Computer-assisted prefabrication of individual craniofacial implants

Historically, reconstruction of the skull with intraoperatively modeled implants has been restricted severely by limitations in implant material, unpredictable aesthetic results, prolonged OR time, and indirect techniques that cause decreased precision and increased expense. This article discusses modern computer-aided design and manufacturing systems that allow for direct preoperative fabrication of implants out of pure titanium with a variety of enhanced construction details. Between 1997 and 1999, 135 cranial and craniofacial reconstructions with defects measuring up to 22 cm were performed using this technique at 25 health care centers in Europe. The results obtained in these patients were predictable and constant and demonstrated dramatically reduced OR times.