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Grillo R, Quinta Reis BA, Lima BC, Peral Ferreira Pinto LA, Cruz Meira JB, Melhem-Elias F. The butterfly effect in oral and maxillofacial surgery: Understanding and applying chaos theory and complex systems principles. J Craniomaxillofac Surg 2024; 52:652-658. [PMID: 38582679 DOI: 10.1016/j.jcms.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/12/2024] [Indexed: 04/08/2024] Open
Abstract
The present paper provides a historical context for chaos theory, originating in the 1960s with Edward Norton Lorenz's efforts to predict weather patterns. It introduces chaos theory, fractal geometry, nonlinear dynamics, and the butterfly effect, highlighting their exploration of complex systems. The authors aim to bridge the gap between chaos theory and oral and maxillofacial surgery (OMFS) through a literature review, exploring its applications and emphasizing the prevention of minor deviations in OMFS to avoid significant consequences. A comprehensive literature review was conducted on PubMed, Web of Science, and Google Scholar databases. The selection process adhered to the PRISMA-ScR guidelines and Leiden Manifesto principles. Articles focusing on chaos theory principles in health sciences, published in the last two decades, were included. The review encompassed 37 articles after screening 386 works. It revealed applications in outcome variation, surgical planning, simulations, decision-making, and emerging technologies. Potential applications include predicting infections, malignancies, dental fractures, and improving decision-making through disease prediction systems. Emerging technologies, despite criticisms, indicate advancements in AI integration, contributing to enhanced diagnostic accuracy and personalized treatment strategies. Chaos theory, a distinct scientific framework, holds potential to revolutionize OMFS. Its integration with advanced techniques promises personalized, less traumatic surgeries and improved patient care. The interdisciplinary synergy of chaos theory and emerging technologies presents a future in which OMFS practices become more efficient, less traumatic, and achieve a level of precision never seen before.
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Affiliation(s)
- Ricardo Grillo
- Department of Oral and Maxillofacial Surgery, University of São Paulo School of Dentistry, São Paulo-SP, Brazil; Department of Oral and Maxillofacial Surgery, Faculdade Patos de Minas, Brasília-DF, Brazil.
| | | | - Bernardo Correia Lima
- Department of Oral and Maxillofacial Surgery, University of São Paulo School of Dentistry, São Paulo-SP, Brazil; Department of Oral and Maxillofacial Surgery and Diagnosis, Hospital da Boca, Santa Casa da Misericórdia do Rio de Janeiro, RJ, Brazil
| | | | - Josete Barbosa Cruz Meira
- Department of Biomaterials and Oral Biology, University of São Paulo School of Dentistry, São Paulo-SP, Brazil
| | - Fernando Melhem-Elias
- Department of Oral and Maxillofacial Surgery, University of São Paulo School of Dentistry, São Paulo-SP, Brazil; Private Practice in Oral and Maxillofacial Surgery, São Paulo-SP, Brazil
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Subramanian A, Rudagi BM, Londhe P, Palande C. A Finite Element Analysis of Single, Double & Matrix Miniplate in Fracture of the Mandibular ANGLE Region: An In Vitro Study. J Maxillofac Oral Surg 2024; 23:114-121. [PMID: 38312983 PMCID: PMC10830939 DOI: 10.1007/s12663-022-01799-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 09/14/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose To evaluate and compare the efficacy of three osteosynthesis systems in fixation of mandibular angle fractures using Finite Element Analysis. Materials and Methods In this study, we used a three-dimensional finite element analysis to assess the stress, deformation and strain in three different groups with bite force loads. A three-dimensional finite element model of the mandible with three different plating techniques using modelling software 'Solidworks2018' and was analysed for stress, deformation and strain produced in the bone following biting loads of different magnitude using analysing software 'ANSYS Workbench'. Results In this study, we found out that the tensile forces in the matrix miniplate with vertical struts were well distributed in the cortical and cancellous bone on comparison with other two fixation systems in fixation of the mandibular angle fracture and therefore prevents lateral displacement, torsion and bending. The matrix miniplate system revealed less displacement of the fracture segments as compared to the other two plating systems. Conclusion The use of matrix miniplate for the treatment of mandibular angle fractures can be considered efficacious. The stress transferred onto the cortical & cancellous bone is least in the matrix plate leading to better stability of the fixation system.
