Improving facial prosthesis construction with a contactless scanning and digital workflow: A feasibility crossover randomized controlled trial of digital versus conventional manufacture of orbital and nasal prostheses.

Research is needed to compare the clinical and cost effectiveness of the digital and conventional manufacturing of facial prostheses. Feasibility trials can help acquire the data needed to plan a definitive randomized controlled trial (RCT). The purpose of this clinical study was to assess the feasi...

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Published in:Journal of Prosthetic Dentistry Vol. 134; no. 2; pp. 501 - 513
Main Authors: Jablonski, Rachael Y., Coward, Trevor J., Reed, Caroline, Bartlett, Paul, Keeling, Andrew J., Bojke, Chris, Nattress, Brian R., Pavitt, Sue H.
Format: clinical trial research Journal Article
Published: Elsevier B.V. Aug2025
Online Access:View this record in EBSCOhost
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      dt: Aug2025
      vid: 134
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      pub: Elsevier B.V.
      place: New York, New York
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        187087197
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        10.1016/j.prosdent.2025.03.002
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        atl: Improving facial prosthesis construction with a contactless scanning and digital workflow: A feasibility crossover randomized controlled trial of digital versus conventional manufacture of orbital and nasal prostheses.
      aug:
        au:
          Jablonski, Rachael Y.
          Coward, Trevor J.
          Reed, Caroline
          Bartlett, Paul
          Keeling, Andrew J.
          Bojke, Chris
          Nattress, Brian R.
          Pavitt, Sue H.
        affil: Specialty Registrar in Restorative Dentistry and NIHR Academic Clinical Lecturer, Department of Restorative Dentistry, School of Dentistry, University of Leeds, Leeds, England, UK
      sug:
        subj:
          Nose Abnormalities
          Orbit Abnormalities
          Prosthesis Design Evaluation
          Digital Imaging
          Workflow
          Cost Effectiveness Analysis
          Treatment Outcomes
          Craniofacial Reconstruction
          Craniofacial Abnormalities Surgery
          Patient Selection
          Research Subject Recruitment
          Research Dropouts
          Health Care Costs
          Computer-Aided Design
          Human
          Pilot Studies
          Multicenter Studies
          Academic Medical Centers
          United Kingdom
          Adolescence
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Comparative Studies
          Quality of Life
          Surgical Patients
          Descriptive Statistics
          Pretest-Posttest Control Group Design
          Questionnaires
          Crossover Design
          Clinical Trials
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
      ab: Research is needed to compare the clinical and cost effectiveness of the digital and conventional manufacturing of facial prostheses. Feasibility trials can help acquire the data needed to plan a definitive randomized controlled trial (RCT). The purpose of this clinical study was to assess the feasibility of conducting a future definitive RCT of the clinical and cost effectiveness of the digital versus conventional manufacture of facial prostheses in patients with orbital or nasal defects. The primary objective was to assess eligibility, recruitment, conversion, and attrition rates. Secondary objectives included synthesizing data on outcomes for a definitive trial. A multicenter feasibility crossover RCT compared the digital and conventional manufacture of facial prostheses at Leeds Teaching Hospitals NHS Trust and Guy's and St Thomas' NHS Foundation Trust between December 2021 and October 2023. Patients over 16 years of age were eligible if they had acquired orbital or nasal defects and required a replacement facial prosthesis. Centralized allocation used minimization to allocate participants to 2 groups which differed in the order of receiving the intervention and control prostheses. Participants were masked to the manufacturing method by marking the prostheses with color labels. Data were collected on patient flow and the planned outcomes for a definitive RCT (participant preference, generic and condition specific health related quality of life, and costs from the healthcare perspective). Data were analyzed descriptively and narratively. Fifteen participants were recruited and allocated to receive the intervention (n=7) or the control prosthesis (n=8) first. Analysis of the primary outcomes identified 100% eligibility, 88% recruitment, 100% conversion, and 27% attrition rates. Analysis of secondary outcomes showed the mean ±standard deviation Toronto Outcome Measure for Craniofacial Prosthetics-27 score was 59 ±26% at baseline; the change from baseline was 10 ±14% for the intervention and 13 ±16% for the control. The mean EQ-5D-5L index score was 0.72 ±0.24 at baseline; the change from baseline was 0.07 ±0.12 for the intervention and 0.02 ±0.12 for the control. A definitive study was determined to be feasible. A recommendation for progression has been made with some modifications to study design.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        Journal Article
      ougenre: Article
    language: English
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