Module - Introduction to Biomedical Prosthetics and Rehabilitation (SPE403)

STP

Aim of this module

This module will provide the trainee with an introduction to the principles and scope of biomedical prosthetics and rehabilitation in caring for patients with congenital and acquired defects. They will undertake treatment planning and the manufacture of a range of common prostheses. Introduce the trainee to the role of a maxillofacial prosthetist in caring for patients requiring prosthetic reconstruction and rehabilitation, the range of prostheses that can be prescribed and manufactured, and  demonstrate the understanding in the provision of a prosthesis for a patient.

Work-based learning outcomes


  1. Use a range of imaging modalities, computer modelling and physical examination to recognise both normal and impaired facial anatomy.
  2. Identify treatment options for patients requiring facial prostheses referred to a reconstructive science service.
  3. Develop skills in the manufacture a range of facial and body prostheses.
  4. Assist in the assessment of patients referred from the breast surgery unit and production of a nipple areola complex prosthesis following post- mastectomy reconstruction.
  5. Plan and manufacture dentures and palatal obturators for edentulous (without teeth) patients.

Work-based Competencies


Learning outcome Title Knowledge
1 1,2,3,4

Apply relevant legal, professional, ethical and patient-centred guidelines when treating patients referred for prosthetic replacement of facial or breast tissues.

Planning and Preparing for Treatment

  • Indications and contraindications.
  • Adherence to health and safety of patient, public, staff and self.
  • Basic clinical assessment of patients.
  • Awareness of psychological effects of cancer, facial disfigurement and body image, and introduction to psychological to support these patients.
  • Monitoring of patients during treatment.
  • The requirements for accurate patient data.
  • Patient confidentiality and the Data Protection Act.
  • Principles of the clinical management of facial prosthetic patients, patient rights and managing patients with disabilities.

Infection Control

  • Communicable diseases and microbiological hazards.
  • Sterilisation and disinfection methods.
  • Common methods for prevention of cross-infection:
    • hand washing
    • single patient-use items
    • disinfection of dental impressions and devices.
2 1

Use a range of imaging modalities to identify normal and impaired anatomical features.

  • Anatomy of the head and neck.
  • Computed tomography (CT).
  • Magnetic resonance imaging (MRI).
  • Surface data acquisition.
  • Nuclear medicine.
  • Positive emission tomography (PET).
  • Ultrasound.
3 2

Identify treatment options for patients requiring a nasal prosthesis considering the comfort, safety and wishes of the patient.

  • Anatomy of the head and neck.
  • Range of facial prosthetic options.
  • Design principles for facial prostheses.
  • Methods of retention for facial prostheses.
  • Pre- and post-prosthetic surgical interventions to improve the prosthetic site.
4 2

Identify treatment options for patients requiring an auricular prosthesis, considering the comfort, safety and wishes of the patient.

  • Anatomy of the head and neck.
  • Range of facial prosthetic options.
  • Design principles for facial prostheses.
  • Methods of retention for facial prostheses.
  • Pre- and post-prosthetic surgical interventions to improve the prosthetic site.
5 2

Identify treatment options for patients requiring an orbital prosthesis, considering the comfort, safety and wishes of the patient.

  • Anatomy of the head and neck.
  • Range of facial prosthetic options.
  • Design principles for facial prostheses.
  • Methods of retention for facial prostheses.
  • Pre- and post-prosthetic surgical interventions to improve the prosthetic site.
6 4

Assess patients referred from the breast surgery unit following post- mastectomy reconstruction.

Planning and Preparing for Treatment

  • Adherence to health and safety of patient, public, staff and self.
  • Basic clinical assessment of patients.
  • Awareness of psychological effects of cancer, facial disfigurement and body image, and introduction to psychological support these patients.
  • Monitoring of patients during treatment.
  • The requirements for accurate patient data.
  • Patient confidentiality and the Data Protection Act.
  • Principles of the clinical management of prosthetic patients, patient rights and managing patients with disabilities.
  • Identification of altered anatomy.
  • Identification of patient ability to manage prosthetic options.
  • Anatomy of the breast.
  • Reconstructive techniques post mastectomy.
7 4

Observe the recording of informed consent and how an impression for a nipple areola complex prosthesis is made.

  • The importance of introducing yourself to the patient, including your role and experience as a Clinical Scientist.
  • The importance of checking patient identity.
  • The importance of explaining the procedure for each investigation to the patient and gaining informed consent.
  • The relevant procedures and requirements for patient conformance.
  • Clinical indications for and contraindications to the treatment.
  • Principles, guidance and law with respect to informed consent.
  • Impression technique and materials for nipple prostheses.
8 4

Assist in the manufacture a nipple areola complex prosthesis.

  • Anatomy of the breast.
  • Creation of anatomical form to match patient’s missing nipple.
  • Assessment of trial prosthesis.
  • Mould making.
  • Colour science and skin colour reproduction.
  • Skin pigmentation, racial variation, changes in skin colour due to physiological responses.
  • Silicone polymer chemistry.
  • Silicone elastomers for medical use, requirements, systems, advantages and limitations.
  • Intrinsic and extrinsic colouration.
  • Preparing the patient for colouration techniques.
  • Preparing for clinical fit.
9 4

Assist in the review of the patient after prosthetic rehabilitation for nipple areola complex.

  • Interviewing and recording patient outcomes.
  • Record keeping.
  • Examination of prosthesis and site, identification of tissue reactions, damage to prosthesis, and referring where appropriate for further advice.
10 3

Manufacture an adhesive-retained auricular prosthesis.

