Silicone rubber mould cast polymethylacrylate-hydroxyapatite plate used for repairing skull defect

Department of Cranio-Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Journal of Cranio-Maxillofacial Surgery (Impact Factor: 2.93). 07/2006; 34(4):242-6. DOI: 10.1016/j.jcms.2006.01.005
Source: PubMed


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.
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.
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.
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.

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    • "Recent studies on cranioplasty have described the use of pre-fabricated PMMA implants for full-thickness calvarial defects [27]. These custom PMMA designs reduce operative time as well as eliminating the intra-operative "
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    ABSTRACT: Inappropriate treatment of fractures of the frontal sinus can lead to serious complications. These fractures are often associated with soft tissue injuries and loss of bony structures. This case report shows the use of methyl methacrylate frontal prosthesis to treat a sequel of frontal sinus fracture; surgical options are discusses and one-year follow-up is present to show stability and good cosmetic result.
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    • "At present, the use of synthetic materials is more common (eg, polymethyl methacrylate (PMMA) [12,13], PMMA mixed with hydroxyapatite [14], carbon fiber-reinforced plastics (CFRP) [15], knitted polypropylene-polyester [16]). "
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    • "An SLS polyamide model has been used for repairing large skull defects by constructing custom-made cranial plates. Custommade cranioplasty implants are associated with the advantages of reduced operative time, less invasive surgery, improved cosmetic results, faster recuperation, and reduced costs due to short operative times (Rotaru et al., 2006). SLS models have also allowed for the analysis of abnormalities regarding calvaria morphology, nasal bones and maxilla, improving the criteria for diagnosis and the surgical plan in a case of craniofacial dysostosis (Apert syndrome) (da Rosa et al., 2004; Sannomiya et al., 2006). "

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