Comparative evaluation of accuracy of cranial prosthesis designed by four different workflow protocols analysed by software

Abstract

Cranioplasty aims to reconstruct skull defects from tumours, congenital anomalies, decompressive craniectomies, and fractures in a cosmetically acceptable manner. Since the 1970s, polymethyl methacrylate (PMMA) prostheses have been manually prefabricated using a variety of techniques. However, more recent computer-aided design and computer-aided manufacturing (CAD/CAM) techniques appear to have eclipsed these older methods. These techniques essentially involve using imaging from the patient's cranial defect and prefabricating the PMMA prosthesis using a 3D printer. The traditional methods for producing prostheses require a number of intricate stages, can be extremely stressful for the patient, and their success depends on the expertise of the maxillofacial team. Although there have been advances in digital fabrication for prosthetics, there are still some constraints that prevent a full transition to digital fabrication for the final stages of prosthesis construction. Advance training and modification of current treatment procedures are required due to the introduction of new technologies and methods in the field of maxillofacial prosthodontics. The aim of this study is to compare and evaluate the accuracy of cranial prosthesis designed by conventional, digital and two hybrid workflows We will report on 10 consecutive patients who have undergone cranioplasty surgery or had trauma for an extensive skull defect. The final prosthesis will be analyzed using the software CloudCompare for its accuracy by using reverse engineering principle. The purpose of this research is to develop a hybrid protocol for fabricating a prosthesis that is both cost-effective and more dimensionally accurate than its conventional counterpart, thereby providing ease for both the patient and the maxillofacial team.