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

Area of Science:

• Biomaterials Engineering
• Surgical Reconstruction
• Medical Device Design

Background:

• Conventional reconstruction plates for mandibular defects often fail due to plate fracture or screw pull-out.
• Free vascularized flaps are not always feasible for segmental mandibular defect reconstruction.

Purpose of the Study:

• To develop a mechanically superior, slender, patient-specific (PS) reconstruction plate.
• To reduce mechanical failures, specifically plate fracture and screw pull-out, in mandibular reconstructions.

Main Methods:

• Finite element analysis (FEA) was used to study failed conventional reconstructions.
• A 3D virtual surgical plan (3D-VSP) guided the development of novel PS titanium plates.
• Eight patients underwent reconstruction with PS plates, with accuracy validated by postoperative CBCT scanning.

Main Results:

• All PS plates were accurately placed per the 3D-VSP, with minimal deviation in screw entry point and angle.
• FEA predicted reduced stress and screw pull-out forces with the PS plates.
• No mechanical failures were observed during a mean follow-up of 16 months.

Conclusions:

• Patient-specific reconstruction plates, designed with FEA, effectively address mechanical failures in mandibular continuity defects.
• This approach shows promise in reducing the risks associated with screw pull-out and plate fractures.