From the Maxillo-Facial Surgery Unit, IRCCS Fondazione Policlinico Unviersitario "A. Gemelli"-Università Cattolica del Sacro Cuore sede di Roma, Rome, Italy.
Ann Plast Surg. 2023 Jun 1;90(6):564-567. doi: 10.1097/SAP.0000000000003527. Epub 2023 Mar 8.
Polyetheretherketone (PEEK) is a synthetic material with many favorable characteristics; PEEK implants are increasingly used for a variety of applications ranging from cranioplasty to orthopedic surgery and facial implants.
This study is a retrospective review of patients who underwent PEEK implant placement in our department over the last 5 years. Polyetheretherketone computer-aided design and manufacture facial implants were designed from high-resolution computed tomography (CT) scans of each patient. The implants placed were onlay implants used for facial rehabilitation purposes to correct malformative and posttraumatic malformations.
Twenty-eight consecutive patients (11 males and 17 females) underwent PEEK implant positioning between January 2015 and December 2020. Common indications were anterior plagiocephaly, hemifacial microsomia, and residual facial imbalance after orthognathic surgery. No complications of implant breakdown, exposure, infection, or displacement were noticed during the follow-up period. During routine controls on 3 patients, we requested a craniomaxillofacial CT scan for reasons unrelated to the implanted prostheses. The CT scans were all high resolution (<1-mm slices). The CT images indicated that bone was starting to form around the implant in all 3 patients as well as in the penetrating holes that were planned in the implants.
In our experience, computer-designed, patient-specific PEEK onlay implants are a valid option for the treatment of malformative and posttraumatic malformations. This is, to the best of our knowledge, the first clinical report on bone reaction to PEEK implantation in the maxillofacial field. Moreover, based on the signs of bone regrowth that we observed in CT controls we can presume that the design of this type of prosthesis can probably take advantage of some technical stratagems not yet codified and fully exploited. Despite our preliminary favorable results, further multicentric and comparative studies are necessary to evaluate outcomes and better understand the behavior of this promising material and thus optimize its use in craniomaxillofacial surgery.
聚醚醚酮（PEEK）是一种具有许多优良特性的合成材料；PEEK 植入物越来越多地用于各种应用，从颅骨成形术到骨科手术和面部植入物。
本研究回顾性分析了过去 5 年来在我院行 PEEK 植入物放置的患者。聚醚醚酮计算机辅助设计和制造的面部植入物是根据每位患者的高分辨率计算机断层扫描（CT）扫描设计的。放置的植入物是用于面部康复的覆盖物，用于矫正畸形和创伤后畸形。
2015 年 1 月至 2020 年 12 月期间，连续 28 例患者（男性 11 例，女性 17 例）行 PEEK 植入物定位。常见的适应证为前斜头畸形、半面短小畸形和正颌手术后的残余面部不平衡。在随访期间，未发现植入物破裂、暴露、感染或移位等并发症。在对 3 名患者进行常规检查时，我们要求进行颅颌面 CT 扫描，原因与植入假体无关。所有 CT 扫描均为高分辨率（<1 毫米切片）。CT 图像显示，所有 3 例患者以及计划在植入物中穿孔的部位，骨开始在植入物周围形成。
根据我们的经验，计算机设计的、个体化的 PEEK 覆盖物是治疗畸形和创伤后畸形的有效选择。据我们所知，这是颌面领域 PEEK 植入物骨反应的第一篇临床报告。此外，根据我们在 CT 对照中观察到的骨再生迹象，我们可以推测这种假体设计可能可以利用一些尚未规范和充分利用的技术策略。尽管我们的初步结果是有利的，但仍需要进一步的多中心和对照研究来评估结果，更好地了解这种有前途的材料的行为，从而优化其在颅颌面外科中的应用。
