Additive manufacturing (AM) is rapidly gaining acceptance in the healthcare sector. Three-dimensional (3D) virtual surgical planning, fabrication of anatomical models, and patient-specific implants (PSI) are well-established processes in the surgical fields. Polyetheretherketone (PEEK) has been used, mainly in the reconstructive surgeries as a reliable alternative to other alloplastic materials for the fabrication of PSI. Recently, it has become possible to fabricate PEEK PSI with Fused Filament Fabrication (FFF) technology. 3D printing of PEEK using FFF allows construction of almost any complex design geometry, which cannot be manufactured using other technologies. In this study, we fabricated various PEEK PSI by FFF 3D printer in an effort to check the feasibility of manufacturing PEEK with 3D printing. Based on these preliminary results, PEEK can be successfully used as an appropriate biomaterial to reconstruct the surgical defects in a “biomimetic” design.

With the rapid progression of additive manufacturing and the emergence of new 3D printing technologies, accuracy assessment is mostly being performed on isosymmetric-shaped test bodies. However, the accuracy of anatomic models can vary. The dimensional accuracy of root mean square values in terms of trueness and precision of 50 mandibular replicas, printed with five common printing technologies, were evaluated. The highest trueness was found for the selective laser sintering printer (0.11 ± 0.016 mm), followed by a binder jetting printer (0.14 ± 0.02 mm), and a fused filament fabrication printer (0.16 ± 0.009 mm). However, highest precision was identified for the fused filament fabrication printer (0.05 ± 0.005 mm) whereas other printers had marginally lower values. Despite the statistically significance (p < 0.001), these differences can be considered clinically insignificant. These findings demonstrate that all 3D printing technologies create models with satisfactory dimensional accuracy for surgical use. Since satisfactory results in terms of accuracy can be reached with most technologies, the choice should be more strongly based on the printing materials, the intended use, and the overall budget. The simplest printing technology (fused filament fabrication) always scored high and thus is a reliable choice for most purposes. therefore apply to different fields of medicine and dentistry. With the continuous development of each individual technology, none stand out significantly from the others and so all are represented in the daily medical routine.Even though AM was introduced into medicine many years ago, the production of anatomical models often is still one of the main areas of application [3][4][5][6]. In opinion polls, surgeons still tend to regard anatomical models as advantageous for daily work [7]. For instance, anatomical models offer numerous advantages over other learning resources in understanding complex anatomical correlations [8]. The combination of optical and tactile sensitivity leads to a superior understanding and has defined the concept "touch to comprehend" [9]. A meta-analysis of 158 studies from 2005 to 2015 described further advantages such as possibilities for preoperative planning and time savings in the operating room, but emphasized that accuracy was not satisfactory in 34 studies [10]. Although most manufacturers provide the specifications in terms of accuracy, these are mostly uncertain in the final clinical application. In addition, most tests are performed on isosymmetric-shaped bodies [11], but the use of anatomical models may reveal larger dimensional errors. Measurements with skull and mandibular models revealed incorrect or completely missing anatomy [12]. Even deformations of 3D printed dental surgical guides were reported [13]. Inaccuracies in 3D printing applications can lead to inappropriate treatment that could harm the patient.Identical procedures with the same material under the same circumstances do not necessary lead to identical results. Statistical standards descr...

Summary:Craniofacial defects often result in aesthetic and functional deficits, which affect the patient’s psyche and wellbeing. Patient-specific implants remain the optimal solution, but their use is limited or impractical due to their high costs. This article describes a fast and cost-efficient workflow of in-house manufactured patient-specific implants for craniofacial reconstruction and cranioplasty. As a proof of concept, we present a case of reconstruction of a craniofacial defect with involvement of the supraorbital rim. The following hybrid manufacturing process combines additive manufacturing with silicone molding and an intraoperative, manual fabrication process. A computer-aided design template is 3D printed from thermoplastics by a fused deposition modeling 3D printer and then silicone molded manually. After sterilization of the patient-specific mold, it is used intraoperatively to produce an implant from polymethylmethacrylate. Due to the combination of these 2 straightforward processes, the procedure can be kept very simple, and no advanced equipment is needed, resulting in minimal financial expenses. The whole fabrication of the mold is performed within approximately 2 hours depending on the template’s size and volume. This reliable technique is easy to adopt and suitable for every health facility, especially those with limited financial resources in less privileged countries, enabling many more patients to profit from patient-specific treatment.