Newly designed retentive posts of mandibular reconstruction plate in oral cancer patients based on preliminary FEM study

A Comparative Study of Analog Preoperative Planning Versus Virtual Preoperative Planning for Mandibular Reconstruction With Fibula Free Flap

ABSTRACT

Mandibular reconstruction is a challenging procedure, especially in cancer patients with defects that are greater than 6 cm. Free vascularized fibular flap is the gold standard treatment in these cases since it allows three-dimensional restoration of the lost segments after ablative surgery in addition to providing the possibility of a subsequent implant-supported rehabilitation improving the functional and aesthetic outcomes of the surgery.To obtain accurate results, preoperative planning must be done with detail. Approaches for the preoperative planning include both the conventional analog planning and the virtual planning that are valid alternatives in meeting the trans-surgical requirements.This study makes a comparative analysis of 2 clinical cases with a diagnosis of squamous cell carcinoma that were reconstructed using a vascularized fibular free flap. The first case was planned using the conventional analog method whereas the second case was planned using the virtual planning approach.The impact of virtual planning and conventional analog planning on preoperative planning time, ischemia period, and total surgical time is analyzed according to the experience obtained in the cases presented. In addition, the authors described the technique used for each planning method along with a literature review in which the results are contrasted and discussed.

Mandibular Setback as an Adjunctive Strategy for Reconstruction after Tumor Resection: A Technical Note and Case Report

Mandibular defects due to surgical resection of pathologies are common challenges for maxillofacial surgeons. In some clinical situations, alteration or combination of different surgical procedures is needed to reduce the size of bony defects and improve the success rate of bone grafts. In the current study, an 18-year-old female with a pathological lesion (ameloblastoma) in the mandible is presented. After tumor resection, bony defect reconstruction with autogenous bone graft was combined with a mandibular setback to facilitate the procedure. In this case, the simultaneous combination of orthognathic mandibular setback movement with tumor resection in a single surgical session helped to reduce the bony defect size. The adoption of this approach led to a decrease in the volume of graft harvesting and improved the success rate of the grafting procedure.

Application of bioengineering devices for stress evaluation in dentistry: the last 10 years FEM parametric analysis of outcomes and current trends

INTRODUCTION

Dentistry, therefore implantology, prosthetics, implant prosthetics or orthodontics in all their variants, are medical and rehabilitative branches that have benefited greatly from these methods of investigation to improve the predictability of rehabilitations. We will examine the Finite Element Method and Finite Element Analysis in detail. This method involves the simulation of mechanical forces from an environment with infinite elements, the real one, to a simulation with finite elements.

EVIDENCE ACQUISITION

The study searched MEDLINE databases from 2008 to 2018. Human use of FEM in vitro studies reported a contribution on oral rehabilitation through the use of FEM analysis. The initial search obtained 296 citations. After a first screening, the present revision considered the English-language works referred to human application of the FEM published in the last 10 years. Finally, 34 full texts were available after screening.

EVIDENCE SYNTHESIS

The ultimate aim of this review is to point out all the progress made in the field of bioengineering and therefore, thanks to this, in the field of medicine. Instrumental investigations such as FEM are an excellent tool that allows the evaluation of anatomical structures and any facilities for rehabilitation before moving on to experimentation on animals, so as to have mechanical characteristics and satisfactory load cycle testing.

CONCLUSIONS

FEM analysis contributes substantially to the development of new technologies and new materials in the biomedical field, being able to perform a large number of simulations without the need for patients or to perform human tests. Thanks to the 3D technology and to the reconstructions of both the anatomical structures and eventually the alloplastic structures used in the rehabilitations it is possible to consider all the mechanical characteristics, so that they can be analyzed in detail and improved where necessary. It is possible thanks to these methods to know what are the ideal characteristics of a material to promote an oral rehabilitation, so we know the characteristics, it remains only to take a step in the field of the industry for the construction of materials close to these characteristics.