Low-Cost Cranioplasty—A Systematic Review of 3D Printing in Medicine

Abstract

The high cost of biofabricated titanium mesh plates can make them out of reach for hospitals in low-income countries. To increase the availability of cranioplasty, the authors of this work investigated the production of polymer-based endoprostheses. Recently, cheap, popular desktop 3D printers have generated sufficient opportunities to provide patients with on-demand and on-site help. This study also examines the technologies of 3D printing, including SLM, SLS, FFF, DLP, and SLA. The authors focused their interest on the materials in fabrication, which include PLA, ABS, PET-G, PEEK, and PMMA. Three-dimensional printed prostheses are modeled using widely available CAD software with the help of patient-specific DICOM files. Even though the topic is insufficiently researched, it can be perceived as a relatively safe procedure with a minimal complication rate. There have also been some initial studies on the costs and legal regulations. Early case studies provide information on dozens of patients living with self-made prostheses and who are experiencing significant improvements in their quality of life. Budget 3D-printed endoprostheses are reliable and are reported to be significantly cheaper than the popular counterparts manufactured from polypropylene polyester.

A Single Standard Polyvinyl Chloride 3D Skull Model to Create the Polymethyl Methacrylate Cranioplasty Flap: A Novel and Low-Cost Technique

“…[22][23][24] The costs of customized PMMA (computer-aided design/computer-aided manufacturing [CAD/CAM] version) and acrylonitrile butadiene styrene (ABS) implants are much higher than the cost of the PMMA implant used in this study. 22,25 The total cost incurred using our technique was approximately US$200, including all materials required for surgery, postoperative medication, investigations and hospital charges. 26 The use of a single PVC plastic skull model as a guide to create the PMMA cranioplasty in our study contributed greatly to the reduced procedure cost.…”

Custom-Made 3D-Printed Implants for Anterior Column Reconstruction in the Upper Cervical Spine after Intralesional Extracapsular Excision—Report of 2 Cases and Literature Review

“…Other authors [ 10 , 13 , 14 , 16 , 17 ] were reported to have produced more implants of different sizes ranging from 2 [ 14 ] to 32 [ 10 ]. This needs to be taken into consideration in an eventual cost-effectiveness analysis on the use of 3D-printed implants [ 20 , 21 ].…”

Application of 3D Printing in Bone Grafts

“…The skull, especially when damaged in the face area, can be quite challenging and requires a significant amount of manual postprocessing [ 143 ]. After the process of computer-aided design is complete, the precise scaffolding design is created [ 144 , 145 ]. During production, scaffolding requires a precise shape, size, and mechanical and biological properties to improve the reliability of patient outcomes after surgery [ 11 , 146 ].…”