Chouksey Gunjan, Lal Babu, Shakti Prateek, Yadav Vineeta, Kumar Jitendra, Bhatti Zenish R
Department of Dentistry, All India Institute of Medical Sciences, Bhopal, India.
Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal, India.
Arch Craniofac Surg. 2025 Apr;26(2):80-83. doi: 10.7181/acfs.2024.00185. Epub 2024 Sep 9.
Cranial prostheses are frequently required for patients with cranial defects secondary to trauma, decompressive craniectomy, or other pathologies. When the resected or craniotomized bone cannot be reused, cranioplasty with artificial materials offers both aesthetic and protective benefits. However, high-end custom-made options, like polyether ether ketone or titanium prostheses, are expensive and not widely available. Heat-cured polymethyl methacrylate (PMMA) prostheses are generally preferred over their cold-cured counterparts. In-house dental laboratories can provide a cost-effective and practical solution by employing a lost-wax technique akin to denture fabrication, utilizing a three-dimensional printed custom open mold. Fabricating large heatcured PMMA cranioplasts presents certain challenges, such as the need for large flasks and potential porosity. These can be overcome by using a large stainless steel container (a tiffin box) and M-Seal epoxy to ensure an airtight curing process. This method can be easily adopted by standard dental laboratories. At our center, four patients have successfully fitted with cranioplasty prostheses produced using this technique. Even though the patients are outside of the scope of this technical note all of them indicated high satisfaction, and no complications were reported. This straightforward approach demonstrates that in-house, heat-cured PMMA cranioplasts can represent a viable, cost-effective option for cranial reconstruction.
对于因创伤、减压性颅骨切除术或其他病变而导致颅骨缺损的患者，通常需要颅骨修复假体。当切除的颅骨或开颅后的骨头无法再利用时，使用人工材料进行颅骨成形术兼具美观和保护作用。然而，像聚醚醚酮或钛假体等高端定制选项价格昂贵且不易广泛获取。热固化聚甲基丙烯酸甲酯（PMMA）假体通常比冷固化假体更受青睐。内部牙科实验室可以通过采用类似于假牙制作的失蜡技术，利用三维打印的定制开放模具，提供一种经济高效且实用的解决方案。制造大型热固化PMMA颅骨修复体存在一定挑战，例如需要大型烧瓶以及可能出现孔隙。可以通过使用大型不锈钢容器（一个饭盒）和M密封环氧树脂来确保气密固化过程，从而克服这些问题。这种方法可以被标准牙科实验室轻松采用。在我们中心，有四名患者成功安装了使用该技术制作的颅骨修复假体。尽管这些患者不在本技术说明的范围内，但他们均表示高度满意，且未报告任何并发症。这种简单的方法表明，内部制作的热固化PMMA颅骨修复体可以成为颅骨重建的一种可行且经济高效的选择。
