Application-matched point-of-care 3D printing of functionalized polyetheretherketone (PEEK) composites for patient-specific craniomaxillofacial implants

BACKGROUND: Native polyetheretherketone (PEEK) exhibits limitations in mechanical strength, radiographic visibility, and bioactivity for craniomaxillofacial (CMF) applications. This proof-of-concept study establishes the feasibility of point-of-care (POC) manufacturing for three functionalized PEEK composites for patient-specific CMF implants using a high-temperature material extrusion (MEX) system, with application-specific material selection to overcome these limitations. METHODS: Carbon fiber-reinforced PEEK (CFR-PEEK), barium sulfate-filled PEEK (BaSO₄-PEEK), and biphasic calcium phosphate-filled PEEK (BCP-PEEK) were fabricated into patient-specific mandibular reconstruction plates, orbital floor implants, and chin augmentation implants, respectively. Manufacturing success rates, dimensional accuracy via root mean square (RMS) deviation analysis, post-sterilization dimensional stability, and layer adhesion quality were evaluated. RESULTS: Fabrication success rates of 100% (CFR-PEEK), 100% (BaSO₄-PEEK), and 85.7% (BCP-PEEK) were achieved. Dimensional accuracy analysis revealed RMS deviations of 0.16-0.29 mm between 3D-printed implants and original designs, within clinically acceptable ranges. Post-sterilization dimensional changes were minimal (RMS 0.05-0.07 mm). Complete layer adhesion was demonstrated across all materials, with no delamination or cracking observed. CONCLUSION: These findings establish the manufacturing viability of POC fabrication of application-matched PEEK composites for patient-specific CMF implants, enhancing mechanical, radiographic, and bioactive properties whilst maintaining geometric customization.