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Finite element analysis of customized reconstruction plates for mandibular continuity defect therapy
N. Narra, J. Valášek, M. Hannula, P. Marcián, GK. Sándor, J. Hyttinen, J. Wolff,
Language English Country United States
Document type Journal Article, Research Support, Non-U.S. Gov't
NLK
ProQuest Central
from 2003-01-01 to 2 months ago
Health & Medicine (ProQuest)
from 2003-01-01 to 2 months ago
- MeSH
- Finite Element Analysis MeSH
- Adult MeSH
- Internal Fixators MeSH
- Bone Plates MeSH
- Bone Screws * MeSH
- Middle Aged MeSH
- Humans MeSH
- Mandible anatomy & histology surgery MeSH
- Stress, Mechanical * MeSH
- Tomography, X-Ray Computed methods MeSH
- Computer Simulation MeSH
- Image Processing, Computer-Assisted methods MeSH
- Software MeSH
- Pressure MeSH
- Plastic Surgery Procedures methods MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Large mandibular continuity defects pose a significant challenge in oral maxillofacial surgery. One solution to this problem is to use computer-guided surgical planning and additive manufacturing technology to produce patient-specific reconstruction plates. However, when designing customized plates, it is important to assess potential biomechanical responses that may vary substantially depending on the size and geometry of the defect. The aim of this study was to assess the design of two customized plates using finite element method (FEM). These plates were designed for the reconstruction of the lower left mandibles of two ameloblastoma cases (patient 1/plate 1 and patient 2/plate 2) with large bone resections differing in both geometry and size. Simulations revealed maximum von Mises stresses of 63 MPa and 108 MPa in plates 1 and 2, and 65 MPa and 190 MPa in the fixation screws of patients 1 and 2. The equivalent strain induced in the bone at the screw-bone interface reached maximum values of 2739 micro-strain for patient 1 and 19,575 micro-strain for patient 2. The results demonstrate the influence of design on the stresses induced in the plate and screw bodies. Of particular note, however, are the differences in the induced strains. Unphysiologically high strains in bone adjacent to screws can cause micro-damage leading to bone resorption. This can adversely affect the anchoring capabilities of the screws. Thus, while custom plates offer optimal anatomical fit, attention should be paid to the expected physiological forces on the plates and the induced stresses and strains in the plate-screw-bone assembly.
BioMediTech Institute of Biosciences and Medical Technology Tampere Finland
Department of Oral and Maxillofacial Surgery University of Oulu Oulu Finland
Institute of Biomedical Technology University of Tampere Tampere Finland
References provided by Crossref.org
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- $a Narra, Nathaniel $u Department of Electronics and Communications Engineering, Tampere University of Technology, 33520 Tampere, Finland; BioMediTech, Institute of Biosciences and Medical Technology, Tampere, Finland. Electronic address: nathaniel.narragirish@tut.fi.
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- $a Large mandibular continuity defects pose a significant challenge in oral maxillofacial surgery. One solution to this problem is to use computer-guided surgical planning and additive manufacturing technology to produce patient-specific reconstruction plates. However, when designing customized plates, it is important to assess potential biomechanical responses that may vary substantially depending on the size and geometry of the defect. The aim of this study was to assess the design of two customized plates using finite element method (FEM). These plates were designed for the reconstruction of the lower left mandibles of two ameloblastoma cases (patient 1/plate 1 and patient 2/plate 2) with large bone resections differing in both geometry and size. Simulations revealed maximum von Mises stresses of 63 MPa and 108 MPa in plates 1 and 2, and 65 MPa and 190 MPa in the fixation screws of patients 1 and 2. The equivalent strain induced in the bone at the screw-bone interface reached maximum values of 2739 micro-strain for patient 1 and 19,575 micro-strain for patient 2. The results demonstrate the influence of design on the stresses induced in the plate and screw bodies. Of particular note, however, are the differences in the induced strains. Unphysiologically high strains in bone adjacent to screws can cause micro-damage leading to bone resorption. This can adversely affect the anchoring capabilities of the screws. Thus, while custom plates offer optimal anatomical fit, attention should be paid to the expected physiological forces on the plates and the induced stresses and strains in the plate-screw-bone assembly.
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