Optimisation of osteosynthesis positioning in mandibular body fracture management using finite element analysis

Abstract

Purpose To investigate the applicability of finite element analysis (FEA) in Oral and Maxillofacial (OMF) surgery, by studying the effect of mandibular body height and osteosynthesis positioning on unilateral mandibular body fractures based on Champy’s technique. This proof of principle is a step towards developing a validated FEA simulation method that may be useful in the clinical setting for optimising mandibular fracture management. Methods Mandibles made of polyurethane foam (Synbone®), with heights of 18, 14, and 10 mm were used to create a FEA model with a unilateral straight-line fracture, fixated with a standard commercially available 6-hole 2 mm titanium miniplate (KLS Martin Group). Two different FEA programs were used for the comparison, namely: Solidworks and Comsol Multiphysics. The FEA outcomes were compared with a series of mechanical tests with polymeric models fixed in a customised device and loaded onto a mechanical test bench. Results First, the study illustrated that the optimal plate position appeared to be the upper border. Second, lower mandibular height increases instability and requires a stronger osteosynthesis system. Conclusion The FEA’s and polymeric model testing outcomes of unilateral non-comminuted fractures were highly comparable with current opinions of mandibular fracture management. FEA is an applicable tool in OMF surgery, as it can be used to predict the treatment outcome of mandibular fractures. The promising outcome of this study makes it worthwhile to do more extensive analysis in order to determine whether FEA alone is sufficient for optimisation of fracture management.

Biomechanical assessment of mandibular fracture fixation using finite element analysis validated by polymeric mandible mechanical testing

“…Therefore, in future studies, we aim to use 3D printed mandibles made of a material with known properties that are comparable to real human bone instead of Synbone mandible replicas. Finally, according to the literature, FEA is a promising tool in the OMF surgery for investigating different types of fracture management and different osteosynthesis systems or implants [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]50 . This study shows that our FEA model is an applicable tool for analysing simple mandibular fracture problems; therefore, the outcome of this study is a promising step towards developing a validated FEA model suitable for many different situations (e.g., complex mandibular fractures or other bone fractures in the OMF region).…”