Polyetheretherketone custom-made implants for craniofacial defects: Report of 14 cases and review of the literature.

BACKGROUND Craniofacial defects tend to carry functional and esthetic consequences for the patient. The complex shapes in this region make such reconstructions a challenging procedure and the most suitable material to be used remains controversial. METHODS We report a series of 14 patients whose craniofacial defects were reconstructed using a computer designed PEEK-PSI (Polyetheretherketone- Patient Specific Implant). We analyzed the complications and outcomes of PEEK custom-made implants and compared our results with those of other case series reported in the current literature. RESULTS Fourteen patients underwent craniofacial reconstruction using a PEEK-PSI. Three cases involved a one-step primary reconstruction and the rest of cases underwent a delayed reconstruction. Two cases (14.3 %) presented infection and only in one case was the implant definitively removed. Esthetic results were considered to be highly satisfactory. CONCLUSION With CAD-CAM techniques, it is possible to prefabricate an individual implant. The ideal material for reconstructing maxillofacial defects does not exist, but PEEK has demonstrated good outcomes. When autologous bone is not available or, in selected cases with large or complex defects in the maxillofacial area, PEEK is one of the best options to reconstruct these defects. However, further studies are needed to determine the long-term results.

[1]  Ivan Ng,et al.  Polyetheretherketone implants for the repair of large cranial defects: a 3-center experience. , 2014, Neurosurgery.

[2]  Aatman Shah,et al.  Materials used in cranioplasty: a history and analysis. , 2014, Neurosurgical focus.

[3]  A. Reisner,et al.  Hydroxyapatite Cement in Craniofacial Reconstruction: Experience in 150 Patients , 2006, Plastic and reconstructive surgery.

[4]  J. Fandino,et al.  Combined Bone and Soft-Tissue Augmentation Surgery in Temporo-Orbital Contour Reconstruction , 2011, The Journal of craniofacial surgery.

[5]  S. Schneider,et al.  Methyl methacrylate cranioplasty in children: long-term results. , 1997, Pediatric neurosurgery.

[6]  C. Pérez-López,et al.  Reconstrucción craneal mediante malla de titanio y cemento de apatita carbonatada , 2004 .

[7]  W. Binder,et al.  Custom-designed facial implants. , 2008, Facial plastic surgery clinics of North America.

[8]  M. Yaremchuk,et al.  Facial Skeletal Reconstruction Using Porous Polyethylene Implants , 2003, Plastic and reconstructive surgery.

[9]  J. Persing,et al.  Does an Elevated Bony Ridge Along the Course of the Metopic Suture Equal Metopic Synostosis? Implications for Management , 2014, The Journal of craniofacial surgery.

[10]  U. Steinseifer,et al.  Cranioplasty with customized titanium and PEEK implants in a mechanical stress model. , 2012, Journal of neurotrauma.

[11]  J J Kuttenberger,et al.  Long-term results following reconstruction of craniofacial defects with titanium micro-mesh systems. , 2001, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[12]  J. Poukens,et al.  A treatment algorithm for patients with large skull bone defects and first results. , 2011, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[13]  Neha Goel,et al.  Calvarial Reconstruction With Polyetheretherketone Implants , 2009, Annals of plastic surgery.

[14]  T. Nieminen,et al.  Amorphous and crystalline polyetheretherketone: Mechanical properties and tissue reactions during a 3-year follow-up. , 2008, Journal of biomedical materials research. Part A.

[15]  T. Okumura,et al.  [Alumina ceramic (Bioceram) as the cranioplastic material--experimental study and application in cranioplasty]. , 1984, No shinkei geka. Neurological surgery.

[16]  F. Lauwers,et al.  One-step primary reconstruction for complex craniofacial resection with PEEK custom-made implants. , 2014, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[17]  H. Iwamuro,et al.  Analyses of the factors influencing bone graft infection after delayed cranioplasty , 2006, Acta Neurochirurgica.

[18]  Zhi Yang Ng,et al.  Computer-Designed PEEK Implants: A Peek Into The Future of Cranioplasty? , 2014, The Journal of craniofacial surgery.

[19]  Patrick J Byrne,et al.  Use of customized polyetheretherketone (PEEK) implants in the reconstruction of complex maxillofacial defects. , 2009, Archives of facial plastic surgery.