Purpose
To relieve intracranial pressure and save patient inflicted with severe head injury, neurosurgeons restore cranial defects. These defects can be caused because of trauma or diseases (Osteomyelitis of bone) which are treated by cranioplasty, using the preserved bone of patient. In case of non-availability of bone, a cranial implant is generated using a biocompatible synthetic material, but this process is less accurate and time-consuming. Hence, this paper aims to present the use of rapid prototyping technology that allows the development of a more accurate patient-specific template and saves the surgery time.
Design/methodology/approach
A five-year-old girl patient having cranial defect was taken up for cranioplasty. CT (computed tomography) scans of the patient were used to generate 3D design of the implant suitable to conceal the defect on the left frontal portion using CAD/CAM (computer-aided design/ computer-aided manufacturing) software. The design was used for 3D printing to manufacture a base template, which was finally used to fabricate the actual implant using Simplex® P bone cement material to conceal the defect.
Findings
Surgery using Simplex® P implant was performed successfully on the patient, giving precise natural curvature to left frontal portion of the patient, decreasing surgery time by about 30 per cent.
Originality/value
The case demonstrates the development of a convenient, time-saving and aesthetically superior digital procedure to treat cranial defect in the absence of preserved bone flap using CT scan as input. 3D modelling and printing were deployed to produce an accurate template which was used to generate an implant using bone cement biocompatible material.
Context:
Maxillary posterior region is a problem area for the placement of implants. The advanced resorption of alveolar bone is combined with an increase in pneumatization of maxillary sinus because of higher intra-antral pressure, giving rise to severely atrophied alveolar ridges with reduced bone height.
Materials and Methods:
A total of 26 implants were placed in 21 patients using indirect sinus lift with simultaneous implant placement without using bone grafts. Intra-oral periapical radiographs were taken to determine residual bone height, endosinus bone (ESB), and crestal bone level.
Results:
All the implants were clinically and radiographically stable at the end of 6 months follow-up. All the implants showed ESB gain, with mean being 1.97 mm and 1.99 mm on mesial and distal sides, respectively.
Conclusion:
The findings of this study indicate that successful osseointegration is predictable using osteotome sinus floor elevation without bone graft. Spontaneous new bone formation seemed to be expected with implants placed using indirect sinus lift.
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