{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:00:01Z","timestamp":1793059201673,"version":"4.5.0"},"reference-count":64,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T00:00:00Z","timestamp":1628294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Recent advancements in medical imaging, virtual surgical planning (VSP), and three-dimensional (3D) printing have potentially changed how today\u2019s craniomaxillofacial surgeons use patient information for customized treatments. Over the years, polyetheretherketone (PEEK) has emerged as the biomaterial of choice to reconstruct craniofacial defects. With advancements in additive manufacturing (AM) systems, prospects for the point-of-care (POC) 3D printing of PEEK patient-specific implants (PSIs) have emerged. Consequently, investigating the clinical reliability of POC-manufactured PEEK implants has become a necessary endeavor. Therefore, this paper aims to provide a quantitative assessment of POC-manufactured, 3D-printed PEEK PSIs for cranial reconstruction through characterization of the geometrical, morphological, and biomechanical aspects of the in-hospital 3D-printed PEEK cranial implants. The study results revealed that the printed customized cranial implants had high dimensional accuracy and repeatability, displaying clinically acceptable morphologic similarity concerning fit and contours continuity. From a biomechanical standpoint, it was noticed that the tested implants had variable peak load values with discrete fracture patterns and failed at a mean (SD) peak load of 798.38 \u00b1 211.45 N. In conclusion, the results of this preclinical study are in line with cranial implant expectations; however, specific attributes have scope for further improvements.<\/jats:p>","DOI":"10.3390\/ijms22168521","type":"journal-article","created":{"date-parts":[[2021,8,8]],"date-time":"2021-08-08T21:49:41Z","timestamp":1628459381000},"page":"8521","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":95,"title":["Quantitative Assessment of Point-of-Care 3D-Printed Patient-Specific Polyetheretherketone (PEEK) Cranial Implants"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3299-0945","authenticated-orcid":false,"given":"Neha","family":"Sharma","sequence":"first","affiliation":[{"name":"Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland"},{"name":"Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soheila","family":"Aghlmandi","sequence":"additional","affiliation":[{"name":"Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Dalcanale","sequence":"additional","affiliation":[{"name":"Institute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts North-Western Switzerland, CH-4132 Muttenz, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Seiler","sequence":"additional","affiliation":[{"name":"Institute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts North-Western Switzerland, CH-4132 Muttenz, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Florian","family":"Zeilhofer","sequence":"additional","affiliation":[{"name":"Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4743-5082","authenticated-orcid":false,"given":"Philipp","family":"Honigmann","sequence":"additional","affiliation":[{"name":"Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland"},{"name":"Hand Surgery, Cantonal Hospital Baselland, CH-4410 Liestal, Switzerland"},{"name":"Amsterdam UMC, Department of Biomedical Engineering and Physics, University of Amsterdam, Amsterdam Movement Sciences, NL-1105 Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3035-9308","authenticated-orcid":false,"given":"Florian M.","family":"Thieringer","sequence":"additional","affiliation":[{"name":"Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland"},{"name":"Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1097\/00001665-200303000-00003","article-title":"Clinical outcome in cranioplasty: Critical review in long-term follow-up","volume":"14","author":"Jackson","year":"2003","journal-title":"J. Craniofac. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.wneu.2020.04.211","article-title":"Cranioplasty: A comprehensive review of the history, materials, surgical aspects, and complications","volume":"139","author":"Alkhaibary","year":"2020","journal-title":"World Neurosurg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"162","DOI":"10.4103\/0976-3147.83584","article-title":"Cranioplasty: Review of materials and techniques","volume":"2","author":"Aydin","year":"2011","journal-title":"J. Neurosci. Rural Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1227\/NEU.0000000000000899","article-title":"The Recent Revolution in the Design and Manufacture of Cranial Implants: Modern Advancements and Future Directions","volume":"77","author":"Bonda","year":"2015","journal-title":"Neurosurgery"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1054\/bjps.1999.3268","article-title":"Custom cranioplasty using stereolithography and acrylic","volume":"53","author":"Earwaker","year":"2000","journal-title":"Br. J. Plast. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.wneu.2021.01.102","article-title":"Evaluation of Patient-Specific Cranial Implant Design Using Finite Element Analysis","volume":"148","author":"Huys","year":"2021","journal-title":"World Neurosurg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1097\/01.scs.0000249359.56417.7e","article-title":"Complex orbito-fronto-temporal reconstruction using computer-designed PEEK implant","volume":"18","author":"Scolozzi","year":"2007","journal-title":"J. Craniofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1097\/00006534-200203000-00005","article-title":"Cranial reconstruction with computer-generated hard-tissue replacement patient-matched implants: Indications, surgical technique, and long-term follow-up","volume":"109","author":"Eppley","year":"2002","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1097\/01.prs.0000182386.78775.cd","article-title":"New frontiers in calvarial reconstruction: Integrating computer-assisted design and tissue engineering in cranioplasty","volume":"116","author":"Chim","year":"2005","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1007\/s00170-020-06213-w","article-title":"Design of custom cranial prostheses combining manufacturing and drop test finite element simulations","volume":"111","author":"Palumbo","year":"2020","journal-title":"Int. J. Adv. Manuf. Technol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s10006-018-0704-z","article-title":"Use of 3-D printing technologies in craniomaxillofacial surgery: A review","volume":"22","author":"Ghai","year":"2018","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e1582","DOI":"10.1097\/GOX.0000000000001582","article-title":"Craniofacial Reconstruction by a Cost-Efficient Template-Based Process Using 3D Printing","volume":"5","author":"Msallem","year":"2017","journal-title":"Plast. Reconstr. Surg. Glob. Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1007\/s00170-020-06397-1","article-title":"3D printed composite materials for craniofacial implants: Current concepts, challenges and future directions","volume":"112","author":"Jindal","year":"2021","journal-title":"Int. J. Adv. Manuf. Technol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.medengphy.2004.06.001","article-title":"Design and fabrication of custom mandible titanium tray based on rapid prototyping","volume":"26","author":"Singare","year":"2004","journal-title":"Med. Eng. Phys."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Ghantous, Y., Nashef, A., Mohanna, A., and Abu-El-Naaj, I. (2020). Three-Dimensional Technology Applications in Maxillofacial Reconstructive Surgery: Current Surgical Implications. Nanomaterials, 10.","DOI":"10.3390\/nano10122523"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s12178-014-9214-2","article-title":"Patient specific implants: Scope for the future","volume":"7","author":"Maniar","year":"2014","journal-title":"Curr. Rev. Musculoskelet. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s40902-020-00262-7","article-title":"Patient-specific implants for maxillofacial defects: Challenges and solutions","volume":"42","author":"Alasseri","year":"2020","journal-title":"Maxillofac. Plast. Reconstr. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.jormas.2017.07.002","article-title":"How useful is 3D printing in maxillofacial surgery?","volume":"118","author":"Louvrier","year":"2017","journal-title":"J. Stomatol. Oral Maxillofac. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"456","DOI":"10.21037\/atm.2016.12.18","article-title":"Surgical applications of three-dimensional printing: A review of the current literature & how to get started","volume":"4","author":"Hoang","year":"2016","journal-title":"Ann. Transl. Med."