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Affiliation(s)
- Akshaya Subramanian
- Department of Oral and Maxillofacial Surgery, J.M. F’s A.C.P.M Dental College and Hospital, Dhule, Maharashtra India
| | - B. M. Rudagi
- Department of Oral and Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra India
| | - Puja Londhe
- Department of Oral and Maxillofacial Surgery, J.M. F’s A.C.P.M Dental College and Hospital, Dhule, Maharashtra India
| | - Chinmayee Palande
- Department of Oral and Maxillofacial Surgery, J.M. F’s A.C.P.M Dental College and Hospital, Dhule, Maharashtra India
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Snyder E, Trabia M, Trabelsi N. An approach for simultaneous reduction and fixation of mandibular fractures. Comput Methods Biomech Biomed Engin 2022:1-13. [PMID: 35901285 DOI: 10.1080/10255842.2022.2105143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This article presents a new approach for the design of a flexible V-shaped miniplate for mandibular fractures, which combines simultaneous fracture reduction and fixation. A Computerized Tomography (CT) based finite element model was developed to assess the reliability of this design. Muscle and mastication forces were included to replicate post-surgery loading. The V-plate is compared with a standard, linear miniplate, typically used for mandibular fixation. The results indicate that the proposed design can support the fracture while inducing limited fracture displacement, in addition to reducing the duration of the surgery due to fracture reduction by tightening the wire.
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Affiliation(s)
- Ethan Snyder
- Department of Mechanical Engineering, University of Nevada, Las Vegas, United States of America
| | - Mohamed Trabia
- Department of Mechanical Engineering, University of Nevada, Las Vegas, United States of America
| | - Nir Trabelsi
- Department of Mechanical Engineering, Shamoon College of Engineering, Be'er Sheva, Israel
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Zhong S, Shi Q, Sun Y, Yang S, Van Dessel J, Gu Y, Chen X, Lübbers HT, Politis C. Biomechanical comparison of locking and non-locking patient-specific mandibular reconstruction plate using finite element analysis. J Mech Behav Biomed Mater 2021; 124:104849. [PMID: 34563812 DOI: 10.1016/j.jmbbm.2021.104849] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 01/01/2023]
Abstract
Patient-specific mandibular reconstruction plate (PSMRP), as one of the patient-specific implants (PSIs), offers a host of benefits to mandibular reconstruction. Due to the limitation of fabricating screw hole threads in the PSMRP, 3D printed PSMRP is applied to the non-locking system directly in the mandibular reconstruction with bone graft regardless of the locking system. Since the conventional manual-bending reconstruction plate (CMBRP) provides better fixation in the locking system, it needs to be validated whether the locking PSMRP performs better than the non-locking PSMRP in the patient-specific mandibular reconstruction. Thereupon, the purpose of this study was to compare the biomechanical behavior between the locking and non-locking PSMRP. Finite element analysis (FEA) was used to conduct the biomechanical comparison between the locking PSMRP and non-locking PSMRP by simulating the momentary incisal clenching through static structural analysis. Mandible was reconstructed through the virtual surgical planning, and subsequently a 3D model of mandibular reconstruction assembly, including reconstructed mandible, PSMRP, and fixation screws, was generated and meshed for the following FEA simulations. In the form of equivalent von Mises stress, equivalent elastic strain, and total deformation, the locking PSMRP demonstrated its higher strengths of preferable safety, desirable flexibility, and anticipated stability compared with the non-locking PSMRP, indicated by much lower maximum stress, lower maximum strain and equivalent displacement. Locking PSMRP/screw system provides a better fixation effect to the patient-specific mandibular reconstruction than the non-locking one as a result of its productive fixation nature. FEA plays a paramount role in pre-validating the design of PSMRP through the biomechanical behavior evaluation in static structural analysis.
