The Use Of 3-dimensional (3D) Custom-made Hydroxyapatite Epoxide Acrylate Maleic (EH) Composite Bone Cement Implants In Craniofacial Plasty

Objective:Craniofacial bone defects, mainly caused by trauma, infection and craniectomy for cerebral decompression procedures, tend to carry severe functional and esthetic deficiencies. Craniofacial plasty is an ancient surgical intervention to reverse the altered morphological and physiological state by replacing the defects with succedaneums. A variety of materials have been applied as substitutes through the development of craniofacial plasty. Still there is no such material that is consented by all surgeons. This article is meant to present our experience of using 3-dimensional (3D) custom-made hydroxyapatite/epoxide acrylate maleic (EH) composite bone cement implants in craniofacial plasty, and to make a quantitative assessment on the implant.Method:A total of 11 patients were carried out craniofacial plasty with 3D custom-made EH compound implants in our department during November 2008 to August 2015. After taking history, photos and high-resolution computed tomographic scanning (HRCT) of patients were taken routinely. And a three dimensional graph of the cranium can be obtained from the CT data with computer software. Custom implants were then designed on the basis of cranial symmetry in software and data was transferred to a rapid printing machine to guide the fabrication procedure. Surgical outcomes and complications were estimated by comparing photographs taken before and after the surgery and postoperative follow-up of patients. All the patients and surgeons were required to grade the operation in 3 levels from bad to perfect.Results:Of all the 11 patients, Implants were inserted to patients following the preoperative plan successfully. And all patients got significant improvement in contouring symmetry after surgery. No complication such as wound infection, rejection, implant fracture or migration was noted. Any adjustment or taking out of the implant was not necessary. All patients and surgeons were satisfied with the operation procedure and the postoperative appearance improvement.Conclusion:The EH compound implant is a good choice for craniofacial plasty.3D custom-made EH implants show great advantages in elevating cosmetic satisfactions and reducing complications by accurate reconstruction and shorten operation time. Both patients and surgeons are satisfied with its outcome.