Evaluation of implant properties, safety profile and clinical efficacy of patient-specific acrylic prosthesis in cranioplasty using 3D binderjet printed cranium model: A pilot study.

Autor: Basu B; Materials Research Center, Indian Institute of Science, Bangalore 560012, India; Center for BioSystems Science and Engineering, Indian Institute of Science, Bangalore 560012, India., Bhaskar N; Materials Research Center, Indian Institute of Science, Bangalore 560012, India., Barui S; Materials Research Center, Indian Institute of Science, Bangalore 560012, India., Sharma V; Materials Research Center, Indian Institute of Science, Bangalore 560012, India., Das S; Materials Research Center, Indian Institute of Science, Bangalore 560012, India., Govindarajan N; Department of Metallurgical and Materials Engineering, National Institute of Technology, Surathkal, Mangaluru 575025, Karnataka, India., Hegde P; Department of Neurosurgery, Ramaiah Medical College, Bengaluru, Karnataka 560054, India., Perikal PJ; Department of Neurosurgery, Ramaiah Medical College, Bengaluru, Karnataka 560054, India., Antharasanahalli Shivakumar M; Department of Dental Sciences , Ramaiah Memorial Hospital Bengaluru, Karnataka 560054, India., Khanapure K; Department of Neurosurgery, Ramaiah Medical College, Bengaluru, Karnataka 560054, India., Tekkatte Jagannatha A; Department of Neurosurgery, Ramaiah Medical College, Bengaluru, Karnataka 560054, India. Electronic address: anirudhbmc@yahoo.co.in.
Jazyk: angličtina
Zdroj: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2021 Mar; Vol. 85, pp. 132-142. Date of Electronic Publication: 2021 Jan 23.
DOI: 10.1016/j.jocn.2020.12.020
Abstrakt: There exists a significant demand to develop patient-specific prosthesis in reconstruction of cranial vaults after decompressive craniectomy. we report here, the outcomes of an unicentric pilot study on acrylic cranial prosthesis fabricated using a 3D printed cranium model with its clinically relevant mechanical properties.
Methods: The semi-crystalline polymethyl methacrylate (PMMA) implants, shaped to the cranial defects of 3D printed cranium model, were implanted in 10 patients (mean age, 40.8 ± 14.8 years). A binderjet 3D printer was used to create patient-specific mould and PMMA was casted to fabricate prosthesis which was analyzed for microstructure and properties. Patients were followed up for allergy, infection and cosmesis for a period of 6 months.
Results: As-cast PMMA flap exhibited hardness of 15.8 ± 0.24Hv, tensile strength of 30.7 ± 3.9 MPa and elastic modulus of 1.5 ± 0.1 GPa. 3D microstructure of the semi-crystalline acrylic implant revealed 2.5-15 µm spherical isolated pores. The mean area of the calvarial defect in craniectomy patients was 94.7 ± 17.4 cm 2 . We achieved a cranial index of symmetry (CIS -%) of 94.5 ± 3.9, while the average post-operative Glasgow outcome scale (GOS) score recorded was 4.2 ± 0.9.
Conclusions: 3D printing based patient-specific design and fabrication of acrylic cranioplasty implant is safe and achieves acceptable cosmetic and clinical outcomes in patients with decompressive craniectomy. Our study ensured clinically acceptable structural and mechanical properties of implanted PMMA, suggesting that a low cost 3D printer based PMMA flap is an affordable option for cranioplasty in resource constrained settings.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: