Long-term evaluation of patient-specific carbon fiber implants for calvarial defects.

Abstract

Background: Preformed implants based on computed tomography (CT) data have widened the spectrum of calvaria reconstruction. Different materials have been used. Carbon fiber-reinforced resin implants were first introduced into calvaria reconstruction in 1996.

Method: A long-term study of such implants including subjective comfort data as well as a radiological control of adjacent tissues and a thorough clinical investigation seemed of value to see whether or not the implants were integrated and whether there were long-term complications. From a collective of 27 patients with calvarial defects surgically treated at least 20 years ago with insertion of such an implant, 9 patients could be followed up. A neurological and maxillofacial status was performed, The CT scans were obtained to assess the implant fit, changes in surrounding tissues and the brain. A health-related quality of life evaluation was performed.

Results: There was no implant loss or operative revision. No infection was experienced. Patient satisfaction was maximum in all cases. The stated restrictions in quality of life in the case histories, impaired esthetics, pain and dysesthesia, were completely cured after implantation and were permanent over more than 20 years. There were no neurological pathologies evoked by the reconstruction, except a slight dysesthesia along the coronal scar and a minor muscular atrophy of the temporal muscle in one case each. No other functional deficits were detected. The implant fit was undisturbed without any implant loosening or resorption of bone.

Conclusion: Carbon fiber-reinforced resin implants seem a valuable option for calvarial reconstruction. The material proved to be biologically inert.