Page 22 - Clinical relevance of current materials for cranial implants
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                                Chapter 1
Poly (ether ether ketone) (PEEK)
PEEK is an organic thermoplastic polymer. It was introduced in the automotive and electrical industries before it was used for medical applications. In the nineties, PEEK became popular in orthopedics, trauma and spinal surgical interventions25,34. In 2009 Hasanoso published one of the first cases using PEEK for cranioplasties35. With the use of the patients CT-scan, the unaffected side can be mirrored and a symmetrical and aesthetically satisfying PSI patient-specific implant is manufactured using a milling technique36 (Figure 4). Nowadays, PEEK is an important polymer for medical devices, which is used in different fields of surgery. It has a high mechanical strength and biocompatibility, and does not deform below a temperature of at least 400°C34. It has no cytotoxic activity, it does not induce adverse reactions to human tissues37, and PEEK causes no artifacts in post-operative imaging. PEEK can be manufactured preoperatively as a PSI with satisfactory cosmetic outcomes and reduced operation time36. PEEK does not have a bioactive potential38. Unfortunately, PEEK is expensive39, and controversy exists in literature about its effectiveness in covering larger defects as cranioplasty34,38.
Figure 4: Patient Specific Implant of PEEK Courtesy of Xilloc Medical, The Netherlands
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