CC BY 4.0 · VCOT Open 2023; 06(01): e61-e66
DOI: 10.1055/s-0042-1758679
Case Report

Additive Manufacturing of Titanium Implants for Skull Reconstruction in 2 Dogs after Bone Tumour Excision

Eline J.C. van den Brink
1   Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
Guy C.M. Grinwis
2   Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
Koen Willemsen
3   Department of Orthopedics, University Medical Center Utrecht, Utrecht, the Netherlands
4   Division of Surgical Specialties, University Medical Center Utrecht, Utrecht, the Netherlands
Floor Driessen
1   Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
Susanne A.E.B. Boroffka
5   Boroffka Diagnostic Imaging, Utrecht, the Netherlands
Björn P. Meij
1   Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
› Author Affiliations


In two dogs, skull defects were closed with a patient-specific implant created by additive manufacturing after excision of tumours of the skull. Both dogs presented with a space-occupying mass in which excisional surgery without the use of implants would have resulted in incomplete closure due to extensive bone defects of the skull. The aim of the present case report is to describe the use of individualized three-dimensional-printed titanium implants for skull reconstruction following oncological surgery. The reconstructive implant-based surgeries performed in these patients were feasible without complications.

Publication History

Received: 30 November 2021

Accepted: 02 September 2022

Article published online:
20 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

