Biomechanical comparison of locking and non-locking patient-specific mandibular reconstruction plate using finite element analysis. (December 2021)

• Record Type: Journal Article
• Authors: Zhong, Shengping; Shi, Qimin; Sun, Yi; Yang, Shoufeng; Van Dessel, Jeroen; Gu, Yifei; Chen, Xiaojun; Lübbers, Heinz-Theo; Politis, Constantinus
• Is Part Of: Journal of the mechanical behavior of biomedical materials. Volume 124(2021)
• Publication Date: 2021-12
• Subjects: Mandibular reconstruction -- Computer-aided design -- Patient-specific implant -- Biomechanics -- 3D printing -- Finite element analysis; Biomedical materials -- Periodicals; Biomedical materials -- Mechanical properties -- Periodicals; Biomedical materials; Biomedical materials -- Mechanical properties; Periodicals; Electronic journals; 610.28
• DOI: 10.1016/j.jmbbm.2021.104849
• Languages: English
• ISSNs: 1751-6161

Abstract

Abstract: Patient-specific mandibular reconstruction plate (PSMRP), as one of the patient-specific implants (PSIs), offers a host of benefits to mandibular reconstruction. Due to the limitation of fabricating screw hole threads in the PSMRP, 3D printed PSMRP is applied to the non-locking system directly in the mandibular reconstruction with bone graft regardless of the locking system. Since the conventional manual-bending reconstruction plate (CMBRP) provides better fixation in the locking system, it needs to be validated whether the locking PSMRP performs better than the non-locking PSMRP in the patient-specific mandibular reconstruction. Thereupon, the purpose of this study was to compare the biomechanical behavior between the locking and non-locking PSMRP. Finite element analysis (FEA) was used to conduct the biomechanical comparison between the locking PSMRP and non-locking PSMRP by simulating the momentary incisal clenching through static structural analysis. Mandible was reconstructed through the virtual surgical planning, and subsequently a 3D model of mandibular reconstruction assembly, including reconstructed mandible, PSMRP, and fixation screws, was generated and meshed for the following FEA simulations. In the form of equivalent von Mises stress, equivalent elastic strain, and total deformation, the locking PSMRP demonstrated its higher strengths of preferable safety, desirable flexibility, and anticipated stability compared with the non-locking PSMRP, indicated by much lower maximum stress, lower maximum strain and equivalent displacement. Locking PSMRP/screw system provides a better fixation effect to the patient-specific mandibular reconstruction than the non-locking one as a result of its productive fixation nature. FEA plays a paramount role in pre-validating the design of PSMRP through the biomechanical behavior evaluation in static structural analysis. Graphical abstract: Image 1 Highlights: Patient-specific implants were designed through virtual surgical planning and evaluated using finite element analysis. Biomechanical behaviors of locking and non-locking patient-specific mandibular reconstruction plate were fully compared. Topology-optimized non-locking PSMRP can be an viable alternative responding to the current limitation of 3D printing.