Patient-specific miniplates versus patient-specific reconstruction plate: A biomechanical comparison with 3D-printed plates in mandibular reconstruction.
J Mech Behav Biomed Mater
; 140: 105742, 2023 04.
Article
en En
| MEDLINE
| ID: mdl-36857975
ABSTRACT
BACKGROUND:
Patient-specific 3D-printed miniplates for free flap fixation in mandibular reconstruction were recently associated with enhanced osseous union. Higher mechanical strains resulting from these plates are discussed as reasons, but biomechanical studies are missing. This study aims to examine, whether patient-specific 3D-printed miniplates provide an increased interosteotomy movement (IOM) and lower stiffness compared with reconstruction plates.METHODS:
Polyurethane (PU) mandible and fibula models (Synbone AG, Malans, Schweiz) were used to simulate mandibular reconstruction with a one segment fibula flap equivalent. Osteosynthesis was performed using either four patient-specific 3D-printed miniplates (3D-Mini) or one patient-specific 3D-printed reconstruction plate (3D-Recon). Mastication was simulated using cyclic dynamic loading with increasing loads until material failure or a maximum load of 1000 N. Continuous IOM recording was carried out using a 3D optical tracking system (ARAMIS, Carl Zeiss GOM Metrology, Braunschweig, Germany).FINDINGS:
The averaged stiffness at a load of 100-300 N load did not differ between the groups (p = 0.296). There was a faster 1.0 mm vertical displacement in the 3D-Mini group (26 376 ± 14 190 cycles versus 44 817 ± 30 430 cycles, p = 0.018). The IOM were higher with miniplate fixation in the distal gap (p = 0.040). In the mesial gap, there was no significant difference between the groups (p = 0.160).INTERPRETATION:
Fixation with patient-specific 3D-printed miniplates results in higher mechanical strains. Lower rates of pseudarthrosis, as seen in clinical studies, might be caused by this phenomenon. Surgeons should evaluate the primary use of 3D-printed miniplates in mandibular reconstruction due to advantages of intraoral plate removal alongside safe osteosynthesis.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Reconstrucción Mandibular
Tipo de estudio:
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
J Mech Behav Biomed Mater
Asunto de la revista:
ENGENHARIA BIOMEDICA
Año:
2023
Tipo del documento:
Article