Cranioplasty with customized titanium and PEEK implants in a mechanical stress model.
Large skull defects as a result of craniectomies due to cerebral insults, trauma, or tumors create functional and aesthetic disturbances for the patient. Cranioplasty with implants in these cases are an alternative to autogenous bone transplantation. In our clinic, customized titanium or optima poly-ether-ether ketone (PEEK) implants are used to reconstruct craniectomy defects. To compare the two materials we investigated the structural changes of the implants fixed to a sintered polyamide skull model under mechanical stress in four simplified models. In a standard testing machine, the models were subjected to a load under a quasi-static loading rate of 1.925 mm/min. Fractures of the PEEK implants occurred at a force of 24.2 and 24.5 kN with a displacement of 8.4 and 8 mm. The titanium implants showed no deformation, but extensive damage was seen in the polyamide skull models. The highest pressures achieved were 45.8 and 50.9 kN. In a simplified model with quasi-static loading, both implants withstood forces that were higher than those capable of causing skull fractures. It seems that the mechanical properties of PEEK could provide better protection when used for cranioplasty in patients after craniectomy if reconstruction with autogenous bone is not possible.
Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. bernd.lethaus@mumc.nl
Bernd
B
Lethaus
Yara
Y
Safi
Mariel
M
ter Laak-Poort
Anita
A
Kloss-Brandstätter
Frans
F
Banki
Christian
C
Robbenmenke
Ulrich
U
Steinseifer
Peter
P
Kessler
D001577:Benzophenones; D001672:Biocompatible Materials / Q000737:chemistry; D003399:Craniotomy / Q000379:methods*; D007659:Ketones; D008422:Materials Testing; D008953:Models, Anatomic; D008954:Models, Biological; D011092:Polyethylene Glycols; D011108:Polymers; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000379:methods; D012886:Skull / Q000601:surgery; D013314:Stress, Mechanical; D014025:Titanium
D001577:Benzophenones; D001672:Biocompatible Materials; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols; D014025:Titanium