cranioplasty plates

[acs]

Hi-

I am collecting information on various methods of creating custom
cranioplasty plates.

I am wondering how many practitioners in the United States create the
PMMA plates and who does that work in private practice.

Also, has anyone on this list switched from creating PMMA to directly
manufactured titanium plates? Can anyone speak to differences in
design between the two methods?

Thank you,

Andrea

[h.reintsema]

hello Andrea,

I am not from the States, but from Holland. We are based in a
University Hospital (UMC Groningen), where we use PMMA cranioplasty
implants since a long time. In the past based on casts made of regular
impressions; these days standard on Stereolithographic models made
from CT-data. Makes life very easy I can say and the good thing is
always a perfect fit! We have no experience with the use of titanium
plates.
We are not private, but are organized as a center for special dental
care, which includes all activities known within maxillofacial
prosthetics. It is (still?) financed by central health care money.
If any further information is needed, please let me know.
Regards,
Harry Reintsema

[acs]

Thanks Harry! I really appreciate your response.

I actually have some more specific questions on process.

Do you sculpt the plates in computer, or print the skull and then
create a wax plate from the skull model?

Do you create dental stone molds to cast the PMMA plates, or something
else? If dental stone, what do you use as a release?

How do you cure your plates?

Thanks again,

Andrea

[Paul Tanner]

Andrea,
You may want to talk to Gwen Guilford. She works at Bethesda Naval Hospital in DC and probably does over 100 cranial plate a year. They have a pretty efficient system there. Honestly, I think there are very few private practitioners that make the cranial plates, which is why nobody really responded to your question. Perhaps it's because neurosurgeons don't know our abilities, and perhaps VA assumes the care for the majority of these patients. I put out some feelers at the University of Utah and nobody was really interested.
Paul

[JUAN GARCIA]

Ditto here. My surgeons said they go to Synthes for these.

Juan R. Garcia, MA
Certified Clinical Anaplastologist
Medical Illustrator
Assistant Professor
Johns Hopkins University
Department of Art as Applied to Medicine
1830 E. Monument Street, Suite 7000
Baltimore, Maryland 21205
410 955-8215 Phone; 410 955-1085 Fax



>>> Paul Tanner <paul....@hci.utah.edu> 8/17/2009 12:55 PM >>>

[Ramesh Chowdhary]

Dear Andrea,
Dr.chowdhary from india, am a prosthodntist, sorry to interfear,could not stop from interfearing.
i would like o share my experianceat Glasgow,
i have cmpleted a course in maxillofacail prosthetics at southern general hospital Glasgow.for 4 month,
there in the lab i was trained for skull plate , they earlier use to make with PMMA, but now mostly of titanium plate with the help of sterolithographic models.
The job is tuff, especially geting the shape of the defectd area in titanium under the hydrolic press machine.
even i learnt the casted christinson mandible and glinoid fossa for the hemimandibelectomy cases.
regards
Dr.chowdhary

--- On Mon, 8/17/09, Paul Tanner <paul....@hci.utah.edu> wrote:

[Paul Tanner]

Now that Juan mentioned it, indeed a surgeon told me that said he used Synthes. http://us.synthes.com/Products/CMF/Cranial/Patient+Specific+Implants.htm

On another note, I think we need to talk to our Synthes reps and request that they make a system for craniofacial and finger implants. All I hear is complaints from our surgeons about how cumbersome and inefficient the two American systems are (Cochlear/Entific and Straumann)and they cost way more than they should.

[acs]

Hi all-

Thank you all for your responses. I have talked to Gwen and to Robert
Mann already- just wanted to see what other methods were out there.

Thank you, also, for forwarding that link to Synthes. I was
interested to see they use PEEK. Has anyone heard of comparisons
between PMMA and PEEK- other than that PEEK is machinable? Infection
rates, etc.?

