Reconstruction of Frontal Bone Using Specific Implant Polyether-Ether-Ketone

Abstract

Defects on the craniofacial complex may result in aesthetic defects, functional damage, and psychologic consequences. Previously, surgeons showed no interest in reconstructing the operated area, but in the treatment of the problem, leaving bone contour is a secondary issue. Nowadays, area reconstruction with post-reestablishment of contour and local shape has become one of the surgeon's priorities. The use of alloplastic implants with specific digital design has been stated to be an effective technique on the treatment of craniofacial defects, reducing the need for manipulation in the intraoperative period and decreasing surgery time. Polyether ether ketone (PEEK) is a potential candidate because it is a linear polyaromatic semicrystalline polymer that combines strength, stiffness, durability, and resistance. Polyether ether ketone biocompatibility has been supported in literature, and subsequent medical applications of the material have been observed. The aim of this study was to describe a case of frontal bone defect reconstruction in which the PEEK was used as polymer material in a specific implant for the Synthes (PEEK-PSI) patient.

Computer-Designed PEEK Implants

“…Although there are reports of PEEK cranioplasty for frontal bone reconstruction, 9,10 we feel that PEEK may not be suitable in these instances, especially for large defects, due to the manufacturing process which may limit the size and curvature of the final implant. Certainly, 2 or more implants may be utilized in tandem for such curved defects, but we feel that the increased strength afforded by titanium implants would be more suitable in such scenarios.…”

“…8 However, this may lead to undercorrection of the fracture due to inadequate exposure of the fracture site, and some reports claim that the main reason for the failure to restore entrapped structures in orbital floor fractures is incomplete reduction around the infraorbital artery. 9 Therefore, even though many surgeons only perform minimal dissection around the infraorbital neurovascular bundle in most cases, manipulation of the bundle is inevitable in cases where the infraorbital groove or canal is excessively involved. Moreover, if the surgery was delayed and there was extensive adhesion of the herniated contents with the infraorbital neurovascular bundle, more aggressive dissection is required.…”

3D modeling, custom implants and its future perspectives in craniofacial surgery

“…[32] CAD designed PEEK custom implants have been used to correct cranial, frontal, malar and mandibular defects. [3334]…”

The Use of a Polyetheretherketone (PEEK) Implant to Reconstruct the Midface Region

“…It has been most studied in the field of orthopedics such as joint replacement surgery, 3 but also for dental prostheses, 4 (cranial vault reconstruction and cardiac implants (such as valves, pacemakers, or pumps). 5 Their use has been scantily described in the orbital region including reconstructive surgery after orbital floor fractures and complex frontoorbital reconstructions. 6,7 As far as we are aware, there has been only 1 report describing the use of this biosynthetic material in the maxillofacial region describing 2 cases of postsurgical unsatisfactory results following repair of trauma and long face syndrome.…”