[PEEK customized implant for skull esthetic reconstruction]

Methods to improve antibacterial properties of PEEK: A review

As a thermoplastic and bioinert polymer, polyether ether ketone (PEEK) serves as spine implants, femoral stems, cranial implants, and joint arthroplasty implants due to its mechanical properties resembling the cortical bone, chemical stability, and radiolucency. Although there are standards and antibiotic treatments for infection control during and after surgery, the infection risk is lowered but can not be eliminated. The antibacterial properties of PEEK implants should be improved to provide better infection control. This review includes the strategies for enhancing the antibacterial properties of PEEK in four categories: immobilization of functional materials and functional groups, forming nanocomposites, changing surface topography, and coating with antibacterial material. The measuring methods of antibacterial properties of the current studies of PEEK are explained in detail under quantitative, qualitative, andin vivomethods. The mechanisms of bacterial inhibition by reactive oxygen species generation, contact killing, trap killing, and limited bacterial adhesion on hydrophobic surfaces are explained with corresponding antibacterial compounds or techniques. The prospective analysis of the current studies is done, and dual systems combining osteogenic and antibacterial agents immobilized on the surface of PEEK are found the promising solution for a better implant design.

Evaluating patients’ satisfaction level after using 3D printed PEEK facial implants in repairing maxillofacial deformities

Background

it is generally the case in any traumatic accident where a loss in hard tissue occurs to preform restorative plastic surgery, as there are many materials and approaches used to restore the loss, this research sheds the light on the use of one such material and approach being 3D printed facial implants manufactured from PolyEther Ether Ketone (PEEK) and to evaluate the level of patients’ satisfaction following the use of said method in repairing maxillofacial deformities.

Materials and methods

a research sample consisting of 10 patients with facial deformities underwent maxillofacial reconstructive surgery 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, then the design of the required facial implant was carried out, the final form of the facial implant was printed from PolyEther Ether Ketone (PEEK), and then surgical work was performed, a check-up after 3 months of the surgical procedure was carried out to evaluate the level of satisfaction on a scale of 1–5.

Results

The results from the 10 patients showed a good level of satisfaction except in one case where the facial implant had to be removed due to recurrent infection where the patient showed no signs of response to medicinal treatment following the surgery.

Conclusions

this research suggests that the use of 3D printed PEEK facial implants to be very agreeable in terms of functionality and aesthetics in treating various facial deformities.

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3D Printed PEEK PSIs implants are used for repairing facial injuries.

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PEEK implants are very good means to achieve acceptable aesthetic results.

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The use of the method is very convenient and saves time and effort.

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After surgery results were mostly pleasing.

Thermoplastic Extrusion Additive Manufacturing of High-Performance Carbon Fiber PEEK Lattices

Polyetheretherketone (PEEK) has been the focus of substantial additive manufacturing research for two principal reasons: (a) the mechanical performance approaches that of aluminum at relatively high temperatures for thermoplastics and (b) the potential for qualification in both the aerospace and biomedical industries. Although PEEK provides outstanding strength and thermal stability, printing can be difficult due to the high melting point. Recently, high-temperature soluble support has enabled the printing of lattices and stochastic foams with overhanging features in these high-performance carbon fiber thermoplastics, in which density can be optimized to strike a balance between weight and strength to enhance performance in applications such as custom implants or aerospace structures. Although polymer powder bed fusion has long been capable of the combination of these geometries and materials, material extrusion with high-temperature sacrificial support is dramatically less expensive. This research provides a comprehensive mechanical analysis and CT-scan-based dimensional study of carbon fiber PEEK lattice structures enabled with high-temperature support and including model validation.

PEEK Implants: An Innovative Solution for Facial Aesthetic Surgery

The authors present a case report showing their experience with the use of PolyEtherEtherKetone (PEEK) implants as an innovative solution for the skeleton and soft tissues' reshaping in facial aesthetic plastic surgery. This technique offers the surgeon a reliable and effective way to answer patients' request of increasing volume and reshaping the malar area. A fifty-year-old patient complaining about hypoplasia of the malar area, after undergoing three operations of silicon implants' placement and replacement, was still unsatisfied about the symmetry and feeling through the skin of the lower lid, the rim of the prostheses. The authors suggested the use of bone-anchored PEEK implants, to increase the volume and reshape the malar area by a skeleton and soft tissue camouflage. The treatment was planned and previewed on the preop 3-dimensional CT scans for the customization of the implants. Although no cases are reported in international literature on the use of this material in facial aesthetic surgery, this technique seems to offer a safe and effective solution for the treatment of patients asking to increase and modify the shape of their malar area. Custom made PEEK implants are already used in craniofacial reconstructive bony surgery with good results, and 3D CT scan planning is widely used in these cases. No complications were reported in the case reported and the outcomes seem to the authors and to the patient being, finally, satisfactory.

Enhancing the mechanical properties of SCF/PEEK composites in FDM via process-parameter optimization

Short-carbon-fiber (SCF)–reinforced poly-ether-ether-ketone (PEEK) is a promising polymer composite material with good biocompatibility, a high strength-to-weight ratio, and low friction properties. In artificial-bone fabrication and other applications with more flexible fabrication demands, fused-deposition modeling (FDM) technology enables the rapid and low-cost fabrication of SCF/PEEK parts with sophisticated structures. Owing to the high viscosity of melting PEEK composites, great challenges, associated with the poor internal interface, need to be overcome before enhanced mechanical properties can be obtained. In this study, key processing parameters and various SCF amounts were studied to investigate their effects on the mechanical properties of PEEK composites. It was revealed that the existence of voids and gaps between the SCF and PEEK led to a decrease in the strength of the composite systems. The FDM processing parameters were tuned to eliminate these defects in the PEEK composites. The tensile strength of the 2% SCF/PEEK sample reached 96.4 MPa, which is comparable to that of PEEK parts prepared by injection molding. Meanwhile, its elastic modulus reached 2.6 GPa, which is 169% higher than that of the bare PEEK sample.

3D modeling, custom implants and its future perspectives in craniofacial surgery

Custom implants for the reconstruction of craniofacial defects have gained importance due to better performance over their generic counterparts. This is due to the precise adaptation to the region of implantation, reduced surgical times and better cosmesis. Application of 3D modeling in craniofacial surgery is changing the way surgeons are planning surgeries and graphic designers are designing custom implants. Advances in manufacturing processes and ushering of additive manufacturing for direct production of implants has eliminated the constraints of shape, size and internal structure and mechanical properties making it possible for the fabrication of implants that conform to the physical and mechanical requirements of the region of implantation. This article will review recent trends in 3D modeling and custom implants in craniofacial reconstruction.