Today, along with the development of automobile industry, an increase of hospitalized patients in the Department of Maxillofacial Surgery who have suffered a car accident is notice. The head and neck injuries following the road traffic crashes are the most common cause of morbidity and mortality in most developed and developing countries [1]. The traffic accidents were the cause of approximately 20% maxillofacial injuries [2]. The majority of frontal sinus wall fractures are the result of high – velocity injuries, such as motor vehicle accidents, assaults, and sporting incidents [3]. The incidence of frontal sinus injury is estimated between 6 and 12 % of all craniofacial fractures [4]. The frontal sinus trauma is not rare and it is 8% of the facial fractures [5].

It is important to keep in mind that many patients refer to the service after a few days after the car accident. In this case surgeons have to face up to the delayed treatment which is always a challenge to obtain satisfactory effects. The patients are at risk of prolonged hospital stays. Moreover in many cases they need two or more surgical procedures as it was in the case of our patient. This is because there is a lack of maxillo-facial surgeon in the hospital to which the patient was transported after the accident.

We also have to take into account that nowadays not only the functional results make an importance, but also aesthetic results. Computer and software development meets that need. One example of advanced system is Computer-Aided Design and Manufacturing (CAD/CAM). Computer Aided Design (CAD) is the process of creating, modifying, analyzing, optimizing a design [6] surgeons can design the implants themselves [7]. When this part of the design is finished, we move on to the next stage. In order to build physical models and implants such as a stereo lithograph, we transfer data to the computer- aided manufacturing system (CAM) [8]. This techniques have facilitated the rapid and precise construction of customized implants. The computer-assisted reconstruction of maxillofacial defects could provide a more predictable aesthetic outcome [9], whose postoperative position can be confirmed by CT [10]. The use of 3D imaging and CAD/CAM technology aids in the diagnosis and treatment of facial deformities which can arise after traffic injuries as was in our case, but also can be a result of malformation or iatrogenic surgical defects. CAD/CAM systems also allow customized mandibular condylar implants to be designed and fabricated with the highest degree of fit and then to be perfectly fixed to the surrounding bones [11]. Many authors describe the practical application of this computer program to create alloplastic implants for example in orbital reconstructive surgery where the custom implant covering the bone defect in the lower orbital wall. [12].

There are various kinds of material type such as titanium (solid or powder), High-Density Poly Ethylene (HDPE), Poly Ether Ether Ketone (PEEK), hydroxyapatite (HA) , poly –DL-lactic acid (PDLLA), Poly Lactide- co – Glycoside Acid (PLGA), calcium phosphate, polyethylene includes porous polyethylene (PPE) and Ultra-High Molecular Weight Poly Ethylene (UHMW-PE). We decided to use the last one mentioned above, because has several unique properties including high impact strength and a low friction coefficient that result in self-lubricating and thus non-sticking surfaces after processing [13]. It is worth mentioning that once only autogenously grafts were used, but due to their drawbacks nowadays they are rarer used. Autogenously bone graft often undergoes significant resorption and unpredictable rendering it unreliable for long- term augmentation [14].