Clinical application of triangular parabolic PEEK mesh with hole button produced by combining CAD, FEM and 3DP into cranioplasty

Background: Cranioplasty (CP) helps to restore the integrity of the skull and the stability of the inner brain structure, to greatly improve the aesthetic and to reduce the concerns caused by the weakening of the brain’s protection. However, how to achieve less complications while maintain a high aesthetic effect of CP has always been the pursuits of the neurosurgeons, manufactures and researchers. Objectives: Using Computer-Aided Design (CAD), Finite Element Methods (FEM) and 3D printing (3DP) to produce a customized triangular parabolic polyetheretherketone (PEEK) mesh for patients with skull defect who need Cranioplasty. Patients and Methods: A patient whose left frontal-temporal-parietal temporal skull had defects, need CP, and a customized triangular parabolic polyetheretherketone (PEEK) mesh with hole button prepared by CAD, FEM and 3DP is proposed for CP. After cycled individualized design and mechanical comparison analysis, the implant is formed by 3DP. Results: A triangular parabolic PEEK mesh with 5-hole button produced by CAD and A vertical 2000 N static force was applied in the central area of a 7 mm diameter of implants, then the maximum stress of 5-lock-botton mesh (triangular paraboloid mesh with lock button model σ=5.7228e6; defective bone σ=4.1904e6) and maximum strain of 5-lock-botton mesh (triangular paraboloid mesh with lock button model=9.053e-7; defective bone ε=1.9363e-7) was obtained by stress-strain analysis, the corresponding stress nephogram and stress ribbon image showing that the concentrated force distribution is relatively uniform. Conclusion: Triangular parabolic PEEK mesh with hole button had a high biomechanical performance and aesthetic effect for CP.