The use of patient specific polyetheretherketone implants for reconstruction of maxillofacial deformities

Abstract

The aim of this study was to evaluate polyetheretherketone (PEEK) as a patient-specific implant (PSI) material in maxillofacial reconstructive surgery. Materials and methods: The retrospective study included a cohort of 24 patients who underwent maxillofacial surgery using PEEK PSIs. Each patient underwent preoperative multislice computed tomography (CT) with 0 tilt of gantry. Based on the CT scan, the PEEK PSIs were planned and manufactured using three-dimensional (3D) modeling and computer-aided design/computer-aided manufacturing (CAD/CAM) techniques. All procedures were performed under general anesthesia. Implants were placed intraorally, extraorally or through subciliary, transconjuctival or coronal incisions. Results: In 19 of 24 cases, the PEEK PSI fit well without adjustments. Although the fit to the surrounding bone was perfect in almost all of the cases, the outer contour of the PSI was modified in nine cases before fixation. However, intraoperative implant modification did not affect the infection rate. In two cases, postoperative wound dehiscence and infection needed additional treatment and healed without removal of the implants. Conclusion: The follow-up data in this study showed good outcomes with reliable results for PSI made of PEEK in the maxillofacial region.

A Multi-Criteria Assessment Strategy for 3D Printed Porous Polyetheretherketone (PEEK) Patient-Specific Implants for Orbital Wall Reconstruction

“…The use of PEEK PSIs in cranial reconstructions is well documented in the literature, with a trend toward lower implant failure rates with PEEK versus titanium mesh [55]. Furthermore, PEEK PSIs have also been used in craniofacial defects reconstruction [56], in midface reconstruction as an alternative to composite free tissue transfer or maxillary obturators [57,58]. In addition, PEEK onlay implants have been utilized in zygoma contour augmentation [31,32] and mandibular angle reconstructive surgeries [59].…”

Workflow and Principles for Precisely Designing a Custom-Made Polyetheretherketone Implant Applied in Irregular Craniofacial Bone Defects

“…Since PEEK was first used in the reconstruction of bone defects in the late 1990s [9] , a significant number of studies have evaluated this material. However, most studies have focused on its manufacturing techniques [10][11] and efficacy in clinical applications [12][13] , and only few reports have reported its design workflow, which is indispensable for making custom-made PEEK implants. In this paper, we present the workflow and principles for the design and manufacture of PEEK implants and describe the detailed precise designing protocol to fill this gap.…”

Synergistic anti-fouling and bactericidal poly(ether ether ketone) surfaces via a one-step photomodification

“…PEEK exhibits unprecedented advantages compared to commonly used materials in implantology, with one of the most attractive ones being its processability by additive manufacturing [4]. Nevertheless, as with any other implant material, PEEK is not free of bacterial contamination [6,29,30]. We covalently grafted a combination of anti-fouling and bactericidal polymers on the PEEK surface as a potentially synergistic, powerful combination to prevent PEEK implant infection (Figure 1).…”