Mechanobiological modeling of bone healing in mandibular reconstruction: a comparative study of fixation strategies

Fibula free flaps are the gold standard for mandibular reconstruction, yet non-union remains a significant challenge. This study presents a patient-specific finite element and mechanobiological framework to evaluate early bone healing with reconstruction plates and miniplates. Postoperative CT-based models were subjected to clenching loads, and a mechano-regulation algorithm simulated callus differentiation based on strain stimuli. Both fixation strategies ensured mechanical stability, with stresses below material limits. However, under the simulated loading conditions, miniplates generated more uniform strain distributions, promoting earlier ossification and suggesting a more favorable mechanical environment for early bone healing.