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The first step of patient-specific design calvarial implant: A quantitative analysis of fresh parietal bones

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Abstract

Background

Accurate knowledge of the fracture of cranial bone can provide insight into the prevention of skull fracture injuries and help aid the design of energy-absorbing head protection systems and safety helmets. When cranial bone needs to be removed or is lost, subsequent reconstruction of the defect is necessary to protect the underlying brain, or correct esthetic deformities, or both. Ideal reconstruction of defected bone is possible utilizing a biocompatible implant with a bone-like design individualized for the specific patient. The purpose of this study is to investigate the anatomical and mechanical characteristics of fresh frozen human parietal bones and determine compliance of polylactic acid-based personalized three-dimensional implants in terms of mechanical properties in order to replace such defective bones.

Methods

Parietal bone specimens were extracted from 19 fresh frozen cadavers. Morphological parameters of individual bone specimens were measured using Image J software. Three-point bend tests were performed to extract Young’s modulus and tensile strength of the specimens from the measured force and displacement data by modeling the bone specimens as curved linear elastic beams. Also, three-point bend tests were performed to polylactic acid-based three-dimensional replicas mimicking geometry of the bone specimens in order to determine whether the material’s Young’s modulus and tensile strength properties comply with parietal bones.

Results

Entire fresh parietal specimens were observed to be comprised of a three-layered structure: external layers consisting of compact, high-density cortical bone and the central layer consisting of low-density, irregularly porous bone structure. Mean thickness of three-layered structure was 6.25 ± 1.46 mm. Mean Young’s modulus and tensile strength of the specimens were 1.40 ± 1.34 GPa and 44.56 ± 21.94 MPa, respectively where no statistically significant differences among genders were detected (p > 0.05). Mean Young’s modulus and tensile strength of the polylactic acid-based three-dimensional implants mimicking geometry of the bone specimens were 1.8 ± 0.7 GPa and 72.8 ± 2.5 MPa, respectively.

Conclusions

Polylactic acid-based three-dimensional implants can be considered as acceptable candidates for temporary replacement of parietal defects in terms of mechanical properties.

Level of Evidence: Not ratable.

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Authors and Affiliations

  1. Department of Anatomy, Digital Imaging and 3D Modelling Laboratory, Faculty of Medicine, Ege University, 35100, Izmir, Turkey

    Figen Govsa, Servet Celik & Mehmet Asim Ozer

  2. Department of Neurosurgery, Faculty of Medicine, Ege University, Izmir, Turkey

    Tuncer Turhan

  3. Department of Prosthodontics, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey

    Volkan Sahin

  4. Institute on Drug Abuse, Toxicology and Pharmaceutical Sciences, Ege University, Izmir, Turkey

    Meral Celik

  5. Aerospace Engineering, University of Illinois, Urbana, IL, USA

    Korhan Sahin

  6. Department of Anatomy, Faculty of Dentristy, Kirikkale University, Kirikkale, Turkey

    Zuhal Kazak

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  1. Figen Govsa
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  2. Servet Celik
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  3. Tuncer Turhan
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  4. Volkan Sahin
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Correspondence to Figen Govsa.

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Funding

The authors declare that they have no conflict of interest.

Conflict of interest

Figen Govsa, Servet Celık, Tuncer Turhan, Volkan Sahın, Meral Celık, Korhan Sahın, Mehmet Asim Ozer, Zuhal Kazak declare that they have no conflict of interest.

Ethical approval

This study complies with the current laws of the country in which it was performed (15-11/44 10.11.2015).

Informed consent

This study was carried out in accordance with the protocols of our institution concerning patient data.

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Govsa, F., Celik, S., Turhan, T. et al. The first step of patient-specific design calvarial implant: A quantitative analysis of fresh parietal bones. Eur J Plast Surg 41, 511–520 (2018). https://doi.org/10.1007/s00238-018-1411-6

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  • DOI: https://doi.org/10.1007/s00238-018-1411-6

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