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CATEGORY: CASE REPORT |
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Year : 2020 | Volume
: 20
| Issue : 5 | Page : 25 |
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Cranial vault repair: A novel digital approach
Modhupa Ghosh
Maulana Azad Dental College & Hospital, New Delhi, India
Date of Web Publication | 8-Jan-2021 |
Correspondence Address:
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0972-4052.306380
How to cite this article: Ghosh M. Cranial vault repair: A novel digital approach. J Indian Prosthodont Soc 2020;20, Suppl S1:25 |
Introduction: Cranioplasty is a surgical reconstructive procedure undertaken to repair a deficient cranial vault post-decompressive craniectomy in patients with head injuries, hemorrhages, and infections. It encompasses the placement of an autologous or alloplastic cranial implant to restore a patient's esthetic, functional and psychological balance.
Methodology: This report describes the measures undertaken to rehabilitate a comatose accident victim with tracheostomy in-situ. A previous history of autologous implant failure post-craniectomy, considerable extent of the defect, the non-ambulatory state of the patient and, his inability to respond to commands served as formidable predicaments. The advances in reverse engineering and rapid prototyping were utilized to virtually design and fabricate a customized heat polymerized polymethylmethacrylate cranioplast. A bone level digital try-in using grids for calibration was accurately executed to esthetic and morphological success, without the patient's absence acting as a deterrent. Subsequently, the cranial wax pattern having a multiplanar contour and curvature was invested in a custom-built clamp flask for polymerization.
Conclusion: The exigency to safeguard the exposed neural remnants and restore the skull contour was successfully fulfilled by fabrication of a patient specific cranioplast having a precise marginal fit and contour and reduced surgical duration of placement with minimal adjustments. The appropriate use of contemporary digital tools proved to be a boon in managing a large, complex bony defect in a compromised patient with minimal interference to critical care settings.
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