Cranial polyetheretherketone implants by extrusion–based additive manufacturing: state of the art and prospects

Katschnig, Matthias; Holzer, Clemens

doi:10.15406/mseij.2018.02.00036

Cited by 4 publications

(5 citation statements)

References 22 publications

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“…PEEK PSIs are used clinically in a wide medical field [30]. Various studies conducted with PEEK in the reconstruction of maxillofacial defects have shown good postoperative aesthetic and functional results without any complications [31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Biofunctional Glycol-Modified Polyethylene Terephthalate and Thermoplastic Polyurethane Implants by Extrusion-Based Additive Manufacturing for Medical 3D Maxillofacial Defect Reconstruction

et al. 2020

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This work addresses the topic of extrusion-based additive manufacturing (filament-based material extrusion) of patient-specific biofunctional maxillofacial implants. The technical approach was chosen to overcome the shortcomings of medically established fabrication processes such as a limited availability of materials or long manufacturing times. The goal of the work was a successful fabrication of basic implants for defect reconstruction. The underlying vision is the implants’ clinic-internal and operation-accompanying application. Following a literature search, a material selection was conducted. Digitally prepared three-dimensional (3D) models dealing with two representative mandible bone defects were printed based on the material selection. An ex-vivo model of the implant environment evaluated dimensional and fitting traits of the implants. Glycol-modified PET (PETG) and thermoplastic polyurethane (TPU) were finally selected. These plastics had high cell acceptance, good mechanical properties, and optimal printability. The subsequent fabrication process yielded two different implant strategies: the standard implant made of PETG with a build-up rate of approximately 10 g/h, and the biofunctional performance implant with a TPU shell and a PETG core with a build-up rate of approximately 4 g/h. The standard implant is meant to be intraoperatively applied, as the print time is below three hours even for larger skull defects. Standard implants proved to be well fitting, mechanically stable and cleanly printed. In addition, the hybrid implant showed particularly cell-friendly behavior due to the chemical constitution of the TPU shell and great impact stability because of the crack-absorbing TPU/PETG combination. This biofunctional constellation could be used in specific reconstructive patient cases and is suitable for pre-operative manufacturing based on radiological image scans of the defect. In summary, filament-based material extrusion has been identified as a suitable manufacturing method for personalized implants in the maxillofacial area. A further clinical and mechanical study is recommended.

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Section: Discussionmentioning

confidence: 99%

Biofunctional Glycol-Modified Polyethylene Terephthalate and Thermoplastic Polyurethane Implants by Extrusion-Based Additive Manufacturing for Medical 3D Maxillofacial Defect Reconstruction

et al. 2020

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“…Repeating this process builds up the object one layer at a time, thus additively. [16][17][18][19][20] Regarding 21 processing PEEK needs specific machine configurations including full metal hot end with heating up to approximately 500°C and build chamber isolation system for sensitive components like stepper motors. Currently, AM of PEEK cranial implants is limited to cartesian printers regarding Gebhardt et al, 8 and Thieringer et al, 22 which means the use of 3-axis-kinematics.…”

Section: Extrusion-based Am Approaches For Psismentioning

confidence: 99%

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2018

MSEIJ

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“…Two main materials that have been used for prefabricating patient-specific implants were Ti and PEEK. In the case of Ti, either selective laser melting or electron beam melting or mold pressing could be used whereas traditional milling, selective laser sintering and fused deposition modeling were generally used for PEEK (Peel et al , 2017; Katschnig and Holzer, 2018). Both materials favorably displayed a comparable complication rate to those of other implants with overall satisfactory aesthetic results (Alonso-Rodriguez et al , 2015; Williams et al , 2015).…”

Section: Introductionmentioning

confidence: 99%

Cranial reconstruction using prefabricated direct 3DP porous polyethylene

Rukskul

Suvannapruk

Suwanprateeb

2019

RPJ

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Purpose The purpose of this study is to evaluate the intra- and post-operative performance and safety of direct three dimensional printing (3DP) porous polyethylene implants in cranial reconstruction. Design/methodology/approach Prefabricated porous polyethylene implants were prepared by direct 3DP, and cranioplasty implantation was performed. Postoperative aesthetics, patient satisfaction, firmness of the implant, reactions to the implant and 3D computed tomography (CT) scanning were assessed after 2, 6, 12 and 24 months postoperatively. Findings No complications after surgery were encountered. Excellent aesthetic results were obtained in all cases, and all the patients were satisfied with the reconstruction outcome. Bone density structure was found to ingrowth into these direct 3DP porous polyethylene implants and the content increased with increasing follow-up times. Research limitations/implications This study was a pilot study conducted in a single group and evaluated in a short-term period. The bone formation and ingrowth were indirectly assessed by 3D CT evaluation. Originality/value This work reported the use and evaluation of direct 3DP porous polyethylene in middle- to large-sized cranial reconstructions. It evidently showed the bonding of implants to surrounding tissues which would result in the long-term stability and infection resistance of the implant.

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Cranial polyetheretherketone implants by extrusion–based additive manufacturing: state of the art and prospects

Cited by 4 publications

References 22 publications

Biofunctional Glycol-Modified Polyethylene Terephthalate and Thermoplastic Polyurethane Implants by Extrusion-Based Additive Manufacturing for Medical 3D Maxillofacial Defect Reconstruction

Biofunctional Glycol-Modified Polyethylene Terephthalate and Thermoplastic Polyurethane Implants by Extrusion-Based Additive Manufacturing for Medical 3D Maxillofacial Defect Reconstruction

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Cranial reconstruction using prefabricated direct 3DP porous polyethylene

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