Endosseous Fixtures in the Calotte used for retaining Wigs

Endosseous implants are being placed with increasing frequency in the craniofacial region. The frontiers for craniofacial endosseous implants are expanded more and more. The present study describes a new application of craniofacial implants as anchoring elements for wigs. In two patients (one male, 17 years; one female, 29 years) a split skin graft was used for closing a soft tissue defect in the occipital, parietal, temporal and frontal region (defect size between 10 and 33 cm respectively between 10 and 14 cm). The defect was caused by trauma or pilous naevus excision. A functionally and cosmetically sufficient provision of this hairless region by a conventional wig was not possible. Therefore six titanium implants (length 3 or 4 mm, width 3,75 mm) were placed in each patient. The fixtures were inserted into the cranium under general anaesthesia. Primary implant stability was reached in each implant. Six months after fixture installation abutment connection was performed in general respectively local anaesthesia. After a healing period about four weeks and after peri-implant soft tissue management titanium abutments were substituted by titanium magnetics. Subsequently a fixture retained wig was constructed. In a follow-up period between 3 and 15 months no fixtures have failed. To date, the wigs are incoporated in both patients. The incorporated wigs have been shown to effectively retain a functionally and cosmetically successful craniofacial rehabilitation. Strategy, outcomes and complications of the treatment, especially regarding the peri-implant soft tissue, will be described and discussed. Keywords: craniofacial, endosseous implants, wigs