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Affiliation(s)
- Shengping Zhong
- Department of Biomedical Sciences, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Qimin Shi
- Department of Biomedical Sciences, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Yi Sun
- Department of Biomedical Sciences, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Shoufeng Yang
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton SO17 1BJ, United Kingdom.
| | - Jeroen Van Dessel
- Department of Biomedical Sciences, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Yifei Gu
- Department of Biomedical Sciences, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Xiaojun Chen
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Heinz-Theo Lübbers
- Clinic for Cranio-Maxillofacial Surgery, University Hospital of Zurich, Frauenklinikstrasse 24, Zurich CH, 8091, Switzerland; Surgical Planning Laboratory, Harvard Medical School, Brigham and Women's Hospital, Francis Street 75, Boston, MA, 02115, USA
| | - Constantinus Politis
- Department of Biomedical Sciences, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
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Savoldelli C, Ehrmann E, Tillier Y. Biomechanical assessment of different fixation methods in mandibular high sagittal oblique osteotomy using a three-dimensional finite element analysis model. Sci Rep 2021; 11:8755. [PMID: 33888844 PMCID: PMC8062482 DOI: 10.1038/s41598-021-88332-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/31/2021] [Indexed: 11/09/2022] Open
Abstract
With modern-day technical advances, high sagittal oblique osteotomy (HSOO) of the mandible was recently described as an alternative to bilateral sagittal split osteotomy for the correction of mandibular skeletal deformities. However, neither in vitro nor numerical biomechanical assessments have evaluated the performance of fixation methods in HSOO. The aim of this study was to compare the biomechanical characteristics and stress distribution in bone and osteosynthesis fixations when using different designs and placing configurations, in order to determine a favourable plating method. We established two finite element models of HSOO with advancement (T1) and set-back (T2) movements of the mandible. Six different configurations of fixation of the ramus, progressively loaded by a constant force, were assessed for each model. The von Mises stress distribution in fixations and in bone, and bony segment displacement, were analysed. The lowest mechanical stresses and minimal gradient of displacement between the proximal and distal bony segments were detected in the combined one-third anterior- and posterior-positioned double mini-plate T1 and T2 models. This suggests that the appropriate method to correct mandibular deformities in HSOO surgery is with use of double mini-plates positioned in the anterior one-third and posterior one-third between the bony segments of the ramus.
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Affiliation(s)
- Charles Savoldelli
- Department of Oral and Maxillofacial Surgery, Head and Neck Institute, University Hospital of Nice, 30 Avenue Valombrose, 06100, Nice, France. .,Department of Computational Mechanics Physics CEMEF, MINES ParisTech, PSL Research University, Centre de Mise en Forme Des Matériaux (CEMEF), French National Centre for Scientific Research, Sophia Antipolis, France.
| | - Elodie Ehrmann
- Department of Computational Mechanics Physics CEMEF, MINES ParisTech, PSL Research University, Centre de Mise en Forme Des Matériaux (CEMEF), French National Centre for Scientific Research, Sophia Antipolis, France.,Department of Orthodontics, Oral Rehabilitation and Facial Pain, Dentistry Unit, University Hospital of Nice, Nice, France
| | - Yannick Tillier
- Department of Computational Mechanics Physics CEMEF, MINES ParisTech, PSL Research University, Centre de Mise en Forme Des Matériaux (CEMEF), French National Centre for Scientific Research, Sophia Antipolis, France
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Xu X, Cheng KJ, Liu YF, Fan YY, Wang JH, Wang R, Baur DA, Jiang XF, Dong XT. Experimental validation of finite element simulation of a new custom-designed fixation plate to treat mandibular angle fracture. Biomed Eng Online 2021; 20:15. [PMID: 33546713 PMCID: PMC7866451 DOI: 10.1186/s12938-021-00851-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of the study was to validate biomechanical characteristics of a 3D-printed, novel-designated fixation plate for treating mandibular angle fracture, and compare it with two commonly used fixation plates by finite element (FE) simulations and experimental testing. METHODS A 3D virtual mandible was created from a patient's CT images as the master model. A custom-designed plate and two commonly used fixation plates were reconstructed onto the master model for FE simulations. Modeling of angle fracture, simulation of muscles of mastication, and defining of boundary conditions were integrated into the theoretical model. Strain levels during different loading conditions were analyzed using a finite element method (FEM). For mechanical test design, samples of the virtual mandible with angle fracture and the custom-designed fixation plates were printed using selective laser sintering (SLS) and selective laser melting (SLM) printing methods. Experimental data were collected from a testing platform with attached strain gauges to the mandible and the plates at different 10 locations during mechanical tests. Simulation of muscle forces and temporomandibular joint conditions were built into the physical models to improve the accuracy of clinical conditions. The experimental vs the theoretical data collected at the 10 locations were compared, and the correlation coefficient was calculated. RESULTS The results show that use of the novel-designated fixation plate has significant mechanical advantages compared to the two commonly used fixation plates. The results of measured strains at each location show a very high correlation between the physical model and the virtual mandible of their biomechanical behaviors under simulated occlusal loading conditions when treating angle fracture of the mandible. CONCLUSIONS Based on the results from our study, we validate the accuracy of our computational model which allows us to use it for future clinical applications under more sophisticated biomechanical simulations and testing.
