Evaluation of Using 3D Printed PEEK Facial Implants in Repairing Maxillofacial Deformities
Condition: Maxillofacial Trauma; Face Cancer; Mucormycosis
MeSH terms: Mucormycosis
Study type: Observational

Summary: 
      Objective: Evaluation of using 3D printed polyether ether ketone facial implants in repairing
      maxillofacial deformities.

      Research materials and methods: The research sample consisted of 10 patients with facial
      deformities (maxillofacial trauma patients with hard tissue deficiencies, tumor patients who
      had previous facial surgery, patients have retrognathia, congenital malformation, patients
      with hemifacial microsomia - bone loss as a result of a mucormycotic infection or black
      fungus ) Between 2020 and 2021 in the Department of Oral and Maxillofacial Surgery in the
      Tishreen University Hospital - Latakia - Syria. All patients underwent Computed Tomography
      (CT) scans under the condition of providing a large number of slices (more than 200 slices)
      per axis, and the thickness of each slice is less than 1 mm with 64-bit resolution, Then the
      design of the required facial implant was carried out in coordination between the designer
      and the surgical team. The final form of the facial implant was printed from PolyEther Ether
      Ketone (PEEK), and then surgical work was performed for patients under general anaesthetic
      according to the appropriate surgical entrance. The implants were fixed in place using
      titanium screws and the patients were given appropriate pharmacological coverage .
    

Detailed description: 
      10 patients with maxillofacial deformities (trauma patients, war injuries, patients with
      pre-existing maxillofacial tumours, and mucormycotic patients) for reconstruction with 3D
      printed facial implants made of PEEK, between 2020 and 2021 in the Department of Oral and
      maxillofacial Surgery at the Tishreen University Hospital, Latakia, Syria. All patients
      underwent three-axial CT scan using a Toshiba Slice CT Scanner-Imaging, under the condition
      of providing a large number of slices (more than 200 slices) per axis, and the thickness of
      each slice is less than 1 mm with 64-bit resolution. Representative models of patient
      anatomical data were created based on the radiated raw data of the patient obtained via
      Digital Imaging and Communications in Medicine (DICOM) from the CT scan. The DICOM format is
      0.3 to 0.6 mm thick, depending on the anatomical region. The medical modelling software
      (EXoCad) was used to compile DICOM data at the axial, sagittal, and coronal planes and then
      create a 3D virtual model of the anatomical region.

      The surgeon and the manufacturing technician met to discuss the design format and any
      modifications required, with the proposed areas for placement of the titanium screws for the
      installation of the facial implant. The final default model for the facial implant was
      exported as a STereoLithography (STL) file and sent to the 3D printer, which was eventually
      made for the patient. The printer used in our study is a prototype of OO-Kuma Katana HT PEEK
      3D Printer. After the process of printing, the facial implant is steam sterilized and then
      the implant is encapsulated. The surgical work of the patients was performed under general
      anaesthesia at the Tishreen University Hospital, Latakia, Syria, at the appropriate surgical
      entrance depending on the size and location of the deformity. The facial implant was checked
      to be suitable before stabilization and the required modifications were made during the
      process. The PSI was fixed in place using 1.5 to 2.0mm sized titanium screws, all patients
      received an intravenous 1.2g Augmentin dose and 0.5g of Flagyl during the procedure. After
      the surgery, patients received two doses of Augmentin, after which a prescription of
      Augmentin 1g and Flagyl 0.5g orally per day for a week was given.
    

Intervention name(s): 3D printed polyether ether ketone facial implants in repairing maxillofacial deformities
Intervention type(s): Procedure
Intervention description(s): All patients underwent Computed Tomography (CT) scans under the condition of providing a large number of slices (more than 200 slices) per axis, and the thickness of each slice is less than 1 mm with 64-bit resolution, Then the design of the required facial implant was carried out in coordination between the designer and the surgical team. The final form of the facial implant was printed from PolyEther Ether Ketone (PEEK), and then surgical work was performed for patients under general anaesthetic according to the appropriate surgical entrance. The implants were fixed in place using titanium screws
Other intervention name(s): PSI PEEK
Intervention MeSH terms: Ether
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients diagnosed with facial deformities at the Oral and Maxillofacial department of
        Tishreen University Hospital
      
Keywords: facial implant; 3d printing; polyetheretherketone