Customized mandibular reconstruction plates improve mechanical performance in a mandibular reconstruction model

Gutwald, Ralf; Jaeger, Raimund; Lambers, Floor M.

doi:10.1080/10255842.2016.1240788

Cited by 72 publications

(53 citation statements)

References 48 publications

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“…The mathematical model of the topological optimization based on the density method is shown as follow [ 11 , 33 , 34 ]: a i is design variable, the value is continuous between [a min , 1]; n is the number of optimum design variable; V is the volume of structure before optimization; V * is the volume after optimization. F is the vector of structural force; N is the total stiffness matrix of the structure; M is the displacement vector of the structure.…”

Section: Methodsmentioning

confidence: 99%

“…However, all the mini-plates used in the clinical case are standard and straight plates, and need to be bent to bone surface before fixation, which will increase the time of the operation and may lead to mismatching between the bone surface and titanium plates [ 10 ]. Based on recent clinical statistical studies, the incidence of plate removal has risen to 18%, occurring typically in less than 6–9 months after surgery, so the stability provided by the mini-plates has become a hot issue among surgeons [ 4 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…A few researchers had designed some custom-made or three-dimensional (3D) mini-plates by changing the hole size, distance between the holes and shape of the plate for mandibular angle fractures [ 11 – 13 ]. However, these 3D plates are only modified slightly the dimensions of the existing plates and the biomechanical behavior of fixed mandible isn’t considered.…”

Section: Introductionmentioning

confidence: 99%

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A customized fixation plate with novel structure designed by topological optimization for mandibular angle fracture based on finite element analysis

et al. 2017

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BackgroundThe purpose of this study was to design a customized fixation plate for mandibular angle fracture using topological optimization based on the biomechanical properties of the two conventional fixation systems, and compare the results of stress, strain and displacement distributions calculated by finite element analysis (FEA).MethodsA three-dimensional (3D) virtual mandible was reconstructed from CT images with a mimic angle fracture and a 1 mm gap between two bone segments, and then a FEA model, including volume mesh with inhomogeneous bone material properties, three loading conditions and constraints (muscles and condyles), was created to design a customized plate using topological optimization method, then the shape of the plate was referenced from the stress concentrated area on an initial part created from thickened bone surface for optimal calculation, and then the plate was formulated as “V” pattern according to dimensions of standard mini-plate finally. To compare the biomechanical behavior of the “V” plate and other conventional mini-plates for angle fracture fixation, two conventional fixation systems were used: type A, one standard mini-plate, and type B, two standard mini-plates, and the stress, strain and displacement distributions within the three fixation systems were compared and discussed.ResultsThe stress, strain and displacement distributions to the angle fractured mandible with three different fixation modalities were collected, respectively, and the maximum stress for each model emerged at the mandibular ramus or screw holes. Under the same loading conditions, the maximum stress on the customized fixation system decreased 74.3, 75.6 and 70.6% compared to type A, and 34.9, 34.1, and 39.6% compared to type B. All maximum von Mises stresses of mandible were well below the allowable stress of human bone, as well as maximum principal strain. And the displacement diagram of bony segments indicated the effect of treatment with different fixation systems.ConclusionsThe customized fixation system with topological optimized structure has good biomechanical behavior for mandibular angle fracture because the stress, strain and displacement within the plate could be reduced significantly comparing to conventional “one mini-plate” or “two mini-plates” systems. The design methodology for customized fixation system could be used for other fractures in mandible or other bones to acquire better mechanical behavior of the system and improve stable environment for bone healing. And together with SLM, the customized plate with optimal structure could be designed and fabricated rapidly to satisfy the urgent time requirements for treatment.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A customized fixation plate with novel structure designed by topological optimization for mandibular angle fracture based on finite element analysis

et al. 2017

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“…This is due to significantly less plastic deformation, if any, in the parametric plate. Multiple studies in the literature indicate that conventional plates experience higher maximum and average stress values than custom plates owing to plastic deformation [4] [21].…”

Section: Resultsmentioning

confidence: 99%

Parametric Mandible Reconstruction Plate

Giddy

Merwe

2020

SAJIE

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“…They have oval screw holes, like mentioned compression plates, and they allow potential limited compression [22,23]. To create so-called personalized geometrical models of the plates, which fit anatomy of the traumatized region of the mandible, there is a need to use geometrical model of the patient's mandible as a base model that shape of plate should follow [24]. Thus, the very first step is to digitally reconstruct the model of mandible's boundary surface.…”

Section: Parametric Model Of Plate Implantsmentioning

confidence: 99%

Procedure for Creating Personalized Geometrical Models of the Human Mandible and Corresponding Implants

et al. 2019

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The greatest challenge in engineering of human mandible implants lies in its customization for each patient individually, by adapting them to the patient's anatomical, morphological and physiological characteristics. This customization maximizes the efficiency of the patient's health recovery process. The application of anatomically shaped and personalized bone endoprosthesis, fixation plate and scaffold models bring great improvement to the clinical practice in maxillofacial surgery. It ensures that implant meets the biomechanical and dentofacial aesthetic requirements and, ultimately, reduces complications during recovery. In order to create such implants, novel procedure based on personalized models of mandible and its parts, and also plates and scaffold implants is presented in this paper. Design procedures for the creation of the personalized models are based on the application of Method of Anatomical Features, which has been already applied for the creation of geometrical models of human bones. This procedure improves pre-surgical planning, enables better execution of surgical intervention, and as a consequence improves patient recovery processes.

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Customized mandibular reconstruction plates improve mechanical performance in a mandibular reconstruction model

Cited by 72 publications

References 48 publications

A customized fixation plate with novel structure designed by topological optimization for mandibular angle fracture based on finite element analysis

A customized fixation plate with novel structure designed by topological optimization for mandibular angle fracture based on finite element analysis

Parametric Mandible Reconstruction Plate

Procedure for Creating Personalized Geometrical Models of the Human Mandible and Corresponding Implants

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