Purpose: Low complication rates (0–10%) have previously been reported in craniofacial HTR-PMI reconstructions. We performed a retrospective study comparing our experience with that described in the literature.

Materials and Methods: 21 patients (10 males, 11 females) undergoing HTR-PMI reconstruction by seven surgeons over 3 years were reviewed. Complications were defined as implant exposure and/or infection. We evaluated implant location, preexisting bone infections and whether a history of diabetes or smoking was a risk factor for complication. Differences among outcome measures were evaluated using Fisher's exact test with significance established at p<0.05.

Results: Mean age was 43.8 years and the mean time of follow up was 8.3 months. Complication rate was 5/21 (23.8%), including 1 implant exposure, 1 soft tissue infection, and 3 implant infections. A statistically higher rate of infection was observed when compared to historical pooled data (p=0.0406). There was no correlation between implant location or preexisting bone infections and complication rates. Diabetes and smoking were not risk factors associated with complications.

Conclusion: Treating cranial bone defects with hard tissue replacement-patient matched implants (HTR-PMI) may be associated with a higher rate of complications than previously described.