  • References

  • 1 Kamishina H, Sugawara T, Nakata K. et al. Clinical application of 3D printing technology to the surgical treatment of atlantoaxial subluxation in small breed dogs. PLoS One 2019; 14 (05) e0216445
  • 2 Carwardine DR, Gosling MJ, Burton NJ, O'Malley FL, Parsons KJ. Three-dimensional-printed patient-specific osteotomy guides, repositioning guides and titanium plates for acute correction of antebrachial limb deformities in dogs. Vet Comp Orthop Traumatol 2021; 34 (01) 43-52
  • 3 Choi S, Oh YI, Park KH, Lee JS, Shim JH, Kang BJ. New clinical application of three-dimensional-printed polycaprolactone/β-tricalcium phosphate scaffold as an alternative to allograft bone for limb-sparing surgery in a dog with distal radial osteosarcoma. J Vet Med Sci 2019; 81 (03) 434-439
  • 4 Séguin B, Pinard C, Lussier B. et al. Limb-sparing in dogs using patient-specific, three-dimensional-printed endoprosthesis for distal radial osteosarcoma: a pilot study. Vet Comp Oncol 2020; 18 (01) 92-104
  • 5 Arzi B, Cissell DD, Pollard RE, Verstraete FJ. Regenerative approach to bilateral rostral mandibular reconstruction in a case series of dogs. Front Vet Sci 2015; 2: 4
  • 6 Kim S, Mi Shim K, Jang K, Shim J, Kang S. Three-dimensional printing-based reconstruction of a maxillary bone defect in a dog following tumor removal. In Vivo 2018; 32 (01) 63-70
  • 7 Liptak JM, Thatcher GP, Bray JP. Reconstruction of a mandibular segmental defect with a customized 3-dimensional-printed titanium prosthesis in a cat with a mandibular osteosarcoma. J Am Vet Med Assoc 2017; 250 (08) 900-908
  • 8 Castilho M, Dias M, Vorndran E. et al. Application of a 3D printed customized implant for canine cruciate ligament treatment by tibial tuberosity advancement. Biofabrication 2014; 6 (02) 025005
  • 9 Joffe MR, Parr WCH, Tan C, Walsh WR, Brunel L. Development of a customized interbody fusion device for treatment of canine disc-associated cervical spondylomyelopathy. Vet Comp Orthop Traumatol 2019; 32 (01) 79-86
  • 10 Willemsen K, Tryfonidou MA, Sakkers RJB. et al. Patient-specific 3D-printed shelf implant for the treatment of hip dysplasia tested in an experimental animal pilot in canines. Sci Rep 2022; 12 (01) 3032
  • 11 Willemsen K, Tryfonidou M, Sakkers R. et al. Patient-specific 3D-printed shelf implant for the treatment of hip dysplasia: anatomical and biomechanical outcomes in a canine model. J Orthop Res 2022; 40 (05) 1154-1162
  • 12 Rotaru H, Schumacher R, Kim SG, Dinu C. Selective laser melted titanium implants: a new technique for the reconstruction of extensive zygomatic complex defects. Maxillofac Plast Reconstr Surg 2015; 37 (01) 1-6
  • 13 Willemsen K, Nizak R, Noordmans HJ, Castelein RM, Weinans H, Kruyt MC. Challenges in the design and regulatory approval of 3D-printed surgical implants: a two-case series. Lancet Digit Health 2019; 1 (04) e163-e171
  • 14 Taniguchi N, Fujibayashi S, Takemoto M. et al. Effect of pore size on bone ingrowth into porous titanium implants fabricated by additive manufacturing: an in vivo experiment. Mater Sci Eng C 2016; 59: 690-701
  • 15 Van der Stok J, Van der Jagt OP, Amin Yavari S. et al. Selective laser melting-produced porous titanium scaffolds regenerate bone in critical size cortical bone defects. J Orthop Res 2013; 31 (05) 792-799
  • 16 Oblak M, Hayes G. Use of a custom additive manufactured titanium plate for cranioplasty in a dog with multilobular osteochondrosarcoma. Abstract. European College Veterinary Surgeons 28th Annual Scientific Meeting, July 2–4, 2019, Budapest, Hungary
  • 17 Comrie ML, Monteith G, Zur Linden A, Oblak M, Phillips J, James FMK. Ontario Veterinary College Rapid Prototyping of Patient-specific Implants for Dogs (RaPPID) group. The accuracy of computed tomography scans for rapid prototyping of canine skulls. PLoS One 2019; 14 (03) e0214123
  • 18 Wang H, Su K, Su L, Liang P, Ji P, Wang C. The effect of 3D-printed Ti6Al4V scaffolds with various macropore structures on osteointegration and osteogenesis: a biomechanical evaluation. J Mech Behav Biomed Mater 2018; 88: 488-496
  • 19 Wang H, Su K, Su L, Liang P, Ji P, Wang C. Comparison of 3D-printed porous tantalum and titanium scaffolds on osteointegration and osteogenesis. Mater Sci Eng C 2019; 104: 109908
  • 20 Tanzer M, Chuang PJ, Ngo CG, Song L, TenHuisen KS. Characterization of bone ingrowth and interface mechanics of a new porous 3D printed biomaterial: an animal study. Bone Joint J 2019; 101-B (6_Supple_B, Supple_B): 62-67
  • 21 Reints Bok TE, Willemsen K, van Rijen MHP, Grinwis GCM, Tryfonidou MA, Meij BP. Instrumented cervical fusion in nine dogs with caudal cervical spondylomyelopathy. Vet Surg 2019; 48 (07) 1287-1298
  • 22 McGaffey M, Zur Linden A, Bachynski N, Oblak M, James F, Weese JS. Manual polishing of 3D printed metals produced by laser powder bed fusion reduces biofilm formation. PLoS One 2019; 14 (02) e0212995
  • 23 Bose S, Banerjee D, Shivaram A, Tarafder S, Bandyopadhyay A. Calcium phosphate coated 3D printed porous titanium with nanoscale surface modification for orthopedic and dental applications. Mater Des 2018; 151: 102-112
  • 24 Nimwegen B. Head & Neck tumors: diagnosis, staging, surgery, and multimodal treatment. Abstract. Voorjaarsdagen European Veterinary Conference, April 10–12, 2019, The Hague, The Netherlands
  • 25 Xie K, Guo Y, Zhao S. et al. Partially melted Ti6Al4V particles increase bacterial adhesion and inhibit osteogenic activity on 3D-printed implants: an in vitro study. Clin Orthop Relat Res 2019; 477 (12) 2772-2782
  • 26 Erhart N, Christensen N, Fan T. Tumors of the skeletal system. In: Vail D, Thamm D, Liptak L. eds. Withrow and MacEwan's Small animal Oncology. 6th ed.. St. Louis: Elsevier; 2020: 551-2
  • 27 Dernell WS, Straw RC, Cooper MF, Powers BE, LaRue SM, Withrow SJ. Multilobular osteochondrosarcoma in 39 dogs: 1979-1993. J Am Anim Hosp Assoc 1998; 34 (01) 11-18