title: Silicone rubber mould cast polyethylmethacrylate-hydroxyapatite plate used for repairing a large skull defect.
abstract: BACKGROUND
  Reconstruction of the cranial vault is performed for various reasons and precise repair of the defect is important. A modified method of cranioplasty is presented using three-dimensional (3D) models and polyethylmethacrylate mixed with hydroxyapatite, cast in a silicone rubber mould.
  
  
  METHODS
  A large custom made cranial implant was produced using data acquired from 3D computer tomography, rapid prototyping and cast in a silicone rubber mould. This plate was then applied to a 53 year-old man who had undergone a decompressive fronto-parieto-temporo-occipital craniotomy. The bone flap had been lost due to infection. The cranioplasty was performed at 1 year after the initial operation.
  
  
  RESULTS
  The cranial plate fitted precisely into the defect and needed no correction at the time of surgery. The stability of the reconstruction plate was increased by the presence of thin margins allowed by silicone rubber elasticity. No complications occurred and the final functional and aesthetic results were good.
  
  
  CONCLUSIONS
  The use of 3D imaging and rapid prototyping allow precise repair of large skull defects, with good aesthetic and functional results. At the same time, silicone rubber moulds permit the production of very thin details needed not only for cosmetic reasons but for reconstruction plate stability as well.
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. hrotaru@rdslink.ro
authors.forename: Horatiu
authors.initials: H
authors.lastname: Rotaru
authors.forename: Mihaela
authors.initials: M
authors.lastname: Baciut
authors.forename: Horatiu
authors.initials: H
authors.lastname: Stan
authors.forename: Simion
authors.initials: S
authors.lastname: Bran
authors.forename: Horea
authors.initials: H
authors.lastname: Chezan
authors.forename: Alexandru
authors.initials: A
authors.lastname: Iosif
authors.forename: Mircea
authors.initials: M
authors.lastname: Tomescu
authors.forename: Seong-Gon
authors.initials: SG
authors.lastname: Kim
authors.forename: Alexandru
authors.initials: A
authors.lastname: Rotaru
authors.forename: Grigore
authors.initials: G
authors.lastname: Baciut
mesh_terms: D001860:Bone Plates; D001929:Brain Edema / Q000601:surgery; D003399:Craniotomy / Q000295:instrumentation*; D017886:Durapatite; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008689:Methacrylates; D008875:Middle Aged; D019736:Prostheses and Implants; D011474:Prosthesis Design; D012826:Silicone Elastomers; D014057:Tomography, X-Ray Computed
chemical_list: D008689:Methacrylates; D012826:Silicone Elastomers; D017886:Durapatite