Introduction to Prosthetic Rehabilitation

  • Principles of treatment planning.
  • Creating anatomical form to match missing structures.
  • Processing prostheses.
  • Recognition of anatomical landmarks.
  • Assessment of trial prosthesis.
  • Mould making.
  • Colour science.
  • Skin pigmentation, racial variation, changes in skin colour due to physiological responses.
  • Silicone polymer chemistry.
  • Silicone elastomers for use as facial prostheses, requirements, systems, advantages and limitations.
  • Intrinsic and extrinsic colouration.
  • Preparing for clinical fit.
11 3

Manufacture an adhesive-retained nasal prosthesis.

Introduction to Prosthetic Rehabilitation

  • Principles of treatment planning.
  • Creating anatomical form to match missing structures.
  • Processing prostheses.
  • Recognition of anatomical landmarks.
  • Assessment of trial prosthesis.
  • Mould making.
  • Colour science.
  • Skin pigmentation, racial variation, changes in skin colour due to physiological responses.
  • Silicone polymer chemistry.
  • Silicone elastomers for use as facial prostheses, requirements, systems, advantages and limitations.
  • Intrinsic and extrinsic colouration.
  • Preparing for clinical fit.
12 3

Manufacture an indwelling ocular prosthesis.

Introduction to Prosthetic Rehabilitation

  • Principles of treatment planning.
  • Creating anatomical form to match missing structures.
  • Processing prostheses.
  • Recognition of anatomical landmarks.
  • Assessment of trial prosthesis.
  • Mould making.
  • Colour science.
  • Skin pigmentation, racial variation, changes in skin colour due to physiological responses.
  • Silicone polymer chemistry.
  • Silicone elastomers for use as facial prostheses, requirements, systems, advantages and limitations.
  • Intrinsic and extrinsic colouration.
  • Preparing for clinical fit.
13 1,2,3,4

Apply relevant legal, professional, ethical and patient-centred guidelines when treating patients referred for prosthetic replacement of facial

  • Relevant, current ethical, legal and professional guidance.
  • Good Scientific Practice.
14 5

Plan and manufacture a surgical dressing plate for an edentulous patient undergoing a hemi- maxillectomy for a stage 2 maxillary tumour.

  • Head and neck anatomy.
  • Pathogenesis of disease and abnormalities of the oral cavity.
  • TNM tumour staging system.
  • Role of MDT planning meetings for head and neck cancer.
  • Principles of treatment for stage 1 and 2 maxillary tumours.
  • Effects of irradiation damage of tissues.
  • Common surgical procedures for stage 1 and 2 maxillary tumours.
  • Interpretation of prescriptions.
  • Where, how and when to seek advice and information from colleagues and relevant agencies.
  • Dental impression materials, techniques and the factors affecting the clinical choice.
  • Design factors for immediate devices for oral cancer resection for dentate and edentulous patients.
  • Classification of post-surgical defects.
  • Dental materials selection, baseplates, dental alloys for clasping.
  • Materials and techniques used in obturator construction.
  • Design features of obturator prostheses.
  • Occlusal schemes for patient requiring complete dentures and obturators.
  • Use of dental implants.
  • Type and extent of records required for individual assessment.
15 5

Plan and manufacture a surgical dressing plate for a dentate patient undergoing a partial maxillectomy for a stage 1 and 2 maxillary tumour and classify size.

  • Head and neck anatomy.
  • Pathogenesis of disease and abnormalities of the oral cavity.
  • TNM tumour staging system.
  • Role of MDT planning meetings for head and neck cancer.
  • Principles of treatment for stage 1 and 2 maxillary tumours.
  • Effects of irradiation damage of tissues.
  • Common surgical procedures for stage 1 and 2 maxillary tumours.
  • Interpretation of prescriptions.
  • Where, how and when to seek advice and information from colleagues and relevant agencies.
  • Dental impression materials, techniques and the factors affecting the clinical choice.
  • Design factors for immediate devices for oral cancer resection for dentate and edentulous patients.
  • Classification of post-surgical defects.
  • Dental materials selection, baseplates, dental alloys for clasping.
  • Materials and techniques used in obturator construction.
  • Design features of obturator prostheses.
  • Occlusal schemes for patient requiring complete dentures and obturators.
  • Use of dental implants.
  • Type and extent of records required for individual assessment.
16 5

Plan and manufacture a maxillary denture with an open box obturator for an edentulous patient.

  • Head and neck anatomy.
  • Pathogenesis of disease and abnormalities of the oral cavity.
  • TNM tumour staging system.
  • Role of MDT planning meetings for head and neck cancer.
  • Principles of treatment for stage 1 and 2 maxillary tumours.
  • Effects of irradiation damage of tissues.
  • Common surgical procedures for stage 1 and 2 maxillary tumours.
  • Interpretation of prescriptions.
  • Where, how and when to seek advice and information from colleagues and relevant agencies.
  • Dental impression materials, techniques and the factors affecting the clinical choice.
  • Design factors for immediate devices for oral cancer resection for dentate and edentulous patients.
  • Classification of post-surgical defects.
  • Dental materials selection, baseplates, dental alloys for clasping.
  • Materials and techniques used in obturator construction.
  • Design features of obturator prostheses.
  • Occlusal schemes for patient requiring complete dentures and obturators.
  • Use of dental implants.
  • Type and extent of records required for individual assessment.

Work-based assessment


Complete 1 Case-Based Discussion(s)
Complete 1 of the following DOPS and/or OCEs
Type Title
DOPS Wax up a trial ear prosthesis.
OCE Take a clinical impression of any part of the head or face.