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  4. Patient-specific miniplates versus patient-specific reconstruction plate: a biomechanical comparison with 3D-printed plates in mandibular reconstruction
 
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Patient-specific miniplates versus patient-specific reconstruction plate: a biomechanical comparison with 3D-printed plates in mandibular reconstruction

Publikationstyp
Journal Article
Date Issued
2023-02-24
Sprache
English
Author(s)
Steffen, Claudius  
Sellenschloh, Kay  
Willsch, Magdalena  
Soares, Ana Prates  
Morlock, Michael  
Heiland, Max  
Kreutzer, Kilian  
Huber, Gerd  
Rendenbach, Carsten  
Institut
Biomechanik M-3  
TORE-URI
http://hdl.handle.net/11420/14994
Journal
Journal of the mechanical behavior of biomedical materials  
Volume
140
Article Number
105742
Citation
Journal of the Mechanical Behavior of Biomedical Materials 140: 105742 (2023-04-01)
Publisher DOI
10.1016/j.jmbbm.2023.105742
Scopus ID
2-s2.0-85149176236
Publisher
Elsevier
Background: Patient-specific 3D-printed miniplates for free flap fixation in mandibular reconstruction were recently associated with enhanced osseous union. Higher mechanical strains resulting from these plates are discussed as reasons, but biomechanical studies are missing. This study aims to examine, whether patient-specific 3D-printed miniplates provide an increased interosteotomy movement (IOM) and lower stiffness compared with reconstruction plates. Methods: Polyurethane (PU) mandible and fibula models (Synbone AG, Malans, Schweiz) were used to simulate mandibular reconstruction with a one segment fibula flap equivalent. Osteosynthesis was performed using either four patient-specific 3D-printed miniplates (3D-Mini) or one patient-specific 3D-printed reconstruction plate (3D-Recon). Mastication was simulated using cyclic dynamic loading with increasing loads until material failure or a maximum load of 1000 N. Continuous IOM recording was carried out using a 3D optical tracking system (ARAMIS, Carl Zeiss GOM Metrology, Braunschweig, Germany). Findings: The averaged stiffness at a load of 100–300 N load did not differ between the groups (p = 0.296). There was a faster 1.0 mm vertical displacement in the 3D-Mini group (26 376 ± 14 190 cycles versus 44 817 ± 30 430 cycles, p = 0.018). The IOM were higher with miniplate fixation in the distal gap (p = 0.040). In the mesial gap, there was no significant difference between the groups (p = 0.160). Interpretation: Fixation with patient-specific 3D-printed miniplates results in higher mechanical strains. Lower rates of pseudarthrosis, as seen in clinical studies, might be caused by this phenomenon. Surgeons should evaluate the primary use of 3D-printed miniplates in mandibular reconstruction due to advantages of intraoral plate removal alongside safe osteosynthesis.
Subjects
Biomechanics
Fibula free flap
Mandibular reconstruction
Osteosynthesis
Patient-specific implants
DDC Class
570: Biowissenschaften, Biologie
600: Technik
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