Tissue compatibility of methylmethacrylate in cranial prostheses: a preliminary investigation

Post-Neurosurgical Temporal Deformities: Various Techniques for Correction and Associated Complications

INTRODUCTION

An irregular craniofacial contour along the temporal fossa, known commonly as 'temporal hollowing deformity,' (THD) can arise from multiple etiologies. In fact, up to half of all patients who undergo neurosurgical pterional dissections develop some form of temporal contour deformities. Unfortunately, temporal hollowing correction remains surgically challenging with many techniques resulting in high rates of failure and/or morbidity.

METHODS

Herein, we describe anatomy contributing to postsurgical temporal deformity as well as time-tested prevention and surgical correction techniques. In addition, a review of 25 articles summarizing various techniques and complication profiles associated with temporal hollowing correction are presented.

RESULTS

Complications included infection, implant malposition, revision surgery, pain, and implant removal because of implant-related complications Augmentation with either autologous fat or dermal filler is associated with the highest number of reported complications, including catastrophic events such as stroke, pulmonary embolism, and death. No such complications were reported with use of alloplastic material, use of autologous bone, or free tissue transfer. Furthermore, careful attention to adequate temporalis muscle resuspension and position remain paramount for stable restoration of craniofacial symmetry.

CONCLUSIONS

Catastrophic complications were associated with injection augmentation of both fat and dermal filler in the temporal region. In contrast, use of alloplastic materials was not found to be associated with any catastrophic complications. As such, for the most severe cases of THD, we prefer to employ alloplastic reconstruction.

Rapid prototyping-assisted maxillofacial reconstruction

Rapid prototyping (RP) technologies have found many uses in dentistry, and especially oral and maxillofacial surgery, due to its ability to promote product development while at the same time reducing cost and depositing a part of any degree of complexity theoretically. This paper provides an overview of RP technologies for maxillofacial reconstruction covering both fundamentals and applications of the technologies. Key fundamentals of RP technologies involving the history, characteristics, and principles are reviewed. A number of RP applications to the main fields of oral and maxillofacial surgery, including restoration of maxillofacial deformities and defects, reduction of functional bone tissues, correction of dento-maxillofacial deformities, and fabrication of maxillofacial prostheses, are discussed. The most remarkable challenges for development of RP-assisted maxillofacial surgery and promising solutions are also elaborated.

Preformed acrylic cranial implants using fused deposition modeling: A clinical report

Fabrication of acrylic cranial implants by conventional methods of moulage and mold formation may be difficult when the margin of the defect cannot be accurately detected. Three-dimensional anatomic models built by fused deposition modeling can serve as templates for the fabrication of custom acrylic implants for large or complicated cranial defects. Virtual mirror imaging of the contralateral nondefect side can facilitate the restoration of symmetry in appearance-sensitive areas. This clinical report presents a method for the fabrication of cranial implants for 2 patients using anatomic modeling technology.

Fabrication procedure for cranial prostheses

A procedure for duplication of cranial bone flaps used in cranioplasty is described. This procedure overcomes the difficulties inherent in direct duplication of irregular-shaped bone flaps through primary replication of the flap in wax. The wax pattern is used to fabricate the definitive prosthesis.