In Acta biomaterialia ; h5-index 89.0
Cranioplasty treatment is the surgical repair of a bone defect in the skull resulting from a previous operation or injury. Decompressive craniectomy (DC) is a surgical procedure, that is followed by the cranioplasty surgery. DC is usually performed to treat patients with traumatic brain injury, intracranial hemorrhage, cerebral infarction, brain edema, skull fractures, etc. In many published clinical cases, cranioplasty surgery is reported to restore cranial symmetry with good cosmetic outcomes and neurophysiologically relevant functional outcomes. In this review, a number of key issues related to the manufacturing of patient-specific implants, clinical complications, cosmetic outcomes, and newer alternative therapies are discussed. While exploring alternative therapeutic treatments to cranioplasty, biomolecules and cellular-based approaches have been emphasized. The currently practiced trends in the restoration of cranial defects involve 3D printing to produce patient-specific prefabricated cranial implants, that provide better cosmetic outcomes. Regardless of the advancements in image processing and 3D printing, the complete clinical procedure is time-consuming and requires significant costs. To reduce manual intervention and to meet unmet clinical demands, it has been highlighted that automated implant design by data-driven methods can accelerate the design and manufacturing of patient-specific cranial implants. The data-driven approaches, encompassing E-platforms such as computer applications, publicly accessible clinical databases, and artificial intelligence with 3D printing will lead to the development of the next generation of patient-specific cranial implants, which can provide better predictable clinical outcomes. STATEMENT OF SIGNIFICANCE: Cranioplasty is performed to reconstruct cranial defects of patients who have undergone decompressive craniectomy. Cranioplasty improves the aesthetic and functional outcomes of those patients. To meet the clinical demands of cranioplasty surgery, accelerated designing and manufacturing of 3D cranial implants are required. This review provides an overview of implant biomaterials and bone flap manufacturing methods for cranioplasty surgery. Along with that, tissue engineering and regenerative medicine-based approaches to reduce complications associated with implant biomaterials are covered. The potential use of computer applications and data-driven artificial intelligence-based approaches are highlighted to accelerate the clinical protocols of cranioplasty treatment with less manual intervention.
Jegadeesan Jeyapriya Thimukonda, Baldia Manish, Basu Bikramjit
2022-Oct-19
Automatic implant design, Biomaterials, Cranioplasty, Patient-specific implant
