背景:下颌骨节段性缺损的重建一直是一个挑战。在某些情况下,没有骨移植物的定制重建板也被认为是康复和重建的过渡手段。
方法:本研究使用有限元方法评估了具有不同结构设计的定制板与商用板的生物力学行为,以重建下颌骨外侧缺损。
结果:模拟揭示了板体的应力状态,骨组织和螺钉与宽度有关,高度,板的厚度以及螺钉的分布。在所有的群体中,16毫米高的系统,2.8毫米厚的定制重建板10个螺钉被认为是最理想的设计,因为最和谐的生物力学状态。更重要的是,本实验的应力屏蔽效应不明显。基于上述发现,我们进行了临床病例分析,以验证定制重建的机械性能,并获得了满意的手术效果。
结论:结果表明,通过调整重建板的轮廓参数,一个理想的和可靠的定制板可以制造。而定制的3D打印钛合金植入物将成为无法进行自体植骨手术的患者实现下颌骨重建的新途径。
背景:本试验已在ChiCTR注册,注册号为ChiCTR2,000,038,973,于2020年11月10日。
BACKGROUND: The reconstruction of segmental defect of the mandible has always been a challenge. The customized reconstruction plate without a bone graft is also considered a transitional means of rehabilitation and reconstruction in some cases.
METHODS: This study evaluated the biomechanical behaviors of customized plates with different structural designs comparing with commercial plates using the finite element method in reconstrution of the lateral mandible defect.
RESULTS: Simulations revealed the stress state in the plate bodies, bone tissues and screws were associated with the width, height, thickness of the plates as well as the distribution of screws. In all of the groups, the system of 16 mm-high, 2.8 mm-thick customized reconstruction plate with 10 screws was considered to be the most ideal design because of the most harmonious biomechanical state. What\'s more, the stress shielding effects were not obvious in this experiment. Based on the above findings, we conducted a clinical case analysis to verify the mechanical properties of customized reconstruction and obtained a satisfactory operation result.
CONCLUSIONS: The results show that by adjusting the contour parameters of the reconstruction plates, an ideal and reliable customized plate can be manufactured. And the customized 3D-printed Ti alloy implant will be a new way to achieve mandibular reconstruction in patients unable to perform autologous bone graft surgery.
BACKGROUND: The present trial has been registered with ChiCTR, the registration number is ChiCTR 2,000,038,973 on 11/10/2020.