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Treatment of Facial Deformities using 3D Planning and Printing of Patient-Specific Implants
Published on: May 23, 2020
Complications After Patient-specific Implants for Facial Contouring and Augmentation: A Systematic Review and
Rasmus Kofod Steengaard1,2, Mathias Ørholt1, Mikkel Herly1
1From the Department of Plastic Surgery and Burns Treatment, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Plastic and Reconstructive Surgery. Global Open
|August 6, 2026
Summary
Patient-specific implants (PSIs) made from titanium (Ti) and polyetheretherketone (PEEK) show similar low complication rates for craniofacial reconstruction. Material choice should be individualized based on patient needs and anatomical site.
Area of Science:
- Biomaterials Science
- Craniofacial Surgery
- Medical Device Engineering
Background:
- Patient-specific implants (PSIs) from titanium (Ti) and polyetheretherketone (PEEK) are increasingly utilized for craniofacial contouring and reconstruction.
- A comparative analysis of clinical outcomes between Ti and PEEK PSIs is essential for guiding material selection in reconstructive surgery.
Purpose of the Study:
- To compare the clinical outcomes of patient-specific implants (PSIs) manufactured from titanium (Ti) versus polyetheretherketone (PEEK) in craniofacial reconstruction.
- To evaluate complication rates, healing issues, placement accuracy, and patient satisfaction associated with Ti and PEEK PSIs.
Main Methods:
- A systematic literature search was conducted across PubMed, Embase, and Cochrane Library for clinical studies on Ti and PEEK PSIs in facial reconstruction.
- Single-arm random-effects meta-analyses were performed to estimate pooled event rates for primary outcomes (complications, infection, explantation, healing issues) and secondary outcomes (accuracy, satisfaction).
- The review adhered to PRISMA 2020 and MOOSE guidelines, comparing materials through subgroup tests.
Main Results:
- The meta-analysis included 29 studies with 392 patients and 543 implants (447 PEEK, 96 Ti).
- Pooled overall complication rates were 6.94% for PEEK and 4.77% for Ti, with no statistically significant difference between materials (P=0.58).
- Infection, explantation, and healing-related issues showed low rates for both materials, with no significant between-material differences. Patient satisfaction improved significantly postoperatively for PEEK implants.
Conclusions:
- Both titanium (Ti) and polyetheretherketone (PEEK) patient-specific implants (PSIs) exhibit low complication rates in craniofacial reconstruction, with no clear material superiority when accounting for study variability.
- Individualized material selection based on anatomical site, imaging requirements, and revision strategies is recommended.
- Further prospective, standardized, head-to-head studies with extended follow-up are necessary to definitively establish material-specific advantages.
