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Towards mechanobiologically optimized mandible reconstruction: CAD/CAM miniplates vs. reconstruction plates for fibula free flap fixation: A finite element study

Due to their advantages in applicability, patient-specific (CAD/CAM) reconstruction plates are increasingly used in fibula free flap mandible reconstruction. In addition, recently, CAD/CAM miniplates, with further advantages in postoperative management, have been introduced. However, biomechanical c...

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Autores principales: Ruf, Philipp, Orassi, Vincenzo, Fischer, Heilwig, Steffen, Claudius, Duda, Georg N., Heiland, Max, Kreutzer, Kilian, Checa, Sara, Rendenbach, Carsten
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9712730/
https://www.ncbi.nlm.nih.gov/pubmed/36466355
http://dx.doi.org/10.3389/fbioe.2022.1005022
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author Ruf, Philipp
Orassi, Vincenzo
Fischer, Heilwig
Steffen, Claudius
Duda, Georg N.
Heiland, Max
Kreutzer, Kilian
Checa, Sara
Rendenbach, Carsten
author_facet Ruf, Philipp
Orassi, Vincenzo
Fischer, Heilwig
Steffen, Claudius
Duda, Georg N.
Heiland, Max
Kreutzer, Kilian
Checa, Sara
Rendenbach, Carsten
author_sort Ruf, Philipp
collection PubMed
description Due to their advantages in applicability, patient-specific (CAD/CAM) reconstruction plates are increasingly used in fibula free flap mandible reconstruction. In addition, recently, CAD/CAM miniplates, with further advantages in postoperative management, have been introduced. However, biomechanical conditions induced by CAD/CAM systems remain partially unknown. This study aimed to evaluate the primary fixation stability of CAD/CAM fixators. For a patient-specific scenario, the biomechanical conditions induced in a one segmental fibula free flap stabilized using either a CAD/CAM reconstruction plate or CAD/CAM miniplates were determined using finite element analysis. The main output parameters were the strains between intersegmental bone surfaces and stresses in the fixation systems due to different biting scenarios. CAD/CAM miniplates resulted in higher mechanical strains in the mesial interosseous gap, whereas CAD/CAM reconstruction plate fixation resulted in higher strains in the distal interosseous gap. For all investigated fixation systems, stresses in the fixation systems were below the material yield stress and thus material failure would not be expected. While the use of CAD/CAM miniplates resulted in strain values considered adequate to promote bone healing in the mesial interosseous gap, in the distal interosseous gap CAD/CAM reconstruction plate fixation might result in more beneficial tissue straining. A mechanical failure of the fixation systems would not be expected.
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spelling pubmed-97127302022-12-02 Towards mechanobiologically optimized mandible reconstruction: CAD/CAM miniplates vs. reconstruction plates for fibula free flap fixation: A finite element study Ruf, Philipp Orassi, Vincenzo Fischer, Heilwig Steffen, Claudius Duda, Georg N. Heiland, Max Kreutzer, Kilian Checa, Sara Rendenbach, Carsten Front Bioeng Biotechnol Bioengineering and Biotechnology Due to their advantages in applicability, patient-specific (CAD/CAM) reconstruction plates are increasingly used in fibula free flap mandible reconstruction. In addition, recently, CAD/CAM miniplates, with further advantages in postoperative management, have been introduced. However, biomechanical conditions induced by CAD/CAM systems remain partially unknown. This study aimed to evaluate the primary fixation stability of CAD/CAM fixators. For a patient-specific scenario, the biomechanical conditions induced in a one segmental fibula free flap stabilized using either a CAD/CAM reconstruction plate or CAD/CAM miniplates were determined using finite element analysis. The main output parameters were the strains between intersegmental bone surfaces and stresses in the fixation systems due to different biting scenarios. CAD/CAM miniplates resulted in higher mechanical strains in the mesial interosseous gap, whereas CAD/CAM reconstruction plate fixation resulted in higher strains in the distal interosseous gap. For all investigated fixation systems, stresses in the fixation systems were below the material yield stress and thus material failure would not be expected. While the use of CAD/CAM miniplates resulted in strain values considered adequate to promote bone healing in the mesial interosseous gap, in the distal interosseous gap CAD/CAM reconstruction plate fixation might result in more beneficial tissue straining. A mechanical failure of the fixation systems would not be expected. Frontiers Media S.A. 2022-11-17 /pmc/articles/PMC9712730/ /pubmed/36466355 http://dx.doi.org/10.3389/fbioe.2022.1005022 Text en Copyright © 2022 Ruf, Orassi, Fischer, Steffen, Duda, Heiland, Kreutzer, Checa and Rendenbach. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Bioengineering and Biotechnology
Ruf, Philipp
Orassi, Vincenzo
Fischer, Heilwig
Steffen, Claudius
Duda, Georg N.
Heiland, Max
Kreutzer, Kilian
Checa, Sara
Rendenbach, Carsten
Towards mechanobiologically optimized mandible reconstruction: CAD/CAM miniplates vs. reconstruction plates for fibula free flap fixation: A finite element study
title Towards mechanobiologically optimized mandible reconstruction: CAD/CAM miniplates vs. reconstruction plates for fibula free flap fixation: A finite element study
title_full Towards mechanobiologically optimized mandible reconstruction: CAD/CAM miniplates vs. reconstruction plates for fibula free flap fixation: A finite element study
title_fullStr Towards mechanobiologically optimized mandible reconstruction: CAD/CAM miniplates vs. reconstruction plates for fibula free flap fixation: A finite element study
title_full_unstemmed Towards mechanobiologically optimized mandible reconstruction: CAD/CAM miniplates vs. reconstruction plates for fibula free flap fixation: A finite element study
title_short Towards mechanobiologically optimized mandible reconstruction: CAD/CAM miniplates vs. reconstruction plates for fibula free flap fixation: A finite element study
title_sort towards mechanobiologically optimized mandible reconstruction: cad/cam miniplates vs. reconstruction plates for fibula free flap fixation: a finite element study
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9712730/
https://www.ncbi.nlm.nih.gov/pubmed/36466355
http://dx.doi.org/10.3389/fbioe.2022.1005022
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