Patient-specific polymethylmethacrylate prostheses for secondary reconstruction of large calvarial defects: A retrospective feasibility study of a new intraoperative moulding device for cranioplasty

Moser, Manuel; Schmid, Raphael; Schindel, Ralf; Hildebrandt, Gerhard

doi:10.1016/j.jcms.2016.11.016

Cited by 25 publications

(9 citation statements)

References 51 publications

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“…Studies have quantified and assessed the accuracy of differences between machined and cast PMMA [19], the comparison between manual and automated techniques for cranioplasty plates [20], and the extent of conformity among pressed-titanium sheet implants on CRD contours [21]. Other studies examining 3D printed templates and PSIs often depict the accuracy or the evaluation of cosmetic outcomes based on CT scans, as well as patient questionnaires to obtain objective and subjective assessments [8,22]. Therefore, to investigate the outcome quality of a PSI in a more objective manner, the present study was conducted.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, few materials for 3D printers that are certified for implantation are available. Consequently, non-biocompatible 3D printed templates must be transferred into a certified biocompatible material, such as bone cement [1,[12][13][14][15][16]22,25,29]. Variations in the operator's experience will influence the results, and there may be a learning curve for hand-mixed bone cement [30].…”

Section: Discussionmentioning

confidence: 99%

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Accuracy Assessment of Molded, Patient-Specific Polymethylmethacrylate Craniofacial Implants Compared to Their 3D Printed Originals

Chamo

Msallem

Sharma

et al. 2020

JCM

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The use of patient-specific implants (PSIs) in craniofacial surgery is often limited due to a lack of expertise and/or production costs. Therefore, a simple and cost-efficient template-based fabrication workflow has been developed to overcome these disadvantages. The aim of this study is to assess the accuracy of PSIs made from their original templates. For a representative cranial defect (CRD) and a temporo-orbital defect (TOD), ten PSIs were made from polymethylmethacrylate (PMMA) using computer-aided design (CAD) and three-dimensional (3D) printing technology. These customized implants were measured and compared with their original 3D printed templates. The implants for the CRD revealed a root mean square (RMS) value ranging from 1.128 to 0.469 mm with a median RMS (Q1 to Q3) of 0.574 (0.528 to 0.701) mm. Those for the TOD revealed an RMS value ranging from 1.079 to 0.630 mm with a median RMS (Q1 to Q3) of 0.843 (0.635 to 0.943) mm. This study demonstrates that a highly precise duplication of PSIs can be achieved using this template-molding workflow. Thus, virtually planned implants can be accurately transferred into haptic PSIs. This workflow appears to offer a sophisticated solution for craniofacial reconstruction and continues to prove itself in daily clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Accuracy Assessment of Molded, Patient-Specific Polymethylmethacrylate Craniofacial Implants Compared to Their 3D Printed Originals

Chamo

Msallem

Sharma

et al. 2020

JCM

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“…Casting molds were first reported to be used preoperatively, as an impression cavity mold, by kneading the PMMA into the mold. 18 Other studies describe the use of casting molds intraoperatively, for example, by using an impression cavity mold in a sterile bag, 19,20…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Printed Polymethylmethacrylate Casting Molds for Posterior Fossa Reconstruction in the Surgical Treatment of Chiari I Malformation: Technical Note and Illustrative Cases

et al. 2019

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Objective: To describe a new method for cranial reconstruction after posterior fossa craniectomy in the surgical treatment of Chiari 1 Malformation, through a technical note and by presenting three illustrative cases.Methods and materials: A virtual surgical planning workflow was established for planning of the posterior fossa decompression, the design of the suboccipital reconstruction, and for manufacturing of a 3D-printed PMMA casting mold. The casting accuracy was assessed by conducting a phantom experiment and clinical data was provided by means of three illustrative cases. Results:The accuracy of implant fabrication was found to be excellent, particularly when the PMMA is introduced into the mold in a malleable state. In all three clinical cases the implants were fabricated and positioned with success. Postoperative analysis revealed that accurate placement was achieved, with only minor deviation compared to the preoperative plan.Conclusions: 3D virtual surgical planning provide feasible tools both for planning of the posterior fossa decompression and to intraoperatively fabricate accurate patient-specific suboccipital cranioplasties.

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“…However, hand‐forming of PMMA implants has been replaced by computer‐aided prefabrication methods. Implants are fabricated with the help of computed tomography scans and subsequent production of molds for casting PMMA implants via wax elimination techniques, additive manufacturing methods, milling, or thermoforming …”

Section: Introductionmentioning

confidence: 99%

Impact Optimization of 3D‐Printed Poly(methyl methacrylate) for Cranial Implants

Petersmann

Spoerk

Huber

et al. 2019

Macro Materials & Eng

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Material extrusion‐based additive manufacturing, also known as fused filament fabrication (FFF) or 3D printing facilitates the fabrication of cranial implants with different materials and complex internal structures. The impact behavior plays a key role in the designing process of cranial implants. Therefore, the performance of impact tests on novel implant materials is of utmost importance. This research focuses on investigating the dependency of the infill density and pattern on the impact properties of 3D‐printed poly(methyl methacrylate) (PMMA) sandwich specimens including internal rectilinear, gyroid, and 3D‐honeycomb (3D‐HC) structures. 3D‐HC structures show higher impact forces and dissipated energies as well as dynamic stiffness values compared to rectilinear and gyroid structures at the same infill density. 70% infill 3D‐HC and 100% infill rectilinear structures prove to be most promising. In addition, two different optimization techniques to further improve the impact properties of these specimens, namely a material and a topology optimization, are applied. Topology optimization shows promising results until first damage and material optimization regarding dissipated energies. However, both are not able to outperform the 3D‐HC pattern.

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Patient-specific polymethylmethacrylate prostheses for secondary reconstruction of large calvarial defects: A retrospective feasibility study of a new intraoperative moulding device for cranioplasty

Cited by 25 publications

References 51 publications

Accuracy Assessment of Molded, Patient-Specific Polymethylmethacrylate Craniofacial Implants Compared to Their 3D Printed Originals

Accuracy Assessment of Molded, Patient-Specific Polymethylmethacrylate Craniofacial Implants Compared to Their 3D Printed Originals

Three-Dimensional Printed Polymethylmethacrylate Casting Molds for Posterior Fossa Reconstruction in the Surgical Treatment of Chiari I Malformation: Technical Note and Illustrative Cases

Impact Optimization of 3D‐Printed Poly(methyl methacrylate) for Cranial Implants

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