Bogdanovic, Ivan (55376410100)Ivan (55376410100)BogdanovicMilisavljević, Filip (57219123239)Filip (57219123239)MilisavljevićMiljković, Aleksandar (54899611800)Aleksandar (54899611800)MiljkovićJovanović, Nemanja (57225700904)Nemanja (57225700904)JovanovićIlić, Rosanda (56688276500)Rosanda (56688276500)Ilić2025-06-122025-06-122022https://doi.org/10.2298/SARH210111097Bhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85127262199&doi=10.2298%2fSARH210111097B&partnerID=40&md5=c846cc83d977dd1cc1a0d08bcf3d3d5ahttps://remedy.med.bg.ac.rs/handle/123456789/3783Introduction Significant cranial defects result from a decompressive craniectomy following head trauma, malignant brain edema, intracranial hemorrhage, or resection of tumor affected bone. Unrepaired cranial defects are not just a tremendous esthetic problem. The underlying brain is unprotected, prone to injury, and this state can lead to the so-called “syndrome of the trephined” with mood instability, headaches, and even a neurological deficit. Currently, there is no widely accepted uniform technique of cranial vault shape restoration. Combining 3D technology with the use of polymethylmethacrylate is a challenging field that can bring good functional and aesthetic results and, in the case of smart design, become efficient, low-cost technology. We offer a possible solution to a problem that would be acceptable in neurosurgical practice. Case outline We present a 37-year-old male patient with a massive hemicranial defect as a consequence of previous decompressive craniectomy following severe craniocerebral injury the previous year. Together with engineers from the appropriate 3D modeling studio, we have designed a two-part mold by laser printing technology using biocompatible advanced polyamide. We made a customized polymethylmethacrylate graft intraoperatively using this mold and achieved good aesthetic results. Conclusion Reports of 3D printing assisted cranioplasties are growing, describing different techniques and cost-estimation. We hope to introduce a low-cost and simple method for repairing a skull defect. © 2022, Serbia Medical Society. All rights reserved.3D printingcraniectomycranioplastypolymethylmethacrylateskull defect