Best,

Andrea

On Aug 17, 2:49 pm, "Paul Tanner" <paul.tan...@hci.utah.edu> wrote:
> Now that Juan mentioned it, indeed a surgeon told me that said he used Synthes.  http://us.synthes.com/Products/CMF/Cranial/Patient+Specific+Implants.htm
>
> On another note, I think we need to talk to our Synthes reps and request that they make a system for craniofacial and finger implants. All I hear is complaints from our surgeons about how cumbersome and inefficient the two American systems are (Cochlear/Entific and Straumann)and they cost way more than they should.
>
> Paul
>
> -----Original Message-----
> From: anapla...@googlegroups.com [mailto:anapla...@googlegroups.com] On Behalf Of Ramesh Chowdhary
> Sent: Monday, August 17, 2009 12:33 PM
> To: anapla...@googlegroups.com
> Subject: [Anaplastology] Re: cranioplasty plates
>
> Dear Andrea,
>  Dr.chowdhary from india, am a prosthodntist, sorry to interfear,could not stop from interfearing.
>  i would like o share my experianceat Glasgow,
>   i have cmpleted a course in maxillofacail prosthetics at southern general hospital Glasgow.for 4 month,
>   there in the lab  i was trained for skull plate , they earlier use to make with PMMA, but now mostly of titanium plate with the help of sterolithographic models.
>  The job is tuff, especially geting the shape of the defectd area in titanium under the hydrolic press machine.
>     even i learnt the casted christinson mandible and glinoid fossa for the hemimandibelectomy cases.
>       regards
>  Dr.chowdhary
>

> --- On Mon, 8/17/09, Paul Tanner <paul.tan...@hci.utah.edu> wrote:

[JUAN GARCIA]

Here at JHU they are using PEEK implants made by Synthes as I mentioned before. Here's a paper:
Arch Facial Plast Surg. 2009;11(1):53-57.

Juan R. Garcia, MA
Certified Clinical Anaplastologist
Medical Illustrator
Assistant Professor
Johns Hopkins University
Department of Art as Applied to Medicine
1830 E. Monument Street, Suite 7000
Baltimore, Maryland 21205
410 955-8215 Phone; 410 955-1085 Fax

>>> acs <acste...@gmail.com> 8/18/2009 2:36 PM >>>

[Daril Atkins]

I cannot resist the temptation to relate how we did this forty years
ago. This is how: of course the scalp is well shaved and Vaseline is
applied and rubbed off. Then an alginate impression was backed by
plaster bandage, and finally stone plaster was cast. Thereafter the
cast was given a smooth finish and a model was created in the defect
using wax after which the stone mold was completed. If the defect was
not too large, brass flasks were used. In those days (1969 to 1974)we
used MDX-4-4515 if I remember correctly. It came as a cheese block and
had to be refrigerated. You needed to use surgical gloves and a
sterile SS knife to slice off your requirement and lay it directly
into the mold cavity. We used a hydraulic press to compress the
material which was then heat cured. Later after giving the product a
good finish, we drilled holes on the periphery. After thorough
cleaning the product was sterilized and touched again only at the
event of insertion. We would be present in the OT and urged the
surgeons to change gloves prior to touching the implant. I do not
recall any rejections.

Daril Atkins

On Aug 24, 11:11 pm, "JUAN GARCIA" <jgarc...@jhmi.edu> wrote:
> Here at JHU they are using PEEK implants made by Synthes as I mentioned before. Here's a paper:
> Arch Facial Plast Surg. 2009;11(1):53-57.
>
> Juan R. Garcia, MA
> Certified Clinical Anaplastologist
> Medical Illustrator
> Assistant Professor
> Johns Hopkins University
> Department of Art as Applied to Medicine
> 1830 E. Monument Street, Suite 7000
> Baltimore, Maryland 21205
> 410 955-8215 Phone; 410 955-1085 Fax
>

> >>> acs <acsteven...@gmail.com> 8/18/2009 2:36 PM >>>

> > > > > Andrea- Hide quoted text -
>
> - Show quoted text -