Reconstructive Prosthetics North Bristol NHS Trust, Gate 24, Level 1, Brunel Building, Southmead Hospital, Southmead Road, Westbury-on-Trym, Bristol, BS10 5NB, UK.
J Craniomaxillofac Surg. 2017 Dec;45(12):2017-2027. doi: 10.1016/j.jcms.2017.09.020. Epub 2017 Sep 28.
This study investigated the effect of varying techniques on the surface characteristics of pressed titanium cranioplasty plates, commonly manufactured in laboratory practice. The aim was to highlight the variety of techniques currently used, assess these methods of manufacture and produce manufacturing recommendations.
A questionnaire identified manufacturing methods commonly used by maxillofacial prosthetists. The plate surfaces were examined using scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) spectrometry. The surface differences and titanium compositions were statistically analysed.
Bead blasting with aluminium oxide (AlO) showed a significant decrease (p < 0.001) in titanium surface composition, replaced by a large aluminium content. Trimming tool choice had a significant impact (p = 0.001) on surface contamination by smoothing wheel material deposition; however passivation and anodising techniques had no significant effect (p = 0.293 and p = 0.257, respectively) on the surface composition or roughness of titanium samples.
A large range of manufacturing techniques of titanium cranioplasty plates was confirmed and significant differences were found. Amongst other recommendations, bead blasting with AlO is not recommended for commercially pure titanium implant surface finishing due to aluminium contamination. The recommendations outlined will minimise manufacturing time, reduce risk of complication (thus costs) and unify methods to enable a safe, reliable treatment.
本研究旨在探讨不同技术对实验室常规制作的钛颅骨修补板表面特性的影响。旨在强调目前使用的各种技术，评估这些制造方法，并提出制造建议。
问卷调查确定了颌面修复师常用的制造方法。使用扫描电子显微镜（SEM）和能谱（EDX）对板表面进行了检查。对表面差异和钛成分进行了统计学分析。
氧化铝（AlO）喷砂处理使钛表面成分显著减少（p<0.001），取而代之的是大量的铝含量。打磨工具的选择对平滑轮材料沉积引起的表面污染有显著影响（p=0.001）；然而，钝化和阳极氧化技术对钛样品的表面成分或粗糙度没有显著影响（p=0.293 和 p=0.257）。
确认了钛颅骨修补板的大量制造技术，并发现了显著差异。除其他建议外，由于铝污染，不建议对纯钛植入物表面进行 AlO 喷砂处理。所概述的建议将最大限度地减少制造时间，降低并发症（因此成本）风险，并统一方法，以实现安全、可靠的治疗。
