Biomechanical Evaluation of Reconstructed Extensive Mandibular Defects by Different Models Using Finite Element Method Publisher



Kargarnejad S¹ ; Ghalichi F¹ ; Pourgolmohammad M² ; Oskui IZ¹ ; Garajei A^{3, 4, 5}
Source: Journal of Mechanics in Medicine and Biology Published:2020

Abstract

Rehabilitation of major mandibular defects after tumor resection has become a serious challenge for surgeons. In this research, four various models were designed to repair a critical mandibular lateral defect. Biomechanical behavior of the models was assessed by Finite Element Method. These models are including Fibular-Free Flap (FFF), Customized Prosthesis (CP), Tray Implant without Bone Graft (TI-wo-BG), and Tray Implant with Bone Graft (TI-w-BG). FFF is a subset of microvascular free flap technique in which some segments of patient's fibula bone are used to restore mandibular defects. CP is a hollow and light prosthesis which is fabricated using Additive Manufacturing technology from Ti alloy powder. TI-wo-BG is similar to a crib which is designed according to the geometry of the patient's mandible. TI-w-BG, in fact, is a TI-wo-BG which is filled with small cortico-cancellous chips in order to benefit potential profit of bone grafting. The chewing operation and loading on the mandible was simulated considering the three mandibular muscular forces including masseter, medial pterygoid, and temporalis. The result of FEM analysis of TI-wo-BG and TI-w-BG showed that in both models, screw number 6 endured a strain of 5684 and 2852μm/m which exceeded pathological and mild overload risk, respectively. This may increase the probability of screw loosening and system failure. The results proved the stability of the FFF and CP models. In addition, it can be concluded that stress and strain on the screw's interfaces can decrease by improving the plate and increasing the friction at the interface of plate, bone and screw. © 2020 World Scientific Publishing Company.