Complex Orbito-fronto-temporal Reconstruction Using Computer-Designed PEEK Implant

Scolozzi, Paolo; Martinez, A.; Jaques, Bertrand

doi:10.1097/01.scs.0000249359.56417.7e

Cited by 138 publications

(92 citation statements)

References 11 publications

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“…3 In a series of 29 patients, not a single CFRP plate had to be removed. 39 The CAD/CAM PEEK implants for cranioplasty are gaining access in calvarial reconstruction, 42 but larger case studies have not yet been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Long-term results following titanium cranioplasty of large skull defects

Čabraja¹,

Klein

Lehmann³

2009

FOC

267

171

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Object Decompressive craniectomy is an established procedure to lower intracranial pressure. Therefore, cranioplasty remains a necessity in neurosurgery as well. If the patient's own bone flap is not available, the surgeon can choose between various alloplast grafts. A review of the literature proves that 4–13.8% of polymethylmethacrylate plates and 2.6–10% of hydroxyapatite-based implants require replacement. In this retrospective study of large skull defects, the authors compared computer-assisted design/computer-assisted modeled (CAD/CAM) titanium implants for cranioplasty with other frequently used materials described in literature. Methods Twenty-six patients underwent cranioplasty with CAD/CAM titanium implants (mean diameter 112 mm). With the aid of visual analog scales, the patients' pain and cosmesis were evaluated 6–12 years (mean 8.1 years) after insertion of the implants. Results None of the implants had to be removed. Of all patients, 68% declared their outcomes as excellent, 24% as good, 0.8% as fair, and 0% as poor. There was no resulting pain in 84% of the patients, and 88% were satisfied with the cosmetic result, noting > 75 mm on the visual analog scale of cosmesis. All patients would have chosen cranioplasty again, stating an improvement in their quality of life by the calvarial reconstruction. Nevertheless, follow-up images obtained in 4 patients undergoing removal of meningiomas was only suboptimal. Conclusions With the aid of CAD technology, all currently used alloplastic materials are suited even for large skull defect cranioplasty. Analysis of the authors' data and the literature shows that cranioplasty with CAD/CAM titanium implants provides the lowest rate of complications, reasonable costs, and acceptable postoperative imaging. Polymethylmethacrylate is suited for primary cranioplasty or for long-term follow-up imaging of tumors. Titanium implants seem to be the material of choice for secondary cranioplasty of large skull defects resulting from decompressive craniectomy after trauma or infarction. Expensive HA-based ceramics show no obvious advantage over titanium or PMMA.

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Section: Discussionmentioning

confidence: 99%

Long-term results following titanium cranioplasty of large skull defects

Čabraja¹,

Klein

Lehmann³

2009

FOC

267

171

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show abstract

“…[6][7][8][9][10] Reports of the use of PEEK in the reconstruction of maxillofacial defects have been limited. 11 However, we believe that PEEK-coupled with a prefabrication process that can produce patient-specific implants (PSIs)-may represent an ideal strategy in the reconstruction of challenging maxillofacial defects. In addition, because PEEK implants are durable, workable, and biocompatible, the use of the implant may become more popular in the future.…”

mentioning

confidence: 99%

Use of Customized Polyetheretherketone (PEEK) Implants in the Reconstruction of Complex Maxillofacial Defects

Kim¹,

Boahene

Byrne

2009

Archives of Facial Plastic Surgery

114

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“…The core driving factor to the development of PEEK as a biomaterial was the need to balance strength and rigidity: to develop an implant system which met the structural strength requirements of the body, whilst minimizing rigidity in an attempt to reduce stress shielding risk [33,81]. Traditionally PEEK found use in spinal treatment applications, as well as cranial and maxillofacial applications [54,56,82]. It must be noted that PEEK is a hydrophobic material.…”

Section: Discussionmentioning

confidence: 99%

Cranioplasty and Craniofacial Reconstruction: A Review of Implant Material, Manufacturing Method and Infection Risk

et al. 2017

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Background: Analysis of current literature highlights a wide variation in reported infection risk for different materials in cranial repair. The purpose of these composite materials are to mimic natural bone and assist in restoring function (structurally and aesthetically) to the human skull. This review aims to examine the meta-data in order to provide an amalgamated overview of potential trends between implant material, manufacturing method and infection risk, in order to provide a core reference point for future studies surrounding emerging biomedical materials in the fields of cranioplasty by providing base point for understanding the capabilities and limitations of current technologies. Methods: A search for articles was conducted, with the following criteria seen as fundamental in providing an accurate picture of the current landscape: publication in the last decade, provision of a numerical value for both number of implants and infection cases, patient sample of 10+, adult patients, and cranioplasty/cranial repair. Results: A total of 41 articles were seen to meet the author's inclusion criteria. Average infection rates per material ranged between 2.04% and 10.98%. The results indicate that there is variation between materials in regards to total infection risk, however, depending on the materials compared, this value may be insignificant. Alternative risk factors associated with infection, including surgical time, revisions and previous infection, have a greater impact on infection potential than material variation. Comparison of fabrication methods did highlight a notable effect on average infection rate. Trends can be observed showing that materials with greater levels of surface interaction and active support of tissue ingrowth presented greater infection resistance. Such characteristics are due to the physical structures of the implants. Conclusions: It can be said that the manufacturing methods can influence biomedical materials to assist in minimizing implant infection risk.

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Complex Orbito-fronto-temporal Reconstruction Using Computer-Designed PEEK Implant

Cited by 138 publications

References 11 publications

Long-term results following titanium cranioplasty of large skull defects

Long-term results following titanium cranioplasty of large skull defects

Use of Customized Polyetheretherketone (PEEK) Implants in the Reconstruction of Complex Maxillofacial Defects

Cranioplasty and Craniofacial Reconstruction: A Review of Implant Material, Manufacturing Method and Infection Risk

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