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Three-dimensional image reconstruction and rapid prototyping models improve defect evaluation, treatment planning, implant design, and surgeon accuracy. It is found that both 3-D imaging and physical models are helpful for the evaluation of cranial defects, treatment planning, and custom implant design. While 3-D imaging can be used on a routine basis, the physical skull models could be a useful additional tool, especially when the cranial defects are rare, unusual, or difficult. In this case, the introduction of a rapid prototyping stereolithographic medical model for manufacturing a large cranioplasty implant is considered to be an improvement over other traditional techniques. Because of the accuracy of the physical model, the surgeon has a good understanding of the cranial defect and precise fitting implants can be fabricated in order to re-establish skull contours for the patient. In addition, the excellent fitting and fixation techniques of cranioplasty have reduced operating time significantly.