Implants for cranioplasty.

As long as there have been skull defects, there has been a recognized need to cover them in some way. Cranioplasty is the surgical correction of skull defects. The two major purposes of performing a cranioplasty are to protect the brain and to provide reasonable cosmesis. The two physical requirements of the implant are strength and malleability. Originally, foreign materials such as precious metals were used. Autogenous bone grafts have also achieved successful results. Over the past quarter-century, the popularization of acrylics and radiolucent metals has favored them over bone because of their ease of use, the absence of need to harvest donor bone, and, particularly, bone's tendency to resorb or scar. Yet foreign materials can cause excessive inflammation, producing a synovial membrane at the interface between the host bone and cranioplasty construct, increasing the risk of infection. Currently, hydroxyapatite-based ceramics, which may induce bone growth into the implant, are increasingly being used. Future applications will include antibiotic-impregnated implants and computer-generated models to improve the precision of cranioplasty fit and cosmesis.