Page 186 - IJB-9-1

International Journal of Bioprinting PEEK skull implant in cranioplasty

a lower complication rate compared to autologous bone, and 5. Conclusion
a lower implant failure rate compared with titanium mesh .
[21]
As an established surgical method, cranioplasty has been
However, the production process of traditional PEEK modified many times, and the ideal material has been long
implants for clinical use is complicated. First, the defective sought for use in cranioplasty. 3D-printed PEEK skull
skull model is reconstructed by computer, and then the implant, which is characterized by high strength, high
appropriate PEEK implant is designed by computer-aided toughness, and excellent biocompatibility for cranioplasty,
design/computer-aided manufacture technology. Then, the can be prepared instantly, and the production process is
cube of PEEK material is step-by-step cut and polished, and rather cost-efficient. For the first time, we applied a PEEK
processed into the final shape of the patient’s physiological implant manufactured by FFF technology to cranioplasty
structure. This subtractive manufacturing method requires
a large amount of PEEK raw material, which contributes in a patient who did not complain of any implant-related
to huge waste . In addition, for complex anatomical complications during the hospital stay.
[23]
structures, conventional production methods can only piece
together the materials of multiple PEEK implants, which Acknowledgments
also complicates the production process and increases the The authors thank all researchers involved in this study
production cost. Recently, two technologies, selective laser and health care workers involved in this case.
sintering (SLS) [24,25] and FFF , have been promoted for the
[26]
shaping of PEEK materials. Both of them can process PEEK Funding
raw materials into desired shapes. The material consumption
and the toughness of the FFF technology were significantly This work was supported by the National Natural
better compared with that of the SLS technology, making Science Foundation of China (82271306, 81971132)
FFF technology gradually widely used . and the Young Elite Scientist Sponsorship Program
[27]
In this report, we combine FFF technology with by the China Association for Science and Technology
specific temperature control. To control the mechanical (YESS20200178); the OPEN Project (BHJ17C019);
properties of PEEK implants, this technique uses a Guangdong Basic and Applied Basic Research Foundation
cooling fan to rapidly cool the PEEK filaments ejected (2020B1515130002); the Sichuan Science and Technology
from the nozzle. The PEEK material was rapidly cooled Program (2021ZYD0106, 23NSFSC0040); Luzhou
during extrusion, and the desired PEEK material skull Government-Southwest Medical University Strategic
implant with both strength and toughness was obtained Cooperation Project and Southwest Medical University
(Figure 2D). Except for tensile strength, the mechanical Project (2021LZXNYD-P01, 2021ZKZD013); Key R&D
properties of the 3D-printed PEEK implants are superior Program of Guangdong Province (2018B090906001);
to those of the skull . In addition, PEEK implants made China Postdoctoral Science Foundation-funded project
[13]
by FFF have higher impact toughness than skulls, and can (2021M702597); the Fundamental Research Funds for the
better protect brain tissue from damage caused by external Central Universities (xzy012022048); the Youth Innovation
force. This AM technology can help save raw materials Team of Shaanxi Universities; and the Fundamental
and reduce costs. Importantly, the AM technology is more Research Funds for the Central Universities.
suitable than the traditional subtractive manufacturing
technology for fabricating complex anatomical structures, Conflict of interest
especially those in the skull base and maxillofacial junction
regions [22,28] . Notably, a preclinical study has provided a The authors declare no conflicts of interest.
morphological and structural quantitative assessment of
3D-printed PEEK implants for cranial reconstruction and Author contributions
suggested that 3D-printed PEEK implants are safe for use
in cranioplasty . To the best of our knowledge, the case Conceptualization: Jiaqi Zhang, Yanwen Su, Xiao Rao
[29]
we reported herein is the first known clinical application of Resources: Jianhua Peng, Yong Jiang, Ligang Chen, Dichen
PEEK material made by FFF technology in cranial repair. Li, Jiankang He
In order to significantly reducing the production cost Supervision: Hui Zhu, Jianhua Peng, Liang Liu
of PEEK implants, this process produces implants with Writing – original draft: Jiaqi Zhang, Yanwen Su, Jiankang
better appearance that not only deliver increased surgical He, Huanhao Pang
satisfaction, but also improve quality of life without Writing – review & editing: Jiaqi Zhang, Yanwen Su,
increasing the financial burden on patients. Jianhua Peng

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Volume 9 Issue 1 (2023)olume 9 Issue 1 (2023) 178 https://doi.org/10.18063/ijb.v9i1.634