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Affiliation(s)
- Xu Xu
- Department of Stomatology, People's Hospital of Quzhou, Quzhou, 324000, China
| | - Kang-Jie Cheng
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, 310023, China
- Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou, 310023, China
- National International Joint Research Center of Special Purpose Equipment and Advanced Processing Technology, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Yun-Feng Liu
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, 310023, China.
- Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou, 310023, China.
- National International Joint Research Center of Special Purpose Equipment and Advanced Processing Technology, Zhejiang University of Technology, Hangzhou, 310023, China.
| | - Ying-Ying Fan
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, 310023, China
- Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou, 310023, China
- National International Joint Research Center of Special Purpose Equipment and Advanced Processing Technology, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Joanne H Wang
- Department of Orthopedic Surgery, University Hospitals of Cleveland, Case Medical Center, 11100 Euclid Ave., Cleveland, OH, 44016, USA
| | - Russell Wang
- Department of Comprehensive Care, Case Western Reserve University School of Dental Medicine, 10900 Euclid Ave., Cleveland, OH, 44106-4905, USA
| | - Dale A Baur
- Department of Oral Maxillofacial Surgery, Case Western Reserve University School of Dental Medicine, 10900 Euclid Ave., Cleveland, OH, 44106-4905, USA
| | - Xian-Feng Jiang
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, 310023, China
- Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Xing-Tao Dong
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, 310023, China
- Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou, 310023, China
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Biomechanical comparison of the All-on-4, M-4, and V-4 techniques in an atrophic maxilla: A 3D finite element analysis. Comput Biol Med 2020; 123:103880. [PMID: 32768041 DOI: 10.1016/j.compbiomed.2020.103880] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/16/2020] [Accepted: 06/21/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Patients with severely atrophied jaws can be challenging in implantology. The All-on-4 treatment concept eliminates advanced augmentation procedures in highly resorbed ridges by preserving the relevant anatomic structures. In addition, the inclination of the distal implants enables the placement of longer implants. Hence, tilting the anterior implants allows longer implant placement, in line with the distal implants of the All-on-4 concept. This study compared the biomechanical aspects of the standard All-on-4 treatment concept with the M-4 and V-4 techniques. METHODS A three-dimensional model of an edentulous maxilla was created to perform three-dimensional finite element analysis. Three different configurations (All-on-4, M-4, and V-4) were modeled by changing the tilt angle of the anterior implants. In each model, to simulate a foodstuff, a solid spherical material was placed on the midline of the incisors and the right first molar region, separately applying an occlusal load of 100 Newtons. The maximum principal stress and minimum principal stress values were acquired for cortical bone, and von Mises stress values were obtained for ductile materials. RESULTS According to the present study's findings, although there were no considerable differences among the models, in general, the All-on-4 group demonstrated slightly higher stresses and the M-4 and V-4 group showed lower stresses. CONCLUSION M-4 or V-4 configurations may be used in cases of severely atrophied anterior maxillae to achieve better primary stabilization.