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Chamo, D., Msallem, B., Sharma, N., Aghlmandi, S., Kunz, C., and Thieringer, F.M. (2020). Accuracy Assessment of Molded, Patient-Specific Polymethylmethacrylate Craniofacial Implants Compared to Their 3D Printed Originals. J. Clin. Med., 9.","DOI":"10.3390\/jcm9030832"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e356","DOI":"10.1016\/j.wneu.2020.12.138","article-title":"3D-Printer-Assisted Patient-Specific Polymethyl Methacrylate Cranioplasty: A Case Series of 16 Consecutive Patients","volume":"148","author":"Skalicky","year":"2021","journal-title":"World Neurosurg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2297.e1","DOI":"10.1016\/j.joms.2020.08.007","article-title":"Computer-Guided In-House Cranioplasty: Establishing a Novel Standard for Cranial Reconstruction and Proposal of an Updated Protocol","volume":"78","author":"Tel","year":"2020","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s41205-021-00096-7","article-title":"Cranioplasty with three-dimensional customised mould for polymethylmethacrylate implant: A series of 16 consecutive patients with cost-effectiveness consideration","volume":"7","author":"Lobo","year":"2021","journal-title":"3D Print Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s41205-021-00101-z","article-title":"Point-of-care manufacturing: A single university hospital\u2019s initial experience","volume":"7","author":"Pascau","year":"2021","journal-title":"3D Print Med."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Msallem, B., Sharma, N., Cao, S., Halbeisen, F.S., Zeilhofer, H.F., and Thieringer, F.M. (2020). Evaluation of the Dimensional Accuracy of 3D-Printed Anatomical Mandibular Models Using FFF, SLA, SLS, MJ, and BJ Printing Technology. J. Clin. Med., 9.","DOI":"10.3390\/jcm9030817"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s41205-020-00082-5","article-title":"3D printed bone models in oral and cranio-maxillofacial surgery: A systematic review","volume":"6","author":"Meglioli","year":"2020","journal-title":"3D Print Med."},{"key":"ref_27","first-page":"4520636","article-title":"Patient-Specific Surgical Implants Made of 3D Printed PEEK: Material, Technology, and Scope of Surgical Application","volume":"19","author":"Honigmann","year":"2018","journal-title":"Biomed Res. Int."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Han, X., Sharma, N., Xu, Z., Scheideler, L., Geis-Gerstorfer, J., Rupp, F., Thieringer, F.M., and Spintzyk, S. (2019). An In Vitro Study of Osteoblast Response on Fused-Filament Fabrication 3D Printed PEEK for Dental and Cranio-Maxillofacial Implants. J. Clin. Med., 8.","DOI":"10.3390\/jcm8060771"},{"key":"ref_29","unstructured":"Sharma, N., Honigmann, P., Cao, S., and Thieringer, F. (2020). Dimensional characteristics of FDM 3D printed PEEK implant for craniofacial reconstructions. Trans. AMMM, 2."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1097\/SCS.0000000000007192","article-title":"Surgical and Patient-Reported Outcomes in Patients with PEEK Versus Titanium Cranioplasty Reconstruction","volume":"32","author":"Asaad","year":"2021","journal-title":"J. Craniofac. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"433","DOI":"10.21037\/jss.2017.09.01","article-title":"Systematic review of 3D printing in spinal surgery: The current state of play","volume":"3","author":"Wilcox","year":"2017","journal-title":"J. Spine Surg."},{"key":"ref_32","first-page":"1301028","article-title":"In-Hospital 3D Printed Scaphoid Prosthesis Using Medical-Grade Polyetheretherketone (PEEK) Biomaterial","volume":"11","author":"Honigmann","year":"2021","journal-title":"Biomed Res. Int."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Sharma, N., Aghlmandi, S., Cao, S., Kunz, C., Honigmann, P., and Thieringer, F.M. (2020). Quality characteristics and clinical relevance of in-house 3D-printed customized polyetheretherketone (PEEK) implants for craniofacial reconstruction. J. Clin. Med., 9.","DOI":"10.3390\/jcm9092818"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s10006-017-0668-4","article-title":"Considerations in computer-aided design for inlay cranioplasty: Technical note","volume":"22","author":"Nout","year":"2018","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/j.jcms.2018.07.012","article-title":"The use of cranial resection templates with 3D virtual planning and PEEK patient-specific implants: A 3 year follow-up","volume":"47","author":"Schreurs","year":"2019","journal-title":"J. Craniomaxillofac. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Basgul, C., Spece, H., Sharma, N., Thieringer, F.M., and Kurtz, S.M. (2021). Structure, properties, and bioactivity of 3D printed PAEKs for implant applications: A systematic review. J. Biomed Mater. Res. B Appl. Biomater., online ahead of print.","DOI":"10.1002\/jbm.b.34845"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"4845","DOI":"10.1016\/j.biomaterials.2007.07.013","article-title":"PEEK biomaterials in trauma, orthopedic, and spinal implants","volume":"28","author":"Kurtz","year":"2007","journal-title":"Biomaterials"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.wneu.2019.05.191","article-title":"Three-dimensional printed polymethylmethacrylate Casting molds for Posterior Fossa reconstruction in the surgical Treatment of Chiari I Malformation: Technical note and Illustrative cases","volume":"129","author":"Pijpker","year":"2019","journal-title":"World Neurosurg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.jocn.2020.12.020","article-title":"Evaluation of implant properties, safety profile and clinical efficacy of patient-specific acrylic prosthesis in cranioplasty using 3D binderjet printed cranium model: A pilot study","volume":"85","author":"Basu","year":"2021","journal-title":"J. Clin. Neurosci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1007\/s00701-013-1977-5","article-title":"Intraoperative fabrication of patient-specific moulded implants for skull reconstruction: Single-centre experience of 28 cases","volume":"156","author":"Stieglitz","year":"2014","journal-title":"Acta Neurochir."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.matdes.2017.10.078","article-title":"Additive manufacture of PEEK cranial implants: Manufacturing considerations versus accuracy and mechanical performance","volume":"139","author":"Berretta","year":"2018","journal-title":"Mater. Des."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Kung, W.M., Chen, S.T., Lin, C.H., Lu, Y.M., Chen, T.H., and Lin, M.S. (2013). Verifying three-dimensional skull model reconstruction using cranial index of symmetry. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0074267"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.3171\/2015.5.JNS15119","article-title":"The feasibility of producing patient-specific acrylic cranioplasty implants with a low-cost 3D printer","volume":"124","author":"Tan","year":"2016","journal-title":"J. Neurosurg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.jcms.2016.11.016","article-title":"Patient-specific polymethylmethacrylate prostheses for secondary reconstruction of large calvarial defects: A retrospective feasibility study of a new intraoperative moulding device for cranioplasty","volume":"45","author":"Moser","year":"2017","journal-title":"J Craniomaxillofac. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1016\/j.jbiomech.2009.05.030","article-title":"The mechanical properties of cranial bone: The effect of loading rate and cranial sampling position","volume":"42","author":"Motherway","year":"2009","journal-title":"J. Biomech."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1089\/neu.2011.1794","article-title":"Cranioplasty with customized titanium and PEEK implants in a mechanical stress model","volume":"29","author":"Lethaus","year":"2012","journal-title":"J. Neurotrauma"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1080\/17452759.2015.1097053","article-title":"Extrusion-based additive manufacturing of PEEK for biomedical applications","volume":"10","author":"Vaezi","year":"2015","journal-title":"Virtual Phys. Prototyp."},{"key":"ref_48","first-page":"102097","article-title":"Heat transfer-based non-isothermal healing model for the interfacial bonding strength of fused filament fabricated polyetheretherketone","volume":"46","author":"Basgul","year":"2021","journal-title":"Addit. Manuf."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.1016\/j.jmbbm.2011.05.039","article-title":"Mechanical characterization and numerical simulation of polyether-ether-ketone (PEEK) cranial implants","volume":"4","author":"Rodriguez","year":"2011","journal-title":"J. Mech. Behav. Biomed Mater."