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

• DOI: 10.1111/odi.13331
• Publication Date: 2020-03-16T20:12:09Z
• Authors: Bram B. J. Merema; Joep Kraeima; Sebastiaan A. H. ...; Baucke van Minnen; Fred K. L. Spijke...; Kees‐Pieter Schepman; Max J. H. Witjes
• Keywords: Absolute deviation

When the application of a free vascularised flap is not possible, segmental mandibular defect often reconstructed using conventional reconstruction plate. Mechanical failure such reconstructions mostly caused by plate fracture and screw pull-out. This study aims to develop reliable, mechanically superior, yet slender patient-specific that reduces due these causes.Eight patients were included in study. Indications as follows: fractured (2), loosened screws (1) primary continuity (5). Failed studied finite element analysis (FEA). A 3D virtual surgical plan (3D-VSP) with novel (PS) titanium was developed for each patient. Postoperative CBCT scanning performed validate accuracy.All PS plates placed accurately according 3D-VSP. Mean entry point deviation 1.54 mm (SD: 0.85, R: 0.10-3.19), mean angular 5.76° 3.27, 1.26-16.62). FEA indicated decreased stress pull-out inducing forces. No mechanical failures appeared (mean follow-up: 16 months, 7-29).Reconstructing defects bookshelf-reconstruction underpinning design seems reduce risk fractures.