Intraoperative fabrication of patient-specific moulded implants for skull reconstruction: single-centre experience of 28 cases

BACKGROUND Intraoperatively fabricated polymethylmethacrylate (PMMA) implants based on computer-designed moulds were used to improve cosmetic results after hard tissue replacement. To assess the implant's cosmetic and functional results we performed both subjective and objective assessments. METHODS This retrospective analysis was performed using a cohort of 28 patients who received PMMA implants between February 2009 and March 2012. The cosmetic and functional results were assessed using a patient questionnaire. Furthermore an objective volumetric subtraction score (0-100) was applied and implant thickness, as well as gaps and tiers, were measured. RESULTS Patients mainly judged their cosmetic result as "good". Two of the 28 patients found their cosmetic result unfavourable. The functional result and stability was mainly judged to be good. Measurements of implant thickness showed a very high correlation with the thickness of the contralateral bone. Volumetric subtraction led to a median quality of 80 on a scale from 0 to 100. Median gaps around the margins of the implant were 1.5��mm parietally, 1.7��mm frontally and 3.5��mm fronto-orbitally, and median tiers were 1.2��mm, 0��mm and 0��mm respectively. The overall rate of surgical revisions was 10.7��% (three patients). Two patients suffered from wound healing disturbances (7.1��%). The overall complication rate was comparable to other reports in the literature. CONCLUSIONS Implantation of intraoperatively fabricated patient-specific moulded implants is a cost-effective and safe technique leading to good clinical results with a low complication rate.

Patenting Systems, Patentable Subject Matter, and Prior Art

The International School of Solid State Physics presented the 56th Course"Materials for Renewable Energy��� in Erice (Italy), from July 18th to 28th 2012. This course was sponsored by the Italian Ministry of Education, University and Scientific Research, the Materials Research Society and the European Materials Research Society. The event was hosted at the "Ettore Majorana Foundation and Centre for Scientific Culture���. The school reviewed critical materials issues for the production and storage of renewable and sustainable energy. The aim of the School was to present the state-of-the-art and future perspectives in this critical area. It was to bring together the international community of students, young scientists, and experts in a unique atmosphere for reciprocal benefits in terms of enthusiasm, knowledge and new ideas.