Three‐Dimensional CT derived custom implant for repair of facial defects

Abstract

This is a case report of a 28 year old male with a history left maxillary tumor. The defect was treated utilizing a customized 3D implant. 3D CT guided implants, allow for preoperative production of an implant that precisely represents the anatomical defect. These customized implants decrease operative time as they eliminate the need to hand carve implants, reduce the removal of healthy bone, eliminate the need for bone grafting, and promote effective planning of implantation while improving surgical accuracy. Three dimensional modeling also allows improves symmetry with the contralateral anatomic subunit, therefore, enhancing postoperative cosmesis. Available materials include high-density polyethylene, expanded polytetrafluoroethylene, silicone, and combinations of materials such as polymethylmethacrylate (PMMA), polyhydroxyethylmethacrylate (PHEMA) and a calcium hydroxide coating. Complications associated with custom implants include; sensitivity reactions, peripheral neuropathy, migration, extrusion, implant fracture, infection, prominence of the implant in last postoperative period and the need for revision procedures. 1-4 Post-operative satisfaction surveys of patients undergoing surgery with custom implants have shown high patient satisfaction. Patients have specifically commented that their implants remain stable in position after implantation and retain their original size and structure. They are also pleased with their aesthetic outcomes.1, 2