Novel finite element based plate design for bridging mandibular defects; reducing mechanical failure

Oral Diseases
B J MeremaM J H Witjes

Abstract

When the application of a free vascularised flap is not possible, a segmental mandibular defect is often reconstructed using a conventional reconstruction plate. Mechanical failure of such reconstructions is mostly caused by plate fracture and screw pull-out. This study aims to develop a reliable, mechanically superior, yet slender patient-specific reconstruction plate that reduces failure due to these causes. Eight patients were included in the study. Indications were: fractured reconstruction plate (2), loosened screws (1) and primary reconstruction of a mandibular continuity defect (5). Failed conventional reconstructions were studied using finite element analysis (FEA). A 3D virtual surgical plan (3D-VSP) with a novel patient-specific (PS) titanium plate was developed for each patient. Postoperative CBCT scanning was performed to validate reconstruction accuracy. All PS plates were placed accurately according to the 3D-VSP. Mean 3D screw entry point deviation was 1.54 mm (SD 0.85, R: 0.10-3.19) and mean screw angular deviation was 5.76⁰ (SD 3.27, R: 1.26 - 16.62). FEA indicated decreased stress and screw pull-out inducing forces. No mechanical failures appeared (mean follow-up: 16 months, R: 7-29). Reconstructing mandibular...Continue Reading

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Citations

Oct 3, 2020·Oral Diseases·Max J H Witjes, Arjan Vissink

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BETA
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Software Mentioned

Mimics Medical
Matic Medical
Geomagic Studio
Geomagic
MedCalc
Solidworks Professional
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