Prefabricated alloplastic implants for cranial defects

Poly(methyl methacrylate), more commonly known as acrylic, is a valuable biomaterial that has proved effective in reconstructing calvarial defects. "Heat-cured" poly(methyl methacrylate) implants have distinct advantages over conventional poly(methyl methacrylate) preparations and may be custom-fabricated to match a calvarial defect by use of three-dimensional computed tomographic scanning techniques. Exceptional accuracy is obtained, such that only minor adjustments to the implant are needed at the time of surgery, thus reducing operating time. The authors report three patients in whom complex calvarial defects were reconstructed with heat-cured poly (methyl methacrylate) implants, including a secondary recontruction of a patient previously described in Plastic and Reconstructive Surgery. Prefabricated, heat-cured poly(methyl methacrylate) implants were found to be costeffective and to produce excellent aesthetic results without complication in the three patients discussed. Our experience with custom-prefabricated, heat-cured poly(methyl methacrylate) implants for cranial vault reconstruction has been promising. The technique had reduced operating room time and expense and results in a cosmetically acceptable appearance. In addition, accurate fixation of the implant will decrease dead space, lessen the chance of migration and malposition, and, it is hoped, reduce the risk of infection.