An improved process for the fabrication and surface treatment of custom-made titanium cranioplasty implants informed by surface analysis

Abstract

Cranioplasty implants are routinely fabricated from commercially pure titanium plates by maxillofacial prosthetists. The differing fabrication protocols adopted by prosthetists working at different hospital sites gives rise to considerable variations in surface topography and composition of cranioplasty implants, with residues from the fabrication processes having been found to become incorporated into the surface of the implant. There is a growing recognition among maxillofacial prosthetists of the need to standardise these protocols to ensure quality and consistency of practice within the profession. In an effort to identify and eliminate the source of the inclusions associated with one such fabrication protocol, the present study examined the surfaces of samples subjected to each of the manufacturing steps involved. Surface and elemental analysis techniques identified the main constituent of the surface inclusions to be silicon from the glass beads used to texture the surface of the implant during fabrication. Subsequent analysis of samples prepared according to a revised protocol resulted in a more homogeneous titanium dioxide surface as evidenced by the reduction in area occupied by surface inclusions (from 8.51% ± 2.60% to 0.93% ± 0.62%). These findings may inform the development of improved protocols for the fabrication of titanium cranioplasty plates.

Effect and mechanism of propranolol on promoting osteogenic differentiation and early implant osseointegration

“…Early rapid osseointegration is a key factor for successful implantation but is limited by biological inertia, high elastic modulus and limited biological effects of the material surface (27). An effective technique to improve the performance of titanium implants and to promote and accelerate osseointegration has been the focus of research in recent years (28)(29)(30). despite titanium and titanium alloy implants are widely used in the fields of dentistry and oral and maxillofacial surgery, postoperative infection and poor osseointegration remain obstacles to implant surgery (31).…”