[Reconstruction in craniofacial contour and continuity defects with preoperatively designed individual implants]

Area of Science:

• Biomaterials Science
• Medical Engineering
• Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM)

Context:

• Craniofacial bone defect reconstruction traditionally involves intraoperative modeling, limiting material choices and aesthetic predictability.
• This often leads to prolonged surgical procedures and increased patient stress.

Purpose:

• To evaluate a novel CAD/CAM-based approach for prefabricating patient-specific titanium prostheses for craniofacial bone defect reconstruction.
• To assess the precision, predictability, and efficiency of this digital workflow.

Summary:

• Helical CT data is used to create 3D models of bony defects, enabling the design and milling of custom titanium prostheses with precise margins (0.25 mm) and harmonious surface contours.
• Integrated fixation elements accommodate microplate dimensions, addressing challenges with screw hole placement in thin prosthesis margins.
• Eighteen patients with post-traumatic or postoperative cranial defects underwent reconstruction using this method, with uniformly uneventful wound healing.

Impact:

• This digital fabrication technique significantly reduces surgical duration and provides predictable, consistent aesthetic and functional results.
• It offers a precise and efficient alternative to traditional intraoperative methods for complex craniofacial reconstructions.