Paradigm Shift in Materials for Skull Reconstruction Facilitated by Science and Technological Integration

Abstract

The surgical repair of a bone deficiency in the skull caused by a prior procedure or accident is known as cranioplasty. There are various types of cranioplasties, but the majority entail raising the scalp and reshaping the skull using either the original piece of bone from the skull or a specially molded graft created from Titanium (plate or mesh), artificial bone in place of, a stable biomaterial (prefabricated customized implant to match the exact contour and shape of the skull). Cranioplasty, one of the oldest surgical treatments for cranial abnormalities, has undergone several changes throughout the years to discover the best material to improve patient outcomes. Various materials have been utilized in cranioplasty throughout history. As biomedical technology progresses, surgeons will have access to new materials. There is still no agreement on the optimum material, and research into biologic and nonbiologic alternatives is ongoing in the hopes of finding the finest reconstruction material. The materials and techniques used in cranioplasty are covered in this article.

Explanted skull flaps after decompressive hemicraniectomy demonstrate relevant bone avitality. Is their reimplantation worth of the risk?

“…(6, 8) To this end, a relevant shift in the surgical management of the disease and the choice of material for cranioplasty has been already initiated, SF are increasingly replacing ABF for cranioplasties. (5,6,13,22,23) To date, we are aware that younger age, traumatic brain injury, reimplantation of multiple bone fragments and surgical site infection are well established prognostic factors for development of aseptic bone necrosis. (3,4,16,17) The subsequent bone lysis may in turn initiate issues regarding cosmesis, protection, cranioplasty failure and reoperation as well as to rare situations, like sinking skin syndrome.…”

Explanted Skull Flaps after Decompressive Hemicraniectomy Demonstrate Relevant Bone Avitality-Is Their Reimplantation Worth the Risk?

“…Aseptic bone necrosis is observed only after cranioplasty with ABFs, a fact that results in higher overall complications after ABF rather than SF cranioplasty [ 6 , 8 ]. To this end, a relevant shift in the surgical management of the disease and the choice of material for cranioplasty has been already initiated; SFs are increasingly replacing ABFs for cranioplasties [ 5 , 6 , 13 , 22 , 23 ].…”

Digitalization in Cranial Reconstruction: Revolutionizing Precision and Innovation

“…The implementation of VSP utilizing computer-aided design and computer-aided manufacturing (CAD-CAM) techniques has created a different workflow to enhance the precision of preoperative planning, minimizing the reliance on trial and error during surgery. The integration of digital technologies into modern practices has greatly improved the standard of maxillofacial rehabilitation [5]. CAS is a four-stage reconstructive surgery procedure.…”

“…Polyether ether ketone was recently introduced for cranioplasty and has proven to be an effective implant material in orthopedics. A more modern material called titanium has been used to make cranial prosthetics [ 5 ].…”