Novel composite implant in craniofacial bone reconstruction

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Craniofacial Surgery

Background:

• Bioactive glass (BAG) offers bone integration but lacks intraoperative shaping capabilities.
• Polymethyl methacrylate (PMMA) is shapeable but does not bond to bone and is exothermic.
• Limitations of standalone BAG and PMMA hinder optimal craniofacial reconstruction.

Purpose of the Study:

• To develop and evaluate a novel composite implant combining BAG and PMMA for craniofacial reconstruction.
• To assess the clinical and radiological outcomes of the BAG-PMMA implant in patients with large bone defects.
• To investigate the potential of additive manufacturing in creating custom-made implants for complex reconstructions.

Main Methods:

• A composite implant was fabricated using additive manufacturing, with a PMMA core coated in BAG granules.
• Three patients with calvarial defects and one with a midface defect received custom-made BAG-PMMA implants.
• Clinical and radiological assessments, including CT and PET-CT, were conducted over a 5-year follow-up period.

Main Results:

• All patients demonstrated uneventful clinical recovery with satisfactory esthetic and functional outcomes.
• Radiological evaluations (CT and PET-CT) corroborated the positive clinical findings.
• The BAG-PMMA composite implant exhibited good integration and stability in the reconstructed craniofacial defects.

Conclusions:

• The BAG-PMMA composite implant represents a promising alternative for craniofacial reconstruction, addressing limitations of individual materials.
• Additive manufacturing facilitates the creation of patient-specific implants for complex bone defect repair.
• Further clinical investigation is warranted to establish the long-term efficacy and broader applicability of this novel biomaterial.