da Silva Júnior Erasmo Barros, de Aragão Afonso Henrique, de Paula Loureiro Marcelo, Lobo Caetano Silva, Oliveti Ana Flávia, de Oliveira Rafael Martinelli, Ramina Ricardo
Department of Neurosurgery, Instituto de Neurologia de Curitiba, Jeremias Maciel Perretto, 300 - Campo Comprido, Curitiba, Paraná, 81210-310, Brazil.
Post-Graduation Department of Industrial Biotechnology, Universidade Positivo, Curitiba, Brazil.
3D Print Med. 2021 Feb 6;7(1):4. doi: 10.1186/s41205-021-00096-7.
Different methods of cranioplasty for the reconstruction of bony skull defects exist. In the absence of the autologous bone flap, a customised manufactured implant may be the optimal choice, but this implant has several limitations regarding its technical standardisation and better cost-effectiveness.
This study presents a series of 16 consecutive patients who had undergone cranioplasty with customised three-dimensional (3D) template moulds for polymethylmethacrylate (PMMA) implants manufactured after 3D modelling on a specific workstation. The virtual images were transformed into a two-piece physical model using a 3D printer for the biomaterials. PMMA implant was produced intraoperatively with the custom mould. Cosmetic results were analysed by comparing pre- and postoperative 3D computed tomography (CT) images and asking if the patient was satisfied with the result.
The average total time for planning and production of customised mould was 10 days. The 16 patients were satisfied with the result, and CT images presented harmonious symmetry when comparing pre- and postoperative scans. Cases of postoperative infection, bleeding, or reoperation in this series were not observed.
Cranioplasty with high-technology customised 3D moulds for PMMA implants can allow for an aesthetic reconstruction with a fast and cost-effective manufacturing process and possibly with low complication rates.
存在多种用于颅骨缺损重建的颅骨成形术方法。在没有自体骨瓣的情况下，定制制造的植入物可能是最佳选择，但这种植入物在技术标准化和更好的成本效益方面存在一些局限性。
本研究介绍了一系列连续16例患者，他们接受了颅骨成形术，使用定制的三维（3D）模板模具制作聚甲基丙烯酸甲酯（PMMA）植入物，该模具是在特定工作站上进行3D建模后制造的。使用3D打印机将虚拟图像转换为两件式物理模型，用于生物材料。术中使用定制模具制作PMMA植入物。通过比较术前和术后的3D计算机断层扫描（CT）图像并询问患者对结果是否满意来分析美容效果。
定制模具的规划和制作平均总时间为10天。16例患者对结果满意，术前和术后扫描的CT图像呈现出和谐的对称性。本系列中未观察到术后感染、出血或再次手术的病例。
使用高科技定制3D模具制作PMMA植入物进行颅骨成形术，可以通过快速且具有成本效益的制造过程实现美观的重建，并且可能具有较低的并发症发生率。
