History of synthetic materials in alloplastic cranioplasty

Harris, Dominic A.; Fong, Abraham; Buchanan, Edward P.; Monson, Laura A.; Khechoyan, David Y.; Lam, Sandi

doi:10.3171/2014.2.focus13560

Cited by 76 publications

(59 citation statements)

References 30 publications

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“…37,51 Many synthetic materials have been used successfully in cranioplasty. 20,42,43 Today, commonly used synthetic materials include acrylic, hydroxyapatite, titanium, ceramics, and polyetheretherketone (PEEK). 43 Although all of these materials may be used to produce prefabricated patientspecific implants, acrylic and hydroxyapatite are available in cement form that can be shaped intraoperatively.…”

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confidence: 99%

The feasibility of producing patient-specific acrylic cranioplasty implants with a low-cost 3D printer

Tan¹,

Ling²,

Dinesh³

2016

JNS

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T he reconstruction of a skull vault defect, termed cranioplasty, has a rich and fascinating history. For at least 5 millennia, surgeons have patched cranial defects with an immensely diverse range of materials ranging from fruit shells to sheep scapulae and man-made plastics. 42 Even today, the pursuit of the perfect cranioplasty material and technique continues.Skull defects are often the direct result of surgical decompressive craniectomy performed for acute neurosurgical emergencies. 23 The use of a patient's original bone flap for cranioplasty is theoretically sound and avoids the problems related to the use of bone from other sources, such as human cadavers (allografts) or animals (xenografts), or the use of synthetic materials. In practice, however, cranioplasty using these bone flaps, which have been stored for a period of time either in a surgically created subcutaneous pocket or in a medical freezer, is plagued with a not insignificant risk of infections and bony resorption. 8,11,22 With unnatural storage, the nature and content of these bone flaps are changed permanently, hindering successful reincorporation as part of the skull vault. Loss of osteogenesis probably plays a role; studies on human calvarial bone flaps have shown a diminution of osteoblasts after both subcutaneous 44 The feasibility of producing patient-specific acrylic cranioplasty implants with a low-cost 3D printer eddie t. w. tan, mrcsed, Ji min ling, mrcsed, and shree Kumar dinesh, FrcsDepartment of Neurosurgery, National Neuroscience Institute, Singapore obJective Commercially available, preformed patient-specific cranioplasty implants are anatomically accurate but costly. Acrylic bone cement is a commonly used alternative. However, the manual shaping of the bone cement is difficult and may not lead to a satisfactory implant in some cases. The object of this study was to determine the feasibility of fabricating molds using a commercial low-cost 3D printer for the purpose of producing patient-specific acrylic cranioplasty implants. methods Using data from a high-resolution brain CT scan of a patient with a calvarial defect posthemicraniectomy, a skull phantom and a mold were generated with computer software and fabricated with the 3D printer using the fused deposition modeling method. The mold was used as a template to shape the acrylic implant, which was formed via a polymerization reaction. The resulting implant was fitted to the skull phantom and the cranial index of symmetry was determined. results The skull phantom and mold were successfully fabricated with the 3D printer. The application of acrylic bone cement to the mold was simple and straightforward. The resulting implant did not require further adjustment or drilling prior to being fitted to the skull phantom. The cranial index of symmetry was 96.2% (the cranial index of symmetry is 100% for a perfectly symmetrical skull). coNclusioNs This study showed that it is feasible to produce patient-specific acrylic cranioplasty implants with a low-cost 3D printer. Further studies...

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confidence: 99%

The feasibility of producing patient-specific acrylic cranioplasty implants with a low-cost 3D printer

Tan¹,

Ling²,

Dinesh³

2016

JNS

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“…6 Historical alloplastic cranioplasty techniques have evolved from necessity from bone allograft and metallics like gold and silver to modern options including a wide range of synthetic materials. 7,8 While autologous bone grafting, whether the previously removed bone flap or split thickness bone graft, remains an option of choice, the graft is often not available due to infection, radiation, or traumatic damage. 9,10 Synthetic alloplastic materials can be divided into metallics (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…titanium), acrylics such as methyl methacrylate and Polymethyl-methacrylate (PMMAdplexiglass), ceramics such as hydroxyapatite, glass-ceramics, and plastics. 7,8 Titanium implants, while having good strength and biocompatibility properties, are difficult to work within anything but an elastic and malleable mesh format. 7 The ceramics and glass ceramic family of implants offers good reconstructive options but are prone to fracture during inset and from contact trauma.…”

Section: Introductionmentioning

confidence: 99%

“…7,8 Titanium implants, while having good strength and biocompatibility properties, are difficult to work within anything but an elastic and malleable mesh format. 7 The ceramics and glass ceramic family of implants offers good reconstructive options but are prone to fracture during inset and from contact trauma. The PMMA family can become brittle when loaded with high forces such as an impact, may have a high infection rate, and is exothermic.…”

Section: Introductionmentioning

confidence: 99%

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Computed-tomography modeled polyether ether ketone (PEEK) implants in revision cranioplasty

O’Reilly

Barnett

Madden

et al. 2015

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…The first one involves transplantsvarious autogenic prostheses (the patient's own bone taken from various regions of the body). The second one involves implants where allogenic substances are involved such as metals, ceramics or plastics [3]. The patient's own bone is very often resorbed, sometimes causes autoagres sive reaction, and always requires additional operative field [4].…”

Section: Methodsmentioning

confidence: 99%

Cranioplasty as the return-to-work factor – 112 patients with cranial defects treated in the Department of Neurosurgery at the Medical University Of Lodz

Kasprzak

Ormezowska

Jaskólski

2017

Int J Occup Med Environ Health

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Objectives: The number of craniectomies and the consequent reconstructive procedures has grown during the past decades. Cranial defects and methods of their repair could have some influence on work capability of the patients and their employ ability. Material and Methods: The authors analyzed a group of 112 patients with cranial defects treated in the Department of Neurosurgery at the Medical University of Lodz, Poland, in the course of the katamnestic period longer than 6 months after reconstructive operation, and observed them between February 2008 and February 2015. Their work capability and employment were compared, all the patients were interviewed concerning the reasons for not working according to the So cial Insurance Institution predication procedure. Results: Before the cranioplasty, all the patients were capable of work ing without limitations according to biological criteria and 89 of them were employed. Twenty-three not working people consisted of 6 pupils, 7 retired and 10 not working for other reasons. During the period between the craniectomy and the cranioplasty, 88 patients were capable of working and only 2 were employed. After the reconstruction, 93 were capable of working without limitations and 16 -with limitations. Forty-seven were employed during the period of the follow-up, the rest of patients consisted of 2 pupils, 13 retired and 50 not working for various reasons. Conclusions: Cranioplasty is a very important factor contributing to return to work. This outcome may be seen as having a great social value and be add ed to the functions of cranial repair as protective, esthetic and normalizing the intracranial pressure previously described in the literature. Int J Occup Med Environ Health 2017;30(5):803-809

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History of synthetic materials in alloplastic cranioplasty

Cited by 76 publications

References 30 publications

The feasibility of producing patient-specific acrylic cranioplasty implants with a low-cost 3D printer

The feasibility of producing patient-specific acrylic cranioplasty implants with a low-cost 3D printer

Computed-tomography modeled polyether ether ketone (PEEK) implants in revision cranioplasty

Cranioplasty as the return-to-work factor – 112 patients with cranial defects treated in the Department of Neurosurgery at the Medical University Of Lodz

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