Integrated polyetheretherketone patient-specific implants for multi-subunit midface concavity: a retrospective case...

Correction of multi-subunit midface concavity in patients without malocclusion remains challenging when multiple prefabricated implants are used, because implant transitions may be irregular and dissection around the infraorbital foramen is technically demanding. This study evaluated the feasibility, safety, and short-term aesthetic outcomes of integrated polyetheretherketone patient-specific implants designed using computer-aided design and manufacturing technology.

This retrospective case series screened consecutive adults treated with bilateral integrated PEEK patient-specific implants for multi-subunit midface concavity. Eligible patients had normal or essentially normal occlusion, clinical and CT-based moderate-to-severe concavity involving at least two adjacent subunits, adequate soft-tissue coverage, and completed postoperative follow-up. Demographic, implant-planning, satisfaction, and adverse-event data were reviewed. The primary outcome was late postoperative patient-reported aesthetic satisfaction assessed using a modified GAIS-derived 5-point scale. Early (10-30 days) and late (>90 days) satisfaction scores were compared using the Wilcoxon signed-rank test.

Sixty-two implants were placed in 31 patients. The mean follow-up was 8.3 ± 2.1 months. Implant placement was successful in all cases, and no intraoperative reshaping was required. Late postoperative satisfaction scores were significantly higher than early postoperative scores (P < 0.01). At late follow-up, 28 patients (90.3%) were satisfied or very satisfied. Transient postoperative edema occurred in all patients, and transient upper-lip or infraorbital-region hypoesthesia occurred in 12 patients (38.7%), resolving spontaneously within 3 months. No infection, implant exposure, migration, extrusion, chronic inflammation, sinus tract formation, or permanent infraorbital nerve injury was observed.

Integrated polyetheretherketone patient-specific implants appear to be a feasible option for selected patients with multi-subunit midface concavity and normal or essentially normal occlusion. The integrated patient-specific design may support customized skeletal augmentation across adjacent midfacial subunits and individualized aesthetic planning. Further studies with longer follow-up, comparative controls, and objective three-dimensional outcome assessment are warranted.