Finite element analysis of customized implant in mandibular reconstruction after tumor resection with and without using customized surgical osteotomy guide

Dahake, Sandeep W.; Kuthe, Abhaykumar M.; Kulkarni, Sanket; Mawale, Mahesh B.

doi:10.1002/rcs.1854

Cited by 15 publications

(18 citation statements)

References 17 publications

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“…The reliable reconstruction might be attributed to the application of 3D‐printed osteotomy guide plate and prosthesis. Previous studies have showed that no gaps between the implant and the host bone can significantly improve the stability of the reconstruction . 3D printing technology can allow for more accurate tumor resection and enable precise fitting between implant and residual bone fragments .…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, in theory, 3D‐printed prosthesis combines the advantages of prosthetic reconstruction and biologic reconstruction. Moreover, studies have shown that a 3D‐printed osteotomy guide plate based on preoperative imaging can create a rapid and accurate osteotomy without the aid of navigation . In this study, twelve patients with metaphyseal malignant bone tumors around the knee joint were treated by joint‐preserving intercalary tumor resections with the aid of 3D‐printed osteotomy guide plates and reconstructions using 3D‐printed intercalary prostheses.…”

Section: Introductionmentioning

confidence: 99%

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Three‐dimensional‐printed intercalary prosthesis for the reconstruction of large bone defect after joint‐preserving tumor resection

Liu

Shao

Rai

et al. 2020

Journal of Surgical Oncology

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Background: Joint-preserving intercalary tumor resection can result in better proprioception and a more normal joint function after reconstruction. However, most reported reconstruction techniques are usually associated with frequent complications. Therefore, the approach of reconstruction following joint-preserving tumor resection warrants further study. Methods: Between September 2016 and October 2018, 12 patients with metaphyseal malignant bone tumors around the knee joint were treated by joint-preserving intercalary resections with the aid of three-dimensional (3D)-printed osteotomy guide plates and reconstructions using 3D-printed intercalary prostheses. We assessed the accuracy of the resection by comparing the cross sections at the resection plane with 3D-printed matching surface of the prostheses. The functional outcomes, complications and oncological status were also evaluated.Results: All patients were observed for 7 to 32 months with an average follow-up of 22.5 months. The achieved resection was accurate, with accurate matching between the residual bone and prosthesis. The mean MSTS score was 28 (range, 26-30).Superficial infection occurred in two patients. Local recurrence was observed in one patient, while pulmonary metastasis was identified in one patient. Conclusions:The personalized osteotomy guide plate and prosthesis based on 3D printing technique facilitate joint-preserving tumor resection and functional reconstruction. However, longer follow-up and larger sample size are required to clarify its long-term outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Three‐dimensional‐printed intercalary prosthesis for the reconstruction of large bone defect after joint‐preserving tumor resection

Liu

Shao

Rai

et al. 2020

Journal of Surgical Oncology

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“…The loading conditions were as illustrated in Figure 4b; an oblique force of 100 N was applied at 45 • to the lingual-buccal direction [18]. The boundary conditions were as illustrated in Figure 4b; the X, Y, and Z direction of the temporomandibular joint surface were fixed [15]. In this study, the von Mises stress was selected as the index for the evaluation of (1) peak stress values and (2) stress distribution of the implant and its surrounding bones in those 12 models.…”

Section: Finite Element Simulationmentioning

confidence: 99%

“…This successful clinical application of 3D metal printing has garnered considerable interest. Subsequently, many studies have been conducted involving 3D-printed Ti mandibles, including studies on the manufacturing process and clinical evaluation [8][9][10][11], an in vivo experiment [12], an animal experiment [13], and finite element (FE) analyses [10,14,15]. Adopting 3D printing could provide many exciting possibilities for the medical industry, including customized or patient-matched 3D-printed implants.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Assessment of Design Parameters on a Self-Developed 3D-Printed Titanium-Alloy Reconstruction/Prosthetic Implant for Mandibular Segmental Osteotomy Defect

