# Over a Decade of Maxillofacial PEEK Patient-Specific Innovation: A Retrospective Review of the Evolution from In-House Craft to Virtual Design and Remote Manufacturing

## TL;DR

This paper reviews the use of PEEK implants in maxillofacial surgery over a decade, showing they are safe and effective for complex facial reconstructions.

## Contribution

The study provides a comprehensive retrospective analysis of PEEK's clinical application and evolution in maxillofacial reconstruction.

## Key findings

- PEEK implants showed positive outcomes in 56 cases for trauma and deformity.
- Virtual surgical planning and 3D imaging improved implant customization and fit.
- Complications like infection occurred but were manageable with overall good results.

## Abstract

Maxillofacial skeletal reconstruction presents significant challenges due to anatomical complexity, functional requirements, and aesthetic demands. Traditional materials such as titanium and autogenous bone grafts have limitations, prompting interest in Polyetheretherketone (PEEK), a versatile thermoplastic polymer with advantages like biocompatibility, radiolucency, and elasticity similar to human bone. This multi-year case series evaluates the clinical outcomes of PEEK implants used in 56 cases on 53 patients for maxillofacial reconstruction, primarily for trauma (44 patients) and deformity (9 patients). PEEK implants were applied to various facial regions including the orbit, zygoma, mandible, and maxilla. The majority of surgeries utilised virtual surgical planning. Patient-specific implants were fabricated using 3D imaging technologies, allowing customisation for optimal fit and functionality. The mean patient age was 37 years with a split of 37 to 16 females. Some complications were noted such as infection and paraesthesia. However, the majority of patients experienced positive outcomes. The findings support PEEK implants as a safe, effective, and adaptable material for maxillofacial surgery, with potential for further advancements in material properties and surgical technologies to improve long-term outcomes.