Abstract
BACKGROUND: Craniomaxillofacial reconstruction poses significant clinical challenges due to the complexity of the anatomy and the varied causes of defects. Selecting the optimal implant material remains a crucial factor in achieving successful functional and aesthetic outcomes. This study combined a systematic review and a retrospective case series conducted at the Hospital 5, Almaty, Kazakhstan. The sample consisted of 52 patients who underwent craniomaxillofacial reconstruction between 2021 and 2024, receiving either PEEK, titanium, PMMA or silicone implants. Following the surgical procedures, patients were invited to participate in an online survey to evaluate their satisfaction with long-term outcomes. RESULTS: PEEK implants demonstrated the complication rate at 22.2%, attributable only to hematoma. Titanium implants exhibited the complication rate-22.7%, with cases of asymmetry and diplopia (4.5%), exposure (9.1%), hematoma (4.5%) and infection with rejection (9.1%). Aesthetic outcome scores, measured by the ANA scale, varied across materials. PEEK implants achieved the highest mean ANA rating with 8.86 (SD = 0.35; 8.25-9.25), showing a significant difference over PMMA, silicone and titanium. CONCLUSIONS: PEEK implants demonstrated promising clinical and aesthetic outcomes in craniomaxillofacial reconstruction. However, material selection should be personalised, considering defect location, soft tissue coverage to optimise results.