Page 370 - IJB-10-4

International Journal of Bioprinting 3D-printed PEEK in cranioplasty

Furthermore, AM technology features several advantages from the two other materials (i.e., autologous bone and
in terms of low raw material consumption and cost titanium mesh) in terms of implant-related complications
reduction. For clinical application, the AM technique and the patient’s neurological functions. In addition, FFF-
is more suitable for fabricating complex anatomical printed PEEK also has the advantages of good aesthetics,
structures than the traditional SM technique, especially low imaging interference, high mechanical performance,
those in the skull base and maxillofacial junction area. 28,50 and cost-effectiveness. In summary, we believe that FFF-
printed PEEK implants are an important development
Previously, a study provided a quantitative assessment
of the potential clinical efficacy of FFF-printed PEEK for cranioplasty.
for cranial reconstruction, validating the safety of AM Acknowledgments
technology. 29,51,52 Furthermore, we have previously reported
the first clinical case of using FFF-printed PEEK implants The authors would like to thank the patients who
for cranial repair. In the present study, we evaluated the consented to take part in this study and the doctors in the
11
data of patients with FFF-printed PEEK implants and participating center who helped to collect the original data.
compared them with patients with autologous bone and
titanium mesh. The statistical analyses indicated that there Funding
were no significant differences in surgical time, average This study was supported by the OPEN Project (Grant No.
postoperative hospital stay, clinical complications, and BHJ17C019), the National Natural Science Foundation
neurological function among the three groups. Based on of China (82371310, 82271306,81971132, 52125501,
our findings, we suggest that an FFF-printed prosthesis is and 51835010), the Young Elite Scientist Sponsorship
more suitable for patients with large skull defects (strong, Program by the China Association for Science and
artifact-free, and more integrated). Thus, the combination Technology (YESS20200178), the Sichuan Science and
of an efficient production method (e.g., FFF) with a versatile Technology Program (2023YFH0069, 2023NSFSC0028,
material (e.g., PEEK) may produce complex structures and 2022YFS0615), Scientific research Project of
(e.g., 3D-PEEK) with great potential and applicability in Sichuan Provincial Health Commission (23LCYJ040),
the field of medical and industrial integration. Nonetheless, Sichuan Provincial Cadre Health Project (ZH2024-
the present study had several limitations. In comparison to 1501), and the Program for Innovation Team of Shaanxi
general clinical research, this single-center retrospective Province (2023-CX-TD-17).
study had a small sample size of 66 cases. Given the rarity
of the new method (FFF-printed 3D-PEEK skull implant), Conflict of interest
the sample size was considered acceptable. This study
also featured a short follow-up time and the inherent The authors declare no conflicts of interest.
risk of bias. Additionally, this study did not evaluate the
differences between AM and SM PEEK implants due to the Author contributions
limited number of cases. Therefore, we would suggest to Conceptualization: Jianhua Peng, Yong Jiang, Dichen Li,
conduct more and larger sample size multicenter clinical Jiankang He
research in the future to further explore the risk factors of Formal analysis: Hui Zhu, Huanhao Pang
postoperative complications between FFF-printed PEEK Investigation: Kuangyang Yu, Yanwen Su, Xiao Rao
implants, SM PEEK implants, and other conventional Methodology: Huanhao Pang, Changquan Shi, Liang Liu,
materials. Likewise, we would also suggest conducting a Yingchao Liu
longer follow-up on neurological function and appearance Resources: Jianhua Peng, Yong Jiang, Ligang Chen, Dichen
after cranial repair to better evaluate the performance of Li, Jiankang He
different materials for cranioplasty. Supervision: Jianhua Peng, Yong Jiang, Jiankang He
Writing – original draft: Kuangyang Yu, Yanwen Su
5. Conclusion Writing – review editing: Jianhua Peng, Yong Jiang, Dichen
Different materials have been used in cranioplasty over Li, Jiankang He
the years. 3D-printed PEEK implants have the advantages Ethics approval and consent to participate
of rapid production, low cost, good biocompatibility, and
ideal mechanical properties. In this study, we evaluated The protocol was approved by the Ethics Committee and
the application of FFF-printed PEEK implants in a small- Research Board of the Affiliated Hospital of Southwest
scale clinical study. Our findings revealed that the FFF- Medical University (KY2021133). Consent to participate
printed PEEK implants were not significantly different in the study was obtained from the subjects.

Volume 10 Issue 4 (2024) 362 doi: 10.36922/ijb.2583