Bone remodeling following mandibular reconstruction using fibula free flap

Area of Science:

• Biomaterials Science
• Computational Biology
• Oral and Maxillofacial Surgery

Background:

• Mandibulectomy requires reconstruction, often with fibula free flaps (FFF).
• Understanding bone remodelling post-reconstruction is crucial for long-term outcomes.
• Patient-specific data can improve simulation accuracy.

Purpose of the Study:

• To computationally simulate bone remodelling after FFF maxillofacial reconstruction.
• To correlate simulation with patient-specific longitudinal data and clinical follow-up.
• To compare the long-term effects of different fixation plate designs on bone healing.

Main Methods:

• Development of a joint external and internal bone remodelling algorithm.
• Incorporation of patient-specific longitudinal data for simulation.
• Analysis of bone density changes over 28 months, focusing on the union site.

Main Results:

• Overall bone density decreased post-reconstruction, except at the Docking Site (DS1).
• The Docking Site showed a cessation of bone density decrease followed by apposition.
• Different screw positioning showed negligible influence on bone remodelling outcomes.

Conclusions:

• The developed algorithm provides a novel method for simulating bone turnover post-FFF reconstruction.
• Bone healing dynamics are complex, with specific sites exhibiting unique remodelling patterns.
• Fixation plate design has a limited impact on the simulated bone remodelling outcomes.