Abstract:
Oral cavity tumors are a prevalent cause of mandible reconstruction surgeries. The mandible is vital for functions like oralization, respiration, mastication, and deglutition. Current mandible reconstruction methods have low success rates due to complications like plate fracture or exposure, infections, and screw loosening. Autogenous bone grafts are commonly used but carry the risk of donor region morbidity. Despite technological advances, an ideal solution for mandible reconstruction remains elusive. Additive manufacturing in medicine offers personalized prosthetics from patient-specific medical images, allowing for the creation of porous structures with tailored mechanical properties that mimic bone properties. This study compared a commercial reconstruction plate with a lattice-structured personalized prosthesis under different biting and osseointegration conditions using Finite Element Analysis. Patient-specific images were obtained from an individual who underwent mandible reconstruction with a commercial plate and suffered from plate fracture by fatigue after 26 months. Compared to the commercial plate, the maximum von Mises equivalent stress was significantly lowered for the personalized prosthesis, hindering a possible fatigue fracture. The equivalent von Mises strains found in bone were within bone maintenance and remodeling intervals. This work introduces a design that doesn\'t require grafts for large bone defects and allows for dental prosthesis addition without the need for implants.
摘要:
口腔肿瘤是下颌骨重建手术的主要原因。下颌骨对于口述等功能至关重要,呼吸,咀嚼,和吞咽。目前的下颌骨重建方法由于钢板骨折或暴露等并发症,成功率较低。感染,并松开螺钉。自体骨移植物是常用的,但具有供体区域发病的风险。尽管技术进步,下颌骨重建的理想解决方案仍然难以捉摸。医学中的增材制造提供了来自患者特定医学图像的个性化假肢,允许创建具有模拟骨骼特性的定制机械性能的多孔结构。这项研究使用有限元分析在不同的咬合和骨整合条件下比较了商业重建板与网格结构的个性化假体。患者特定的图像是从使用商业钢板进行下颌骨重建并在26个月后因疲劳而遭受钢板骨折的个体获得的。与商业板块相比,个性化假体的最大vonMises等效应力显着降低,阻碍可能的疲劳断裂。在骨骼中发现的等效vonMises应变在骨骼维持和重塑间隔内。这项工作介绍了一种设计,不需要移植大骨缺损,并允许在不需要植入物的情况下添加假牙。