Reconstruction of Post-Traumatic Orbital Defects and Deformities with Custom-Made Patient-Specific Implants: Evaluation of the Efficacy and Clinical Outcome

Abstract

The main purpose of this article is to evaluate the efficacy of patient-specific implants (PSI) in treatment of patients with post-traumatic orbital defects and deformities. Twenty-three patients with post-traumatic orbital defects and deformities, who underwent subsequent reconstructive procedures using PSI, were included in the study. All the patients were examined according to the standard algorithm involving the local status examination, vision assessment, and computed tomography before and after surgery. The study findings show neither postoperative infectious complications nor decreased visual acuity or loss of visual fields. Functional disorders resolved in 65.2% of cases 1 month after the surgical intervention and in 86.96% of patients within a 3-month term. Positive aesthetic outcomes were seen in 95.7% of cases. Reconstruction with computer-aided design/computer-aided manufactured PSI is an effective procedure that allows accurate restoring of the complex orbital anatomy.

A Multi-Criteria Assessment Strategy for 3D Printed Porous Polyetheretherketone (PEEK) Patient-Specific Implants for Orbital Wall Reconstruction

“…In addition, PEEK onlay implants have been utilized in zygoma contour augmentation [31,32] and mandibular angle reconstructive surgeries [59]. While the use of CAD/CAM milled PEEK orbital implants have been documented in the literature [60,61], the production of porous, mesh-like orbital implants by FFF is relatively new. With improvement in AM systems, the potential for customized FFF 3D printed PEEK implants has surfaced, boosting interest in POC manufacturing [25,26,30].…”

Evaluation of Customized Polyether Ether Ketone Implant in Reconstruction of Orbital Floor Fractures (Clinical Trial)”

“…The most commonly utilized alloplastic material for orbital reconstruction, the stock titanium mesh comes with a 0.4 mm thickness. However this minimal thickness is to allow the operator to preadapt the mesh to the innate and bizarre anatomical configuration of the orbit (31).On the other hand, a customized patient-specific hardware does not need an operativemodification, and they meticulously fit the anatomical configuration of the orbit. Alexandria Dental Journal.…”

“…Furthermore, the rigid nature of the polymer requires a minimum thickness in order to evade deformation. There is a consensus about the minimum producible thickness of PEEK material using milling machines, which is based on the manufacture recommendation is 0.4 mm (9,30,31). Sharma et al (2021) conducted a computational finite element orbital model to test the durability and maximum deformation values for different thicknesses and porosity of PEEK orbital sheets (32).…”

“…Wang et al (2021) even reported an antibacterial effect for the PEEK material, making it a more favorable reconstructive option for orbital defects (34). Furthermore, the PEEK sheet is capable of handling several cycles of the heat and moist sterilization process while attaining its convenient physical and mechanical properties (9,31,33) Transient paresthesia in the ramification course of the infraorbital nerve was reported in the first follow-up period, however by the end of the follow-up period all of the investigated subjects regained normal sensation. The infraorbital nerve is in a vulnerable position to injury or entrapment within a collapsed infraorbital canal during orbito-zygomatic fracture.…”

A Multi-Criteria Assessment Strategy for 3d Printed Porous Polyetheretherketone (Peek) Patient-Specific Implants for Orbital Wall Reconstruction

“…The advanced capabilities of 3D CAD modeling and printing technology are changing a wide range of medical specialties, with craniomaxillofacial surgery being one of the most significant benefactors. While the use of CAD/computer-aided manufactured (CAM) milled PEEK orbital implants has been documented in the literature [43][44][45], the production of porous, mesh-like orbital implants by FFF is relatively new. With improvement in AM systems, the potential for customized FFF 3D printed PEEK implants has surfaced, boosting interest in POC manufacturing [16,17,21].…”