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Complications with PMMA compared with other materials used in cranioplasty: a systematic review and meta-analysis

Rafaella de Souza Leão1, Juliana Raposo Souto Maior1, Cleidiel Aparecido de Araújo Lemos2

  • 1Universidade de Pernambuco - UPE, Dentistry School, Recife, PE, Brazil.

Brazilian Oral Research
|June 14, 2018
PubMed

Insights

Polymethyl methacrylate (PMMA) offers complication rates comparable to autologous bone and titanium mesh for cranioplasty. This systematic review found no significant differences in complication rates between PMMA and other materials, supporting its use.

Area of Science:

  • Neurosurgery
  • Biomaterials Science
  • Medical Engineering

Background:

  • Cranioplasty is a surgical procedure to repair skull defects.
  • Polymethyl methacrylate (PMMA) is a commonly used material, but its complication profile requires comparison.
  • No definitive consensus exists on the optimal material for cranioplasty regarding complication minimization.

Purpose of the Study:

  • To systematically review and meta-analyze complication rates of PMMA versus autologous bone and titanium mesh in cranioplasty.
  • To determine if PMMA prostheses exhibit similar complication rates to autologous bone and titanium mesh.

Main Methods:

  • Systematic literature search on PubMed/MEDLINE, Scopus, and Web of Science.
  • Meta-analysis of complication rates from 11 eligible studies involving 1,256 patients and 1,278 cranioplasties.
  • Comparison of risk ratios (RR) and 95% confidence intervals (CI) for dichotomous outcomes.

Main Results:

  • No significant difference in complication rates between PMMA and autologous bone (RR, 0.98; 95%CI, 0.54-1.75; p=0.94).
  • No significant difference in complication rates between PMMA and titanium mesh (RR, 1.59; 95%CI, 0.57-4.48; p=0.38).
  • Sub-analysis based on craniotomy reason (trauma/non-trauma) showed no significant difference (RR, 0.95; 95%CI, 0.37-2.42; p=0.91).

Conclusions:

  • PMMA demonstrates complication rates comparable to autologous bone and titanium mesh for cranioplasty.
  • PMMA is a viable option for cranioplasty, with similar safety profiles to established materials.
  • Further research may refine optimal material selection based on specific patient factors and defect types.

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