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Many children with microtia face a tough childhood with a prosthetic ear that is glued on or attached to osseointegrated implants. I have an article on the subject( J Oral Maxillofac Surg 64: 1639-1654, 2006). The later is preferred for predictability, ease of use, etc, but the ear can be bumped off due to failure of the limited clip or magnet type attachments. The major dental implant companies from which the extraoral fixtures originate feature an interchangeable terminal keeper so the clinician can select from different magnet sizes/orientations as needed. However, the retention is still very poor. I am creating pull testers for one attachment company, but even the stronger attachment they are working toward misses the point in my view. I envision a hinge or spring attachment that allows abrupt displacement, but immediate return of the prosthesis. A passive lock design would lessen abrasive wear of donning/doffing prosthesis and give the wearer needed confidence. Again, I have the experience with low durometer silicones, molding, etc, and ideas on how to incorporate hinges or constant force springs. We also have patient simulator models with current magnet systems for students as reference.
