Mechanical stress in plates for bridging reconstruction mandibular defects and purposes of double plate reinforcement

Hoefert, Sebastian; Taier, Roberto

doi:10.1016/j.jcms.2018.01.016

Cited by 19 publications

(11 citation statements)

References 29 publications

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“…Markwardt did not conduct a long‐term observation; therefore, they may not have been able to determine a significant difference. However, some reports (Hoefert & Taier, ; Park, Lee, & Noh, ; Yi et al, ) present analysis results from a biomechanical viewpoint and demonstrate that reconstruction plates and screws are often subjected to excessive stress produced by functional loading, moment, and shear forces. From these reports, the reconstruction plate bridging mandibular bone can be estimated to burden excessive load by the shape of bone defect and the loading points (Hoefert & Taier, ; Park et al, ; Yi et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…However, some reports (Hoefert & Taier, ; Park, Lee, & Noh, ; Yi et al, ) present analysis results from a biomechanical viewpoint and demonstrate that reconstruction plates and screws are often subjected to excessive stress produced by functional loading, moment, and shear forces. From these reports, the reconstruction plate bridging mandibular bone can be estimated to burden excessive load by the shape of bone defect and the loading points (Hoefert & Taier, ; Park et al, ; Yi et al, ). In particular, Park et al, divided patients into three groups—unilateral molar clenching, group function clenching, and incisal clenching—and measured the von Mises stress, a value used to determine if a given material will yield or fracture, occurring on the reconstruction plate.…”

Section: Discussionmentioning

confidence: 99%

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A small number of residual teeth after the mandibular resection of oral cancer is associated with titanium reconstruction plate exposure

Hirohata

Yanagawa

Takaoka

et al. 2019

Clinical & Exp Dental Res

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ObjectiveReconstruction plates are used to treat patients with a segmental mandibular defect after oral cancer surgery. Reconstruction plate failure analysis has rarely focused on occlusion, which conducts a mechanical force to the mandible and the plate. To determine the prognostic factors, we retrospectively evaluated patients who underwent reconstruction of a mandibular segmental defect with a reconstruction plate and assessed the number of residual paired teeth.Material and MethodsFrom among 390 patients with oral cancer who visited University of Tsukuba Hospital (Tsukuba, Japan) between 2007 and 2017, we selected and analyzed the data of 37 patients who underwent segmental resection of the mandible and reconstruction with reconstruction plates. Prognostic factors evaluated were patient age, sex, TNM classification, plate manufacturer, treatment with radiotherapy or chemotherapy, whether the patient had diabetes or smoked, and whether the patient had a small number of residual paired teeth, plate length, and use of a fibular‐free flap. Among these 37 patients, eight reconstruction plates had intraoral or extraoral exposure and were removed in 5 years.ResultsKaplan–Meier and log‐rank analyses revealed that the prognosis for the 5‐year plate exposure‐free rate was significantly poorer for patients with a small number of residual teeth than for patients with no teeth or those with a large number of residual teeth (.01). Univariate Cox regression analysis revealed that a small number of residual teeth was a significant prognostic factor in the loss of a reconstruction plate (hazard ratio: 5.63; 95% confidence interval [1.10, 25.85]; .04).ConclusionsA small number of residual teeth after the segmental resection of oral cancer is significantly involved in reconstruction plate survival and may be important in predicting reconstruction plate prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A small number of residual teeth after the mandibular resection of oral cancer is associated with titanium reconstruction plate exposure

Hirohata

Yanagawa

Takaoka

et al. 2019

Clinical & Exp Dental Res

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“…Yield information can be obtained but is strongly dependant on the assumed material YM and PR. We found only two studies that state the yield strength and/or ultimate strength of the cortical and cancellous bone (Chen et al, 2018;Hoefert & Taier, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Most of the FEA-related publications do not describe the max- (Chen et al, 2018;Hoefert & Taier, 2018).…”

Section: Discussionmentioning

confidence: 99%

Patient‐specific finite element models of the human mandible: Lack of consensus on current set‐ups

et al. 2020

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Over the last decennia, a large variety of osteosynthesis plates and prostheses has been presented in the literature for the treatment of, for example, trauma, oncology or TMJ patients. These applications have in common that failure (loosening or fracturing) of the implanted material, or the screw-fixation of the implant to the patient's bone will often result in failure of the application. It appears crucial for success that the implanted osteosynthesis plates and its fixations are of a matching strength for the patient's specific situation. Mandibular reconstruction failure through either osteosynthesis plate failure or screw loosening are widely reported in the literature as the most common

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“…Although the finite element (FE) method provides mechanical responses and alters parameters in a more controllable manner, it becomes commonly used as an analytical tool in dental biomechanical studies [ 13 – 15 ]. However, when applying the FE method to investigate every possible combination of values for each parameter, the total number of simulations required is extremely high.…”

Section: Introductionmentioning

confidence: 99%

Anatomical Thin Titanium Mesh Plate Structural Optimization for Zygomatic-Maxillary Complex Fracture under Fatigue Testing

Wang

Huang

Fang

et al. 2018

BioMed Research International

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This study performs a structural optimization of anatomical thin titanium mesh (ATTM) plate and optimal designed ATTM plate fabricated using additive manufacturing (AM) to verify its stabilization under fatigue testing. Finite element (FE) analysis was used to simulate the structural bending resistance of a regular ATTM plate. The Taguchi method was employed to identify the significance of each design factor in controlling the deflection and determine an optimal combination of designed factors. The optimal designed ATTM plate with patient-matched facial contour was fabricated using AM and applied to a ZMC comminuted fracture to evaluate the resting maxillary micromotion/strain under fatigue testing. The Taguchi analysis found that the ATTM plate required a designed internal hole distance to be 0.9 mm, internal hole diameter to be 1 mm, plate thickness to be 0.8 mm, and plate height to be 10 mm. The designed plate thickness factor primarily dominated the bending resistance up to 78% importance. The averaged micromotion (displacement) and strain of the maxillary bone showed that ZMC fracture fixation using the miniplate was significantly higher than those using the AM optimal designed ATTM plate. This study concluded that the optimal designed ATTM plate with enough strength to resist the bending effect can be obtained by combining FE and Taguchi analyses. The optimal designed ATTM plate with patient-matched facial contour fabricated using AM provides superior stabilization for ZMC comminuted fractured bone segments.

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Mechanical stress in plates for bridging reconstruction mandibular defects and purposes of double plate reinforcement

Cited by 19 publications

References 29 publications

A small number of residual teeth after the mandibular resection of oral cancer is associated with titanium reconstruction plate exposure

A small number of residual teeth after the mandibular resection of oral cancer is associated with titanium reconstruction plate exposure

Patient‐specific finite element models of the human mandible: Lack of consensus on current set‐ups

Anatomical Thin Titanium Mesh Plate Structural Optimization for Zygomatic-Maxillary Complex Fracture under Fatigue Testing

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