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1097\/00006534-199809010-00027","article-title":"Determinations of strength of synthetic hydroxyapatite ceramic implants","volume":"102","author":"Ono","year":"1998","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_51","first-page":"e136","article-title":"The efficacy of custom-made porous hydroxyapatite prostheses for cranioplasty: Evaluation of postmarketing data on 2697 patients","volume":"13","author":"Stefini","year":"2015","journal-title":"J. Appl. Biomater. Funct. Mater."},{"key":"ref_52","first-page":"e356","article-title":"Load-bearing capacity and fracture behavior of glass fiber-reinforced composite cranioplasty implants","volume":"15","author":"Piitulainen","year":"2017","journal-title":"J. Appl. Biomater. Funct. Mater."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e399","DOI":"10.1016\/j.wneu.2018.10.061","article-title":"Patient-Specific Titanium-Reinforced Calcium Phosphate Implant for the Repair and Healing of Complex Cranial Defects","volume":"122","author":"Linder","year":"2019","journal-title":"World Neurosurg."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"103701","DOI":"10.1016\/j.jmbbm.2020.103701","article-title":"Mechanical behaviour of composite calcium phosphate\u2013titanium cranial implants: Effects of loading rate and design","volume":"104","author":"Lewin","year":"2020","journal-title":"J. Mech. Behav. Biomed Mater."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"109207","DOI":"10.1016\/j.matdes.2020.109207","article-title":"Additively manufactured mesh-type titanium structures for cranial implants: E-PBF vs. L-PBF","volume":"197","author":"Lewin","year":"2021","journal-title":"Mater. Des."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1002\/rcs.171","article-title":"A classification of cranial implants based on the degree of difficulty in computer design and manufacture","volume":"4","author":"Poukens","year":"2008","journal-title":"Int. J. Med. Robot."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"647923","DOI":"10.3389\/fphys.2021.647923","article-title":"Design and Additive Manufacturing of a Biomimetic Customized Cranial Implant Based on Voronoi Diagram","volume":"12","author":"Sharma","year":"2021","journal-title":"Front. Physiol."},{"key":"ref_58","unstructured":"Kurtz, S. (2019). Additive Manufacturing of Polyaryletherketones. PEEK Biomaterials Handbook, William Andrew Publishing. [2nd ed.]."},{"key":"ref_59","unstructured":"Kurtz, S. (2019). FDA Regulation of PEEK Implants. PEEK Biomaterials Handbook, William Andrew Publishing. [2nd ed.]."},{"key":"ref_60","unstructured":"International Organization for Standardization (2021, July 10). ISO 5725-2:2019. Accuracy (Trueness and Precision) of Measurement Methods and Results\u2014Part 2: Basic Method for the Determination of Repeatability and Reproducibility of a Standard Measurement Method. Available online: https:\/\/www.iso.org\/standard\/69419.html."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/S0022-3913(13)60028-1","article-title":"Accuracy of complete-arch dental impressions: A new method of measuring trueness and precision","volume":"109","author":"Ender","year":"2013","journal-title":"J. Prosthet. Dent."},{"key":"ref_62","first-page":"537","article-title":"Cranial index of symmetry: An objective semiautomated measure of plagiocephaly. Technical note","volume":"100","author":"Zonenshayn","year":"2004","journal-title":"J. Neurosurg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/j.jcms.2018.12.016","article-title":"Analysis of simulated mandibular reconstruction using a segmental mirroring technique","volume":"47","author":"Davies","year":"2019","journal-title":"J. Craniomaxillofac. Surg."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1002\/hed.21946","article-title":"Maxillary reconstruction using the scapular tip free flap: A radiologic comparison of 3D morphology","volume":"34","author":"Pagedar","year":"2012","journal-title":"Head Neck"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/22\/16\/8521\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:42:21Z","timestamp":1760164941000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/22\/16\/8521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,7]]},"references-count":64,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2021,8]]}},"alternative-id":["ijms22168521"],"URL":"https:\/\/doi.org\/10.3390\/ijms22168521","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,7]]}}}