3D-Printed PEEK versus Conventional Free Fibula Flap for Jaw Reconstruction: A Comparative Clinical Study

Feng Dongdong^1,2,3Zhang Yuxiang^1,4Haiwei Guo^1,2,3Zheng Chuanming^1,2,3Zhang Yining^1,5Wanchen Zhang^1,6Lai Fangyuan⁷Jiajie Xu^1,2,7*

• ¹Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou City, China
• ²Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou City, China
• ³Clinical Research Center for Cancer of Zhejiang Province, Hangzhou City, China
• ⁴Second Clinical Medical School, Hangzhou Normal University, Hangzhou City, China
• ⁵The Second Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou City, China
• ⁶The First Affiliated Hospital of Ningbo University, Ningbo City, China
• ⁷Center for Plastic & Reconstructive Surgery, Department of Plastic & Reconstructive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou City, China

1. Abstract: Purpose : Aims to evaluate the application value of PEEK based on 3D printing technology for jaw reconstruction. Methods: This study retrospectively analyzed 16 patients who underwent jaw reconstruction in the Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital from August 2019 to December 2023. A subsequent comparison was made between the effectiveness of FFF and PEEK schemes. Result: A total of 16 patients were included in this study. In the FFF group, six male and two female patients (mean age: 40.8±21.2 years) underwent jaw defect reconstruction successfully. However, one patient in this group required removal of the titanium plate due to uncontrollable infection. In the PEEK group, which consisted of five males and three females (mean age: 56.3±12.6 years), six patients achieved satisfactory outcomes, including accurate jaw restoration and good occlusal function during follow-up, and were successfully discharged. However, two patients in this group experienced secondary infection, which necessitated removal of the PEEK implants and subsequent salvage reconstruction using FFF. The operative time was significantly shorter in the PEEK group compared to the FFF group (P<0.05). Infection was identified as the primary cause of reconstruction failure in the PEEK group, for which FFF served as an effective salvage procedure. Although the PEEK group showed lower means in intraoperative blood loss, postoperative drainage and reduction in BMI compared to the FFF group, these differences did not reach statistical significance. Conclusion: 3D printing technology enables the fabrication of patient-specific PEEK implants with customized geometries. Owing to its stable biocompatibility, PEEK is suitable for reconstructing complex and irregular jaw defects. As a viable alternative for primary jaw reconstruction, it demonstrates promising clinical application prospects.