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Silicone Restoration 



Ancient literature offers the first reports of the cosmetic artificial body parts, from wax ears during the time of the Pharaohs, to the metal noses of the 16th century.  By the 18th century, dentists developed more sophisticated dentures and enhanced the customization, fabrication, and fitting of facial prosthetics.  More durable and lifelike materials, such as resins and rubbers, began to be incorporated into prosthetic designs and prostheses were retained on the wearer by using more discreet methods of attachment.  With each major battle in our world’s history, facial injuries increased and the demand for more realistic prostheses became undeniable. The most significant milestones in the fabrication of cosmetic prostheses occurred after World War II, with the advent of plastics, particularly polyvinylchloride (PVC), polymethylmetacrylate (PMMA), and silicone. 

stroke joinstyle="miter">The materials and fabrication techniques used in facial prosthetics have crossed over into other types of prosthetic designs, from prosthetic fingers to prosthetic feet.  Silicone is the most commonly used material for these types of prostheses, namely because of its realistic texture, durability, and hypoallergenic properties.    

The most common methods of suspension for silicone prostheses today are:  suction, liquid adhesives, and magnetic implantation.  The type of prosthesis, amputation site, and amputation severity, often dictates which type of suspension method is required.  Most silicone fingers are retained on the wearer using suction suspension, making application and removal easier daily rituals. 

The term ‘cosmetic’, when referring to silicone prostheses, is actually a misnomer, as these types of prostheses serve undeniably functional roles.  A silicone finger allows for improved dexterity and opposition, allowing its user to accomplish basic tasks such as grasping an object or typing on a computer.  Silicone prostheses also improve proprioception, which occurs via vibrations that travel through the silicone, to the user, and gives the amputee a better idea of where his or her limb is in space.  Wire armatures can be including in silicone hand prostheses, so that the fingers play an even more functional role.  The silicone material also cushions the amputation site, which can be tender and hypersensitive for many amputees.

Dan Didrick’s new X-Finger, a non-robotic, mechanical device that works exclusively by operating levers, is the latest development in the field of finger prosthetics and practitioners will eventually be able to incorporate this mechanism into a custom silicone covering.

How is a custom silicone finger made?

Impressions

Using silicone, or other casting material, a cast of the residual digit is taken.  This impression is filled with plaster, taken out of the impression, and reduced circumferentially.  This results in a smooth, smaller version of the residual digit. 

A cast is also taken of the ‘sound’ finger of the opposite hand, if possible.  This is also filled with plaster, but not modified.  The result is a plaster replica of the ‘sound’ finger of the opposite hand.  This is used for sculpting reference.

Sculpture

Using the plaster replica of the ‘sound’ finger as reference, an artist sculpts the reverse of this finger in wax.  The sculpture is fit onto the cast of the residual digit.

Mold Making

A mold of this sculpture is made and, once completed, the wax is melted away.

Coloring

An artist paints the inside of the mold to match the amputee’s skin color.

Cure

The silicone paint is left to cure inside the mold.  Once properly cured, the mold is opened, the prosthesis removed from the mold, and a custom acrylic nail is applied.  During this time, additional extrinsic coloring can be added.



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