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Ramos A, Semedo T, Mesnard M. Study of fixation of a mandibular plate for favourable fractures of the mandibular angle: numerical predictions. Br J Oral Maxillofac Surg 2020; 58:652-658. [DOI: 10.1016/j.bjoms.2020.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 03/09/2020] [Indexed: 10/24/2022]
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Brucoli M, Boffano P, Pezzana A, Benech A, Corre P, Bertin H, Pechalova P, Pavlov N, Petrov P, Tamme T, Kopchak A, Romanova A, Shuminsky E, Dediol E, Tarle M, Konstantinovic VS, Jelovac D, Karagozoglu KH, Forouzanfar T. The “European Mandibular Angle” research project: the analysis of complications after unilateral angle fractures. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:14-17. [DOI: 10.1016/j.oooo.2019.02.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/25/2019] [Indexed: 11/16/2022]
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Three-Dimensional Finite Element Analysis of Different Plating Techniques for Unfavorable Mandibular Angle Fractures. J Craniofac Surg 2018; 29:603-607. [PMID: 29419593 DOI: 10.1097/scs.0000000000004327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of the current study was to assess the biomechanical behavior of 5 different fixation schemes for unfavorable mandibular angle fractures using the three-dimensional finite element analysis method. Five different miniplate fixation schemes were modeled for the fixation of unfavorable mandibular angle fractures. A double parallel miniplate (M1), which was placed at the halfway point of the mandibular angle height; a 1/3 superior-positioned miniplate (M2); a single miniplate (M3), which was placed at the halfway point of the mandibular angle height (1/2 middle-positioned); a 1/3 inferior-positioned miniplate (M4); and an X-miniplate which was placed at the halfway point of the mandibular angle height (M5). The lowest mechanical stresses were detected in the double miniplate model when compared with the other schemes, whereas 1/3 inferior-positioned miniplate had the highest stress and displacement values. The authors suggest that the double miniplate is an adequate rigid fixation technique, whereas the 1/3 inferior-positioned miniplate configuration should not be used in case of unfavorable mandibular angle fracture.
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Liu YF, Fan YY, Jiang XF, Baur DA. A customized fixation plate with novel structure designed by topological optimization for mandibular angle fracture based on finite element analysis. Biomed Eng Online 2017; 16:131. [PMID: 29141673 PMCID: PMC5688740 DOI: 10.1186/s12938-017-0422-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 11/10/2017] [Indexed: 12/26/2022] Open
Abstract
Background The purpose of this study was to design a customized fixation plate for mandibular angle fracture using topological optimization based on the biomechanical properties of the two conventional fixation systems, and compare the results of stress, strain and displacement distributions calculated by finite element analysis (FEA). Methods A three-dimensional (3D) virtual mandible was reconstructed from CT images with a mimic angle fracture and a 1 mm gap between two bone segments, and then a FEA model, including volume mesh with inhomogeneous bone material properties, three loading conditions and constraints (muscles and condyles), was created to design a customized plate using topological optimization method, then the shape of the plate was referenced from the stress concentrated area on an initial part created from thickened bone surface for optimal calculation, and then the plate was formulated as “V” pattern according to dimensions of standard mini-plate finally. To compare the biomechanical behavior of the “V” plate and other conventional mini-plates for angle fracture fixation, two conventional fixation systems were used: type A, one standard mini-plate, and type B, two standard mini-plates, and the stress, strain and displacement distributions within the three fixation systems were compared and discussed. Results The stress, strain and displacement distributions to the angle fractured mandible with three different fixation modalities were collected, respectively, and the maximum stress for each model emerged at the mandibular ramus or screw holes. Under the same loading conditions, the maximum stress on the customized fixation system decreased 74.3, 75.6 and 70.6% compared to type A, and 34.9, 34.1, and 39.6% compared to type B. All maximum von Mises stresses of mandible were well below the allowable stress of human bone, as well as maximum principal strain. And the displacement diagram of bony segments indicated the effect of treatment with different fixation systems. Conclusions The customized fixation system with topological optimized structure has good biomechanical behavior for mandibular angle fracture because the stress, strain and displacement within the plate could be reduced significantly comparing to conventional “one mini-plate” or “two mini-plates” systems. The design methodology for customized fixation system could be used for other fractures in mandible or other bones to acquire better mechanical behavior of the system and improve stable environment for bone healing. And together with SLM, the customized plate with optimal structure could be designed and fabricated rapidly to satisfy the urgent time requirements for treatment.
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Affiliation(s)
- Yun-Feng Liu
- Key Laboratory of E &M (Zhejiang University of Technology), Ministry of Education & Zhejiang Province, Hangzhou, 310014, Zhejiang, China.
| | - Ying-Ying Fan
- Key Laboratory of E &M (Zhejiang University of Technology), Ministry of Education & Zhejiang Province, Hangzhou, 310014, Zhejiang, China
| | - Xian-Feng Jiang
- Key Laboratory of E &M (Zhejiang University of Technology), Ministry of Education & Zhejiang Province, Hangzhou, 310014, Zhejiang, China
| | - Dale A Baur
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, 44106, USA
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