Huang

Shie

Shen

et al. 2019

Metals

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Patients with oral cancer often have to undergo the surgery for mandibular excision. Once the bone in the cancerous area is removed, not only the facial area but also chewing function of the patient is needed to be repaired by clinicians. In recent years, the rapid growth of three-dimensional (3D) metal printing technology has meant that higher-quality facial reconstructions are now possible, which could even restore chewing function. This study developed 3D-printed titanium (Ti)-alloy reconstruction implant for a prosthesis designed for mandibular segmental osteotomy defects, and 3D finite element (FE) analysis was conducted to evaluate its biomechanical performance. The analyzed parameters in the FE models were as follows: (1) two prosthesis designs, namely a prosthesis retaining the residual mandibular bone (for patients with mild oral cancer) and a prosthesis with complete mandibular resection (for patients with severe oral cancer); (2) two lengths of prosthesis, namely 20 and 25 mm; and (3) three thicknesses of prosthesis, namely 0.8, 1, and 1.5 mm. A 45° lateral bite force (100 N) was applied to the top of the prosthesis as the loading condition. The results revealed that for the two prosthesis designs, the prosthesis retaining the residual mandibular bone showed higher stress on the prosthesis and cortical bone compared with the prosthesis with complete mandibular resection. Regarding the two prosthesis lengths, no fixed trend of prosthesis stress was found, but stress in the cortical bone was relatively high for a prosthesis length of 20 mm compared with that of 25 mm. For the three prosthesis thicknesses, as the thickness of the prosthesis decreased, the stress in the prosthesis decreased but the stress in the cortical bone increased. These findings require confirmation in future clinical investigations.

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“…There is a lack of studies regarding what residual height of mandibular bone implies a significant fracture risk; however, some authors advise preventive osteosynthesis with a reconstruction plate for residual unaffected bone of 6 mm or less [13]. Despite the sparsity of the literature, virtual surgical planning (VSP) and the computer-aided design/computer-aided manufacturing (CAD/CAM) of surgical guides and reconstruction plates may provide superior outcomes in comparison to conventional approaches and surgical materials [15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Prevention of Mandible Fractures in Medication-Related Osteonecrosis of the Jaws: The Role of Virtual Surgical Planning and Computer-Aided Design and Manufacturing in Two Clinical Case Reports

et al. 2021

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Background: Marginal mandible resection is required to achieve healing in some cases of medication-related osteonecrosis of the jaws (MRONJ). Despite the sparsity of the literature, computer-aided design/computer-aided manufacturing (CAD/CAM) materials may provide superior outcomes for patients with an increased risk of mandible fracture. The aim of this study was to report a digital workflow for surgical interventions to prevent mandible fracture in MRONJ patients. Methods: We present two cases in which virtual surgical planning (VSP) and CAD/CAM surgical guides and reconstruction plates were used to prevent mandible fractures in elderly MRONJ patients submitted for marginal resection. Two osteoporotic patients, aged 73 and 84 years, presented with stage 3 MRONJ of the right mandibular body with inferior alveolar nerve involvement. The unaffected bone height was 6 mm in both cases, implying a high risk of mandible fracture. After preoperative VSP, surgery was performed through a combined intraoral–transbuccal approach. CAD/CAM-customized cutting guides and reconstruction plates were used for the marginal resection of necrotic bone and internal fixation. Results: Complete healing was achieved and the patients remained asymptomatic up to 1 year post-surgery. Conclusions: VSP and CAD/CAM-customized materials facilitated the complete resection of necrotic bone and rigid fixation in MRONJ patients, allowing a simplified approach with shorter operative times, reduced morbidity, and predictable results.

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Finite element analysis of customized implant in mandibular reconstruction after tumor resection with and without using customized surgical osteotomy guide

Cited by 15 publications

References 17 publications

Three‐dimensional‐printed intercalary prosthesis for the reconstruction of large bone defect after joint‐preserving tumor resection

Three‐dimensional‐printed intercalary prosthesis for the reconstruction of large bone defect after joint‐preserving tumor resection

Biomechanical Assessment of Design Parameters on a Self-Developed 3D-Printed Titanium-Alloy Reconstruction/Prosthetic Implant for Mandibular Segmental Osteotomy Defect

Prevention of Mandible Fractures in Medication-Related Osteonecrosis of the Jaws: The Role of Virtual Surgical Planning and Computer-Aided Design and Manufacturing in Two Clinical Case Reports

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