Effects of skeletal fixation on craniofacial imaging

Area of Science:

• Biomedical Engineering
• Radiology
• Materials Science

Background:

• Plate and screw fixation systems are crucial in craniomaxillofacial surgery.
• The metallic composition of these implants can cause artifacts in medical imaging.
• Understanding these artifacts is essential for accurate diagnosis and surgical planning.

Purpose of the Study:

• To evaluate the imaging artifacts caused by different metal compositions in craniofacial fixation systems.
• To compare the image clarity of titanium, stainless steel, and cobalt-chromium-molybdenum alloys.
• To assess the influence of overlying soft tissue on imaging artifacts.

Main Methods:

• Cadaveric craniomaxillofacial skeletons were used for assessment.
• Computed tomographic (CT) scanning was employed to capture imaging data.
• Three-dimensional (3D) reconstructions were generated to analyze image quality.

Main Results:

• Significant differences in image clarity were observed among titanium, stainless steel, and cobalt-chromium-molybdenum alloy onlay fixation systems.
• The presence or absence of overlying soft-tissue density (facial drape) did not significantly alter these imaging differences.
• Artifacts were reduced when plates were placed in an intrabony location, as demonstrated in a plaster model.

Conclusions:

• The metal composition of craniofacial fixation systems directly impacts CT imaging artifact severity and 3D reconstruction quality.
• Implant material selection is a critical factor influencing diagnostic image interpretation in craniomaxillofacial applications.
• Intrabony placement may mitigate imaging artifacts compared to onlay applications, though material differences persist.