Accuracy Assessment of Molded, Patient-Specific Polymethylmethacrylate Craniofacial Implants Compared to Their 3D Printed Originals

Abstract

The use of patient-specific implants (PSIs) in craniofacial surgery is often limited due to a lack of expertise and/or production costs. Therefore, a simple and cost-efficient template-based fabrication workflow has been developed to overcome these disadvantages. The aim of this study is to assess the accuracy of PSIs made from their original templates. For a representative cranial defect (CRD) and a temporo-orbital defect (TOD), ten PSIs were made from polymethylmethacrylate (PMMA) using computer-aided design (CAD) and three-dimensional (3D) printing technology. These customized implants were measured and compared with their original 3D printed templates. The implants for the CRD revealed a root mean square (RMS) value ranging from 1.128 to 0.469 mm with a median RMS (Q1 to Q3) of 0.574 (0.528 to 0.701) mm. Those for the TOD revealed an RMS value ranging from 1.079 to 0.630 mm with a median RMS (Q1 to Q3) of 0.843 (0.635 to 0.943) mm. This study demonstrates that a highly precise duplication of PSIs can be achieved using this template-molding workflow. Thus, virtually planned implants can be accurately transferred into haptic PSIs. This workflow appears to offer a sophisticated solution for craniofacial reconstruction and continues to prove itself in daily clinical practice.

Design and Additive Manufacturing of a Biomimetic Customized Cranial Implant Based on Voronoi Diagram

“…In the anatomical design modeling phase, .STL file of the 3D volumetric reconstructed model (Figure 2A) was imported into a medically certified CAD modeling software (3-matic Medical v. 13.0, Materialise, Leuven, Belgium). For the precise reconstruction of the virtual cranial defect, a mirror-based reconstruction approach was followed (Benazzi and Senck, 2011;Chamo et al, 2020). First, a datum plane (mid-plane reference system) was created, and the healthy (non-defect) side was mirrored to the defect side.…”

Quantitative Assessment of Point-of-Care 3D-Printed Patient-Specific Polyetheretherketone (PEEK) Cranial Implants

“…There have been several reports on applying point-of-care (POC) 3D printing in numerous avenues, including the fabrication of anatomical biomodels for preoperative surgical planning, surgical guides, and prosthetic aids [18,19]. Particularly in the context of cranioplasty, recently published reports have demonstrated the fabrication of customized acrylic cranioplasty implants in hospitals assisted by 3D-printed molds [20][21][22][23]. However, very few reports have addressed the avenue of POC manufacturing of 3D-printed personalized implants.…”

Quality Characteristics and Clinical Relevance of In-House 3D-Printed Customized Polyetheretherketone (PEEK) Implants for Craniofacial Reconstruction

“…The level of accuracy required in a PSI depends on the clinical application. According to our results, PSIs in Group 1 and Group 2 were within the acceptable accuracy range required in cranioplasty procedures, with overall 3D deviations under 2 mm [ 27 ]. Further analysis of the spatial distribution of variations revealed that the deviation pattern depended on the size and shape of the cranial defect, which was reflected in the PSIs fabricated ( Figure 8 ).…”