Finite Element Analysis and Biomechanical Testing to Analyze Fracture Displacement of Alveolar Ridge Splitting

Abstract

The alveolar ridge splitting technique enables reconstruction of atrophied alveolar ridges prior implantation. However, in cases of severe atrophy, there is an unpredictable risk of fracturing the buccal lamella during the expansion. Currently, there is no preoperative assessment to predict the maximum distraction of the lamella. The aim of this study was to develop a biomechanical model to mimic the alveolar ridge splitting and a finite element (FE) model to predict the experimental results. The biomechanical testing was conducted on porcine mandibles. To build the FE model high resolution peripheral quantitative computer tomography scans of one specimen was performed after the osteotomy outline, but before the lamella displacement. A servo-electric testing machine was used for the axial tension test to split the lamellae. Results showed, in line with clinical observations, that the lamellae broke primarily at the base of the splits with a median displacement of 1.27 mm. The FE model could predict fracture force and fracture displacement. Fracture force showed a nonlinear correlation with the height of the bone lamella. In conclusion, good correspondence between mechanical testing and virtual FE analysis showed a clinically relevant approach that may help to predict maximum lamella displacement to prevent fractures in the future.

The Alveolar Ridge Splitting Technique on Maxillae: A Biomechanical Human Cadaveric Investigation

“…The most common complication of ARST is the intraoperative fracture of the buccal lamella [ 16 ]. It is therefore of essential importance to preoperatively estimate the maximum possible displacement of the lamella in order to adapt the surgical protocol accordingly.…”

“…A pilot study by Stricker et al successfully developed a biomechanical setup for relevant replication of lamellar fracturing applying ARST on porcine jaw specimens; a mean critical lamella displacement of 1.27 mm was reported for porcine mandibles osteotomized via piezosurgery and tested in lateral distraction with an osteotome [ 16 ]. Comparable results in alveolar ridge splitting of porcine mandibles were obtained in a study by Jung et al [ 15 ] who analyzed lamella displacement by vertical force application utilizing either a mallet and chisel (control group) or an engine-driven ridge spreader (test group).…”

“…Previous work investigated lamellar fracturing in porcine specimens [ 15 ]. Another in vitro animal study developed a biomechanical model to simulate the surgical procedure and fracture behavior during alveolar bone splitting [ 16 ]. However, both those previous investigations were limited by the use of porcine specimens which may differ from the human tissue.…”

Patient-Specific Bone Multiscale Modelling, Fracture Simulation and Risk Analysis—A Survey

“…Parallel to the work conducted on modelling human bone, there have been efforts to model bone of several animals. Studies range from small animals such as mice [287,[329][330][331][332][333][334][335][336], rats [288,[337][338][339][340][341][342][343] and zebrafish [344], to medium-sized animals such as dogs [345], as well as large animals such as pigs [346][347][348][349][350][351][352], sheep [353][354][355], bovine [220,[356][357][358][359][360][361][362][363] and horses [273,364].…”

“…Biocompatibility evaluation, via in vivo experiments, of implant materials [339,355,356,360,372,373], implant designs [352,374], and surgical techniques [353], with the host tissue. These evaluations, are first performed on animal tissues as a stepping stone towards application in human tissues.…”