Comparison between the different types of heterologous materials used in cranioplasty: a systematic review of the literature

Morselli, Carlotta; Zaed, Ismail; Tropeano, Maria Pia; Cataletti, Giovanni; Iaccarino, Corrado; Rossini, Zefferino; Servadei, Franco

doi:10.23736/s0390-5616.19.04779-9

Cited by 33 publications

(55 citation statements)

References 74 publications

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“…PEEK, together with PMMA, is one of the most interesting materials used in medicine field such as in spine surgery, orthopedic surgery, prosthodontics surgery, maxillo-facial surgery and cardiac surgery and more recently in cranioplasty [ 5 , 10 , 57 , 58 ]. It is a semicrystalline thermoplastic aromatic polymer, chemically inert, which can be easily modelled with a smooth surface and accurately incorporated during cranioplasty, with the aid of 3D printing technology [ 28 , 59 ].…”

Section: Discussion On Cranioplasty Materialsmentioning

confidence: 99%

“…Consequently, there is a broad range in the type of cranioplasty material utilized in various countries. As reported by Morselli and collaborators [ 10 ], “titanium is mostly used in Australia, the UK and Germany, PMMA in the USA, PEEK in the USA, Singapore and Korea, HA in France and Italy”.…”

Section: Introductionmentioning

confidence: 99%

“…Over time, several materials have been taken into account. An interesting review was presented by Morselli et al [ 10 ], where they allied heterologous materials choose to cranioplasty most frequent complications. In particular titanium, PMMA, polyetheretherketone (PEEK) and hydroxyapatite (HA) materials were analyzed, selecting retrospective and prospective studies that thought postoperative complications in custom-made reconstruction [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…As highlighted by Morselli et al [ 10 ], despite the great interest in cranial reconstruction procedure, there is a low number of multicentric study. Consequently, there is a broad range in the type of cranioplasty material utilized in various countries.…”

Section: Introductionmentioning

confidence: 99%

“…To our knowledge, few papers were published dealing on the “best choice” material [ 1 , 2 , 3 , 4 , 5 , 6 , 10 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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State-of-Art of Standard and Innovative Materials Used in Cranioplasty

2021

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Cranioplasty is the surgical technology employed to repair a traumatic head injury, cerebrovascular disease, oncology resection and congenital anomalies. Actually, different bone substitutes are used, either derived from biological products such as hydroxyapatite and demineralized bone matrix or synthetic ones such as sulfate or phosphate ceramics and polymer-based substitutes. Considering that the choice of the best material for cranioplasty is controversial, linked to the best operation procedure, the intent of this review was to report the outcome of research conducted on materials used for such applications, comparing the most used materials. The most interesting challenge is to preserve the mechanical properties while improving the bioactivity, porosity, biocompatibility, antibacterial properties, lowering thickness and costs. Among polymer materials, polymethylmethacrylate and polyetheretherketone are the most motivating, due to their biocompatibility, rigidity and toughness. Other biomaterials, with ecofriendly attributes, such as polycaprolactone and polylactic acid have been investigated, due to their microstructure that mimic the trabecular bone, encouraging vascularization and cell–cell communications. Taking into consideration that each material must be selected for specific clinical use, the main limitation remains the defects and the lack of vascularization, consequently porous synthetic substitutes could be an interesting way to support a faster and wider vascularization, with the aim to improve patient prognosis.

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