Quantitative Assessment of Point-of-Care 3D-Printed Patient-Specific Polyetheretherketone (PEEK) Cranial Implants

Abstract

Recent advancements in medical imaging, virtual surgical planning (VSP), and three-dimensional (3D) printing have potentially changed how today’s craniomaxillofacial surgeons use patient information for customized treatments. Over the years, polyetheretherketone (PEEK) has emerged as the biomaterial of choice to reconstruct craniofacial defects. With advancements in additive manufacturing (AM) systems, prospects for the point-of-care (POC) 3D printing of PEEK patient-specific implants (PSIs) have emerged. Consequently, investigating the clinical reliability of POC-manufactured PEEK implants has become a necessary endeavor. Therefore, this paper aims to provide a quantitative assessment of POC-manufactured, 3D-printed PEEK PSIs for cranial reconstruction through characterization of the geometrical, morphological, and biomechanical aspects of the in-hospital 3D-printed PEEK cranial implants. The study results revealed that the printed customized cranial implants had high dimensional accuracy and repeatability, displaying clinically acceptable morphologic similarity concerning fit and contours continuity. From a biomechanical standpoint, it was noticed that the tested implants had variable peak load values with discrete fracture patterns and failed at a mean (SD) peak load of 798.38 ± 211.45 N. In conclusion, the results of this preclinical study are in line with cranial implant expectations; however, specific attributes have scope for further improvements.

Low-Cost Cranioplasty—A Systematic Review of 3D Printing in Medicine

“…In a study performed by Mian et al, 3D-printed PEEK implants delivered great precision, minimal deviation (0.5919 mm), with maximal von Mises stress (8.15 MPa), von Mises strain (0.002) and minimal deformation (0.18 mm), which underlines the implant’s extraordinary load-bearing capability [ 192 ]. Similar observations have been made in a preclinical study designed by Sharma et al [ 193 ]. De Barros described a one-step customized PEEK cranioplasty, reaching a favorable outcome without any major complications during a 3-month follow-up [ 194 ].…”

Evaluation of the Fitting Accuracy of CAD/CAM-Manufactured Patient-Specific Implants for the Reconstruction of Cranial Defects—A Retrospective Study

“…Cranioplasty has been indicated to restore the form and function of bone defects of the neurocranium after trauma, intracranial bleeding, or tumor surgery [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. The term “cranioplasty” is defined as a surgical procedure which reconstructs the cranial bone defects of various etiologies [ 12 , 13 ].…”

“…It is one of the most common neurosurgical procedures [ 14 ]. Craniofacial defects have serious functional and aesthetic consequences, with negative psychological effects [ 11 , 15 ]. In addition to the reconstruction of the shape (symmetry), functional restoration, such as protection, cerebral function, and the improvement of quality of life through surgical measures is essential [ 11 , 16 ].…”

“…Craniofacial defects have serious functional and aesthetic consequences, with negative psychological effects [ 11 , 15 ]. In addition to the reconstruction of the shape (symmetry), functional restoration, such as protection, cerebral function, and the improvement of quality of life through surgical measures is essential [ 11 , 16 ]. Reconstruction in the case of sinking scalp flaps or a “syndrome of the trephined” plays a major role, especially in neurological recovery [ 12 , 17 , 18 , 19 , 20 , 21 ].…”

Adaptive Mechanism for Designing a Personalized Cranial Implant and Its 3D Printing Using PEEK

“…An elevated thermoplastic polymer called polyetheretherketone (PEEK)—which is a partly crystalline, poly-aromatic, linear, thermoplastic material [ 41 , 42 ]—is by far the most plausible innovative substitute to Ti. It is an organic synthetic polymeric material with higher temperature stability above 300 °C, high mechanical strength, adaptable mass production, production possibility utilizing plastic techniques, natural radiolucency and MRI compatibility, nontoxicity, excellent chemical and sterilization tolerance, and a pure and quantifiable supply channel [ 41 , 43 , 44 ].…”