Efficacy of 3D-Printed Titanium Mesh-Type Patient-Specific Implant for Cranioplasty

Korean J Neurotrauma. 2021 Sep 9;17(2):91-99. doi: 10.13004/kjnt.2021.17.e25. eCollection 2021 Oct.

Abstract

Objective: Autologous bone grafting for cranioplasty is associated with a high infection rate and bone absorption. Synthetic implant materials for cranioplasty have been developed. In this study, we evaluated the efficacy of titanium mesh-type patient-specific implants (PSIs) for patients with skull defects using the dice similarity coefficient (DSC), clinical outcomes, and artifacts caused by implants.

Methods: This retrospective study included 40 patients who underwent cranioplasty with a titanium mesh PSI at our institution. Based on preoperative and postoperative computed tomography scans, we calculated DSC and artifacts.

Results: The calculated DSC of 40 patients was 0.75, and the noise was 13.89% higher in the region of interest (ROI) near the implanted side (average, 7.64 hounsfield unit [HU]±2.62) than in the normal bone (average, 6.72 HU±2.35). However, the image signal-to-noise ratio did not significantly differ between the ROI near the implanted side (4.77±1.78) and normal bone (4.97±1.88). The patients showed no significant perioperative complications that required a secondary operation.

Conclusion: Titanium mesh-type PSIs for cranioplasty have excellent DSC values with lower artifacts and complication rates.

Keywords: Artifact; Printing, three-dimensional; Titanium.