Novel finite element-based plate design for bridging mandibular defects: Reducing mechanical failure.
Oral Dis
; 26(6): 1265-1274, 2020 Sep.
Article
in En
| MEDLINE
| ID: mdl-32176821
ABSTRACT
INTRODUCTION:
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. PATIENTS ANDMETHODS:
Eight patients were included in the study. Indications were as follows 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.RESULTS:
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 5.76° (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).CONCLUSION:
Reconstructing mandibular continuity defects with bookshelf-reconstruction plates with FEA underpinning the design seems to reduce the risk of screw pull-out and plate fractures.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Oral Dis
Journal subject:
ODONTOLOGIA
Year:
2020
Document type:
Article
Affiliation country:
Netherlands