title: Cranioplasty with custom-made implants: analyzing the cases of 10 patients.
abstract: OBJECTIVE
  The aim of this study was to assess quantitatively whether a symmetric reconstruction of the calvaria could be achieved using 3-dimensional (3D) custom-made implants and to examine any complications caused by the cranioplasty.
  
  
  METHODS
  Custom-made cranial implants were produced using data obtained from computed tomographic scanning of the defect using computer-aided design and rapid prototyping techniques. Polymethylmethacrylate was used as the reconstruction material and the implant was cast from a silicone rubber mold. These implants were used in 10 patients (9 men and 1 woman) who previously received a craniectomy. The symmetry gained after cranioplasty was quantified by volumetric analysis using 3D reconstructed postoperative computed tomographic imaging. Any complications after cranioplasty also were recorded.
  
  
  RESULTS
  The average follow-up was 42.5 months (range, 7 to 85 mo). The esthetic appearance of all patients was much improved. When the volume of the reconstructed right calvaria was compared with the left calvaria, the difference was not statistically significant (P > .05). There were 2 cases of complications. One exhibited a transient seroma collection. Another had a wrinkle formation in the forehead. No infectious episodes or signs of plate rejection were encountered.
  
  
  CONCLUSIONS
  The custom-made implants for cranioplasty showed a significant improvement in morphology. The implants may be very useful for repairing large and complex-shaped cranial defects. The technique may be useful for the bone reconstruction of other sites.
authors.affiliation: Department of Craniomaxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Horatiu
authors.initials: H
authors.lastname: Rotaru
authors.forename: Horatiu
authors.initials: H
authors.lastname: Stan
authors.forename: Ioan Stefan
authors.initials: IS
authors.lastname: Florian
authors.forename: Ralf
authors.initials: R
authors.lastname: Schumacher
authors.forename: Yong-Tae
authors.initials: YT
authors.lastname: Park
authors.forename: Seong-Gon
authors.initials: SG
authors.lastname: Kim
authors.forename: Horea
authors.initials: H
authors.lastname: Chezan
authors.forename: Nicolae
authors.initials: N
authors.lastname: Balc
authors.forename: Mihaela
authors.initials: M
authors.lastname: Baciut
mesh_terms: D000328:Adult; D001672:Biocompatible Materials / Q000737:chemistry; D017076:Computer-Aided Design; D003399:Craniotomy / Q000379:methods*; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D005546:Forehead / Q000473:pathology; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D019904:Polymethyl Methacrylate / Q000737:chemistry; D011183:Postoperative Complications; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D049291:Seroma / Q000209:etiology; D012867:Skin / Q000473:pathology; D012886:Skull / Q000293:injuries / Q000601:surgery; D012888:Skull Neoplasms / Q000601:surgery; D020521:Stroke / Q000601:surgery; D036542:Tomography, Spiral Computed / Q000379:methods; D014584:User-Computer Interface; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D019904:Polymethyl Methacrylate