ABSTRACT
Hard tissue cranial defects may result from traumatic or iatrogenic etiology and warrants adequate reconstruction to provide protection to the underlying brain and cosmesis. Various techniques have been described in the literature for fabrication of patient specific titanium cranial implants. The process of fabrication of titanium patient specific implants (PSI) can be broadly classified into indirect and direct techniques. With the improvements in the medical imaging and computational modeling, direct technique of computer assisted prefabricated patient specific implants have gained popularity. However indirect method of PSI fabrication hold some specific advantage. Here we describe a technique for fabrication of titanium PSI by combining the principles of direct and indirect methods for reconstruction of cranial defects.