Polymethyl methacrylate (PMMA) has been considered a suitable material for cranioplasty. However, no consensus has been reached concerning the best material for cranioplasty with regard to minimizing complications. Thus, this systematic review and meta-analysis aimed to compare the complication rates of PMMA with those of autologous bone and titanium mesh. This review was registered with PROSPERO (CRD42016042725). Systematic searches were conducted on PubMed/MEDLINE, Scopus, and Web of Science. The focus question was, "Do PMMA prostheses used in cranioplasty have complications rates similar to those of autologous bone and titanium mesh?" A meta-analysis of complication rates was performed on the basis of dichotomous outcomes assessed by risk ratio (RR) with corresponding 95% confidence intervals (CI). From 1014 data sources, 11 articles were selected according to eligibility criteria. These articles involved 1,256 individuals and 1,278 cranioplasties using autologous bone (n = 408), PMMA (n = 379), or titanium (n = 151). The follow-up period ranged from 63 days to 54.3 months. No difference was observed between the complication rates of PMMA and autologous bone (p = 0.94; RR, 0.98; 95%CI, 0.54-1.75) or between PMMA and titanium (p = 0.38; RR, 1.59; 95%CI, 0.57-4.48). Sub-analysis of the reasons for craniotomy (trauma/non-trauma) was conducted, which revealed no significant difference (p = 0.91; RR, 0.95; 95%CI, 0.37-2.42). The meta-analysis indicated that the use of PMMA yields complication rates that are near those of autologous bone and titanium mesh.

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Rafaella de Souza Leão 1, Juliana Raposo Souto Maior 1, Cleidiel Aparecido de Araújo Lemos 2, Belmiro Cavalcanti do Egito Vasconcelos 3, Marcos Antônio Japiassú Resende Montes 1, Eduardo Piza Pellizzer 2, Sandra Lúcia Dantas Moraes 1

1Universidade de Pernambuco - UPE, Dentistry School, Recife, PE, Brazil. 2Universidade de Pernambuco - UPE, Dentistry School, Programs in Oral and Maxillofacial Surgery, Recife, PE, Brazil. 3Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba, SP, Brazil.

Braz Oral Res

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2018

29898018

10.1590/1807-3107bor-2018.vol32.0031