Q COSTA RICA — Costa Rica’s public health system, the Caja Costarricense de Seguro Social (CCSS) or “Caja”, implanted, for the first time in Costa Rica, a personalized cranial prosthesis designed and manufactured by the institution itself using 3D printing technology.
This innovation opens new possibilities for treating patients who need highly specialized medical devices.
The procedure consisted of a cranioplasty, a surgery designed to repair a defect or opening in the skull that can occur as a result of trauma, infections, tumors, or previous surgical interventions.
Unlike a standard prosthesis, the device used was specifically made according to the patient’s anatomical characteristics, using medical images to digitally reconstruct the shape of the skull and manufacture a piece that fits the bone defect.
The executive president of the Caja, Mónica Taylor Hernández, described the procedure as a concrete application of the technological capabilities that the institution has developed in research and innovation.
“This advancement is most valuable in what it represents for the patient. We are using innovation and institutional knowledge to develop a personalized solution, specifically designed to respond to a health need,” Taylor stated.
Taylor maintained that having their own capabilities allows them to expand the available alternatives for specialized care and directly leverage technology for the benefit of patients.
“We want research and innovation to have a very clear purpose: to improve care. This first case demonstrates that the institution can develop specialized solutions that place the patient’s specific needs at the center of the process,” she added.
The development of these devices is led by the Logistics Management, through the Orthotics and Prosthetics Laboratory of the CCSS Industrial Production Directorate.
Logistics Manager Esteban Vega de la O explained that the procedure combines medical imaging, digital design, institutional manufacturing, and technical validation processes.
To produce the prosthesis, studies such as CT scans or MRIs are used, from which a model can be developed that reproduces the patient’s specific anatomical characteristics.
In the case of the first patient, a Computed Tomography (CT) scan was performed. The images were incorporated into a computer program responsible for segmenting the skull.
Subsequently, this information was transferred to another software program specialized in prosthesis fabrication. Once the bone defect was identified, the mirror image of the healthy part of the skull was used as a reference to design the prosthesis and reproduce its shape and symmetry.
Before producing the final version, the prosthesis is inspected to ensure it fits the edges of the defect and has no surfaces that could cause discomfort to the patient. The design is also reviewed by the surgeon to make any necessary adjustments.
After printing, the piece goes through stages of sanding, polishing and cleaning, then it is packaged, transported to the hospital, checked again by the specialist, and finally sterilized before implantation.
PEEK: The Material Used to Manufacture the Prosthesis
One of the keys to this innovation is the material used to produce the prosthesis: PEEK, a high-performance thermoplastic polymer that offers mechanical, thermal, and chemical resistance.
Among its advantages is that, unlike metal prostheses, it is radiolucent, so it does not cause alterations in diagnostic studies such as CT scans or MRIs. It is also characterized by its low weight, rigidity, low density, and dimensional stability.
The process to achieve this first implant began approximately two years ago and included staff training, construction of a cleanroom, acquisition of specialized equipment, and the completion of tests and procedures with health authorities.
“We have been promoting additive manufacturing technologies to institutionally produce cranial prostheses using 3D printing with biocompatible materials, with the goal of providing highly specialized, high-quality devices to the patients who need them,” Vega stated.
Up to 64% Less in Costs and Only Seven Days of Manufacturing
The Caja says it invested about ¢115 million colones (US$252,000) in a technology package for in-house 3D printing of cranial prostheses, including printers, curing equipment, software, and materials for two years.
Producing a size S cranial prosthesis internally costs roughly US$2,554, which cuts expenses by up to 64% compared to outsourcing. The entire process, from imaging to manufacturing, takes about seven days.
By mid-2026, 52 patients across three hospitals are expected to benefit.
Personalized prostheses improve aesthetics, reduce symptoms like headaches, and protect the brain where bone is missing. Candidates typically have skull defects from trauma or tumors.
“In this particular case, since these are personalized prostheses, the bone contour is improved, and therefore, so is the user’s quality of life,” stated the medical director of San Juan de Dios Hospital, María Eugenia Villalta Bonilla.
3D printing within the Caja is not limited to this procedure. The institution has also used this technology to develop surgical planning guides, anatomical models for patient education, pill organizers, tablet extractors, umbilical cord clamps, and spare parts for industrial equipment.