Three-dimensional simulation of mandibular distraction osteogenesis: mechanobiological analysis

Distraction osteogenesis is a surgical process for reconstruction of skeletal deformities, which has been widely investigated from the clinical perspective. However, little has been analyzed about the capability of numerical models to predict the clinical outcome generated by distraction. Therefore, this article presents a finite element analysis of the mechanobiological behavior of a pediatric patient's mandible with hemifacial microsomia during the distraction process. It focuses on the three-dimensional simulation of a long bone defect in the ramus of the mandible and introduces additional aspects to be considered in the computational simulation as compared to the bidimensional simulation. The evolution of the different tissues within the gap is evaluated and in order to check the effectiveness of the model, the predicted numerical outcome will be compared from a qualitative point of view with radiographies provided by the surgeons. It is shown that the morphology of the mandible changed in a similar manner than that observed clinically. These results reveal that three-dimensional models are useful tools in the predictive assessment of mandibular distraction osteogenesis.