[CAD/CAM (computer-aided design/computer-aided manufacturing) titanium implants for cranial and craniofacial defect reconstruction].

The reconstruction of craniofacial bone defects with intraoperatively modeled prosthesis restricts the choice of material and its biocompatibility and the prediction of the esthetic result. A prolonged duration of the surgical procedure and an increased stress on the patient are consequences. In contrast, modern industrial CAD/CAM-systems allow the prefabrication of titanium prosthesis: An individual computer-based 3D model of the bony defect is generated after acquisition, transfer and evaluation of helical CT data. Basing on these data the individual prosthesis-shape is designed using freeform surfaces geometries and fabricated by a numerically controlled milling machine. The conical margins of this prosthesis-geometry are generated by the borders of the defect with a minimal gap of 0.25 mm, and the surface contours by considering the non-affected neighbouring contours with a constant thickness of 1.5 mm. Individual osteosynthesis-microplates for fixation are integrated in design and manufacturing if screw-holes cannot be integrated in the thin margins of the implants. The radiological and clinical results of 17 patients after reconstruction of craniofacial bone defects with CAD/CAM titanium implants were good. Complications were not observed.