Novel finite element‐based plate design for bridging mandibular defects: Reducing mechanical failure

Merema, B.J.; Kraeima, Joep; Visscher, Sebastiaan A. H. J. de; Minnen, Baucke van; Spijkervet, Fred K. L.; Schepman, Kees-Pieter; Witjes, Max J. H.

doi:10.1111/odi.13331

Cited by 14 publications

(7 citation statements)

References 37 publications

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“…Besides ultrasound welding, patient-specific osteosynthesis systems will also contribute to osteosynthesis systems with superior mechanical properties while reducing the total volume of the system, i.e., the system can be strengthened where necessary while removing excess material [ 18 , 83 , 242 , 243 ]. This will also reduce the amount of degradation products and, thus, the risk of foreign body reactions [ 18 ].…”

Section: Future Perspectivesmentioning

confidence: 99%

Titanium or Biodegradable Osteosynthesis in Maxillofacial Surgery? In Vitro and In Vivo Performances

Gareb¹,

Bakelen²,

Vissink³

et al. 2022

Polymers

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Osteosynthesis systems are used to fixate bone segments in maxillofacial surgery. Titanium osteosynthesis systems are currently the gold standard. However, the disadvantages result in symptomatic removal in up to 40% of cases. Biodegradable osteosynthesis systems, composed of degradable polymers, could reduce the need for removal of osteosynthesis systems while avoiding the aforementioned disadvantages of titanium osteosyntheses. However, disadvantages of biodegradable systems include decreased mechanical properties and possible foreign body reactions. In this review, the literature that focused on the in vitro and in vivo performances of biodegradable and titanium osteosyntheses is discussed. The focus was on factors underlying the favorable clinical outcome of osteosyntheses, including the degradation characteristics of biodegradable osteosyntheses and the host response they elicit. Furthermore, recommendations for clinical usage and future research are given. Based on the available (clinical) evidence, biodegradable copolymeric osteosyntheses are a viable alternative to titanium osteosyntheses when applied to treat maxillofacial trauma, with similar efficacy and significantly lower symptomatic osteosynthesis removal. For orthognathic surgery, biodegradable copolymeric osteosyntheses are a valid alternative to titanium osteosyntheses, but a longer operation time is needed. An osteosynthesis system composed of an amorphous copolymer, preferably using ultrasound welding with well-contoured shapes and sufficient mechanical properties, has the greatest potential as a biocompatible biodegradable copolymeric osteosynthesis system. Future research should focus on surface modifications (e.g., nanogel coatings) and novel biodegradable materials (e.g., magnesium alloys and silk) to address the disadvantages of current osteosynthesis systems.

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Section: Future Perspectivesmentioning

confidence: 99%

Titanium or Biodegradable Osteosynthesis in Maxillofacial Surgery? In Vitro and In Vivo Performances

Gareb¹,

Bakelen²,

Vissink³

et al. 2022

Polymers

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“…Technological advances in medical imaging and rapid prototyping would enable the production of 3D models. [24] , [25] ,…”

Section: Discussionmentioning

confidence: 99%

Finite Element Analysis of Low Profile Reconstruction Plates for Atrophic Mandibles: A Comparison of Novel 3D Grid and Conventional Plate Designs

Guerra

Pulino

Salomão³

et al. 2023

Preprint

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This study aimed to compare the reconstruction with type 2.4 and three-dimensional (3D) grid plates relating the areas of weakness to anatomical regions of force incidence in atrophic mandibles with and without segmentation using finite element analysis (FEA). Strength and force quality in the mandible were also determined. The atrophic mandible models with and without segmentation were divided into four groups, and the behavior of each plate was analyzed using finite element analysis. In the atrophic mandible without segmentation using the type 2.4 reconstruction plate, the highest stress concentration in the plate was observed in the posterior region of the mandibular body and in the grid type 3D reconstruction plate was observed in the mandibular angle. In the segmented atrophic mandible with the 2.4 reconstruction plate, higher stress concentration was observed in the mandibular segment defect. Analysis of the 3D grid-like reconstruction plate revealed that the geometry of the plate conferred greater stiffness to the assembly, as the most significant stress concentration was observed at the mandibular angle. The width of the plate design may influence the strength, not the thickness.

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“…Which technique will be incorporated as a reliable tool remains to be answered with scientific studies, but it is likely that in the coming decade surgeons will be supported in intra‐operative decision making by an approved technology. The intra‐operative planning of bone margins is nowadays often routinely supported by 3D technology (Kraeima et al., 2020; Merema et al., 2020; Merema et al., 2020). For example, 3D‐printed cutting guides or navigational devices allow for a highly accurate execution of bone cuts.…”

Section: Figurementioning

confidence: 99%

Cooperation as core value in an innovative era

Witjes

Vissink

2020

Oral Diseases

Self Cite

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Cooperation as core value in an innovative era Diagnosis, treatment, and rehabilitation of patients suffering from oral cancer are shared responsibilities of primary care givers like dentists, physicians and oral medicine specialists, and intramural secondary care specialties. Because of the complex nature of treatment and the necessity of long-term care in most patients, the treatment and follow-up of head and neck cancer patients are confined to centers with dedicated teams in most countries. Early referral of patients suspected for oral cancer is considered important because survival is related to tumor stage and primary care givers play a pivotal role in that respect (Grafton-Clarke et al., 2019). Where health care is organized with possibilities of a quick and easy referral, the risk of delayed referral is greatly reduced. dental rehabilitation after oncological surgery. Several practical issues remain to be resolved, however, such as the timing of placement of dental implants as well as the placement of dental implants in free flaps. Like for surgical planning, planning of an oral rehabilitation is supported by 3D technology. This technology supports precise placement of implants and design of prosthetic devices. Notwithstanding the long experience with dental implants, new ideas based on implant technology still emerge and become implemented in clinical practice. The application of zygoma implants after maxillectomy in combination with soft tissue flaps is an example of a creative idea finding its way into the clinic (Hackett et al., 2020). Treatment of cancer in the head and neck area is commonly accompanied by damage to the salivary glands (Barazzuol et al., 2020; Vissink et al., 2015). Damage to the salivary glands is unavoidable as the salivary glands are located superficially and the ionizing radiation has to pass salivary gland tissue to reach the tumor. While there is many approach to minimize this radiation damage to salivary gland tissue, there is yet no satisfactory therapy to treat radiation-induced salivary gland damage. A feasible option might be harvesting salivary gland tissue during, for example, a head and neck dissection procedure, isolate and proliferate stem cells from this tissue and return these stem cells to the salivary glands that are damaged by the postoperative radiotherapy. Such stem cell therapy is an attractive option for the long-term treatment of hyposalivation related xerostomia induced by irradiation, but is in need of further study in animals and preliminary studies in human before it can evolve into a clinically applicable method. Future studies should also focus on a better understanding of the radiosensitivity of parotid and submandibular salivary gland tissue (Serrano Martinez et al., 2020). All these developments show the benefits for patients of a good cooperation between primary and secondary caregivers. The good cooperation also demonstrates what can be achieved if efforts are focused and put into practice.

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Novel finite element‐based plate design for bridging mandibular defects: Reducing mechanical failure

Cited by 14 publications

References 37 publications

Titanium or Biodegradable Osteosynthesis in Maxillofacial Surgery? In Vitro and In Vivo Performances

Titanium or Biodegradable Osteosynthesis in Maxillofacial Surgery? In Vitro and In Vivo Performances

Finite Element Analysis of Low Profile Reconstruction Plates for Atrophic Mandibles: A Comparison of Novel 3D Grid and Conventional Plate Designs

Cooperation as core value in an innovative era

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