanium would be perfect. But because it isn’t malleable, it would require exact measurements with no margin for error or adjustment.
To that end, DiPede is working on a plan to use technology that involves computer- aided design and computer-aided manufacturing (CAD/CAM) to create the first obturator prosthesis from titanium. He plans to partner with a dental lab, which will mill the material.
Although RSDM has been using CAD/CAM for nearly a decade, it’s typically reserved for crowns and bridges, not artificial palates. “I can take the CAD/CAM technology used for other dental prostheses and apply it to the maxillofacial prosthetic realm,” explains DiPede.
If his experiment succeeds, and he thinks it will, the result will be a more durable, better-fitting device. “Normally, the maxillofacial prosthodontist will have to remake this kind of prosthesis for the patient throughout their life, but if it’s made digitally, they don’t have to go through the original process again. We could just press ‘print’ on the computer and churn out another one,” says DiPede.
