The application of polyetheretherketone (PEEK) implants in cranioplasty

Zhang, Jibo; Tian, Weiqun; Chen, Jiayi; Yu, Jin; Zhang, Jianjian

doi:10.1016/j.brainresbull.2019.08.010

Cited by 100 publications

(100 citation statements)

References 81 publications

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“…Reconstruction of calvarial defects mainly aims to restore the barrier of cranial contents with external elements, and recover the contour between the skull and its overlying tissue in a cosmetic way. [ 248 ] It has been shown that the recreation of the calvaria barrier can improve CSF dynamics. Titanium metal, PEEK and other 3D printed non‐absorbable biomaterials are usually used in calvarial defects repair.…”

Section: Clinical Applicationsmentioning

confidence: 99%

Recent Developments of Biomaterials for Additive Manufacturing of Bone Scaffolds

Zhang

et al. 2020

Adv Healthcare Materials

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Recent years have witnessed surging demand for bone repair/regeneration implants due to the increasing number of bone defects caused by trauma, cancer, infection, and arthritis worldwide. In addition to bone autografts and allografts, biomaterial substitutes have been widely used in clinical practice. Personalized implants with precise and personalized control of shape, porosity, composition, surface chemistry, and mechanical properties will greatly facilitate the regeneration of bone tissue and satiate the clinical needs. Additive manufacturing (AM) techniques, also known as 3D printing, are drawing fast growing attention in the fabrication of implants or scaffolding materials due to their capability of manufacturing complex and irregularly shaped scaffolds in repairing bone defects in clinical practice. This review aims to provide a comprehensive overview of recent progress in the development of materials and techniques used in the additive manufacturing of bone scaffolds. In addition, clinical application, pre-clinical trials and future prospects of AM based bone implants are also summarized and discussed.

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Section: Clinical Applicationsmentioning

confidence: 99%

Recent Developments of Biomaterials for Additive Manufacturing of Bone Scaffolds

Zhang

et al. 2020

Adv Healthcare Materials

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“…Personalized medicine has revolutionized the practice of modern medicine. With advancements in CAD and AM technologies, the use of customized implants with excellent cosmetics and functional results has now become widespread [ 22 ]. These technological improvements have led to a tremendous increase in the use of patient-specific alloplastic implants for cranioplasty applications.…”

Section: Discussionmentioning

confidence: 99%

Quality Characteristics and Clinical Relevance of In-House 3D-Printed Customized Polyetheretherketone (PEEK) Implants for Craniofacial Reconstruction

Sharma

Aghlmandi

Cao

et al. 2020

JCM

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Additive manufacturing (AM) of patient-specific implants (PSIs) is gradually moving towards in-house or point-of-care (POC) manufacturing. Polyetheretherketone (PEEK) has been used in cranioplasty cases as a reliable alternative to other alloplastic materials. As only a few fused filament fabrication (FFF) printers are suitable for in-house manufacturing, the quality characteristics of the implants fabricated by FFF technology are still under investigated. This paper aimed to investigate PEEK PSIs fabricated in-house for craniofacial reconstruction, discussing the key challenges during the FFF printing process. Two exemplary cases of class III (Group 1) and class IV (Group 2) craniofacial defects were selected for the fabrication of PEEK PSIs. Taguchi’s L9 orthogonal array was selected for the following nonthermal printing process parameters, i.e., layer thickness, infill rate, number of shells, and infill pattern, and an assessment of the dimensional accuracy of the fabricated implants was made. The root mean square (RMS) values revealed higher deviations in Group 1 PSIs (0.790 mm) compared to Group 2 PSIs (0.241 mm). Horizontal lines, or the characteristic FFF stair-stepping effect, were more perceptible across the surface of Group 1 PSIs. Although Group 2 PSIs revealed no discoloration, Group 1 PSIs displayed different zones of crystallinity. These results suggest that the dimensional accuracy of PSIs were within the clinically acceptable range; however, attention must be paid towards a requirement of optimum thermal management during the printing process to fabricate implants of uniform crystallinity.

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“…[ 19 , 20 ] In some comparative studies between PEEK and titanium cranioplasty, PEEK is a better implanted option. [ 24 ] The data is limited and there is paucity of high-level evidence comparing PEEK and titanium cranioplasty. The PTCPTBI-1 is the first multicenter, non-randomized, partially blinded, prospective cohort study to provide high-level evidence of implant material choice.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of titanium cranioplasty and polyetheretherketone cranioplasty after decompressive craniectomy for traumatic brain injury

Yang

Yuan

et al. 2020

Medicine

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Introduction: Cranioplasty following decompressive craniectomy is routinely performed to restore integrity of skull and improve neurological function. However, reconstructing the cranial defect brings many challenges to neurosurgeons and search for ideal implant materials is one of the most controversial issues. Although many studies have compared the outcomes of titanium and polyetheretherketone (PEEK) cranioplasty, yet no prospective study exists to guide the choice of titanium and PEEK materials. Methods/design: A non-randomized, partially blinded, prospective cohort study is described that comprehensively compares the long-term outcomes of titanium cranioplasty versus PEEK cranioplasty. One hundred forty-five patients for each group will be recruited. Eligible patients are those with cranial defect due to traumatic brain injury (≥ 16 years), defect size is over 25 cm 2 and they must agree to participate in the trial. Each participant is evaluated before surgery, on discharge, 3, 6, and 12 months after cranioplasty. The primary outcome is the infection, implant failure and implant deformation requiring revision surgery within 12 months. Secondary outcomes include postoperative complication rate, neurological outcomes, motor function, and cosmetic outcome over a 6-month period. Discussion: Search for ideal implant materials is throughout the history of cranioplasty. This study will provide robust evidence for the choice of cranioplasty materials. Trial registration number: ChiCTR2000033406

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The application of polyetheretherketone (PEEK) implants in cranioplasty

Cited by 100 publications

References 81 publications

Recent Developments of Biomaterials for Additive Manufacturing of Bone Scaffolds

Recent Developments of Biomaterials for Additive Manufacturing of Bone Scaffolds

Quality Characteristics and Clinical Relevance of In-House 3D-Printed Customized Polyetheretherketone (PEEK) Implants for Craniofacial Reconstruction

Evaluation of titanium cranioplasty and polyetheretherketone cranioplasty after decompressive craniectomy for traumatic brain injury

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