Introduction. Complex defects of skull bones with different etiology, still
present the challenge in reconstructive surgery. The goldstandard for
cranioplasty is the autologous calvarial bone graft removed during surgery
which cannot be always applied, especially in gunshot wounds for sometimes
complete bone destruction. Autologous reconstruction with split calvarial,
rib bones or iliac bone graft is also possible. Materials routinely used for
reconstructions like titanium mesh, polymethyl metacrylate (PMMA), and other
have numerous disadvantages and limitations. Case report. We presented a
patient with gunshot injury to the head with residual large bone defect in
the frontal region, with involvement of the skull base, and open frontal
sinus. After conservative treatment, six months after the injury,
reconstruction of the residual bone defect was performed. The chosen material
was computerdesigned PEEK-OPTIMA? implant, manufactured on the basis of MSCT
scan. This material has not been used in this region so far. The
postoperative and follow-up period of the next 12 months passed without
surgical complications, neurological deficit, with satisfactory functional
and aesthetic results. Conclusion. Implanted bone replacement was designed
and manufactured precisely according to the skull defect, and we found it
suitable for the treatment of complex defects of the cranium. Early results
are in favor of this cranioplasty method over standardized materials.
Therefore, this material is expected to become a method of choice for
reconstructive surgery of bony defects of the face and skull especially in
complex cases.
Treatment of peri-implantitis with surface decontamination and particulate bone graft in a smoker patient
