Novel finite element-based plate design for bridging mandibular defects: Reducing mechanical failure
| Autor: | Joep Kraeima, Max J. H. Witjes, Fred K L Spijkervet, Kees-Pieter Schepman, Sebastiaan A. H. J. de Visscher, Bram B J Merema, Baucke van Minnen |
|---|---|
| Přispěvatelé: | Translational Immunology Groningen (TRIGR), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE) |
| Rok vydání: | 2019 |
| Předmět: |
Decreased stress
Bridging (networking) Materials science RESECTION SURGERY ACCURACY finite element analysis CAD-CAM CAD‐CAM Titanium plate 03 medical and health sciences 0302 clinical medicine patient-specific modelling RECONSTRUCTION PLATES IMPLANT patient‐specific modelling prosthesis and implants General Dentistry Mouth neoplasm Orthodontics JOINT mouth neoplasms Mechanical failure 030206 dentistry Finite element method FRACTURE Angular deviation Bone and Hard Tissues Otorhinolaryngology 030220 oncology & carcinogenesis Original Article Implant BEHAVIOR mandibular reconstruction |
| Zdroj: | Oral Diseases Oral diseases, 26(6), 1265-1274. Wiley |
| ISSN: | 1601-0825 1354-523X |
| Popis: | 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 and Methods: 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text