Improving the biomechanical performance of screws fixation in a customized mandibular reconstruction prosthesis based on reliability measure
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Abstract
Background: The customized prosthesis is a new method for the reconstruction of large mandibular defects. The ability of dental rehabilitation to improve masticatory functions while maintaining the aesthetics of the main anatomy of the patient’s jaw. But the most important problem with all custom prosthesis is the poor performance of screw fixation strength the connections at the bone-plate interface. Materials and Methods: This study was performed to investigate the effect of the number and layout of screws to improve the strength of the bone–prosthesis interface. Due to the inherent variability of input parameters, Analysis of the biomechanical performance of screw fixation strength, a probabilistic finite element method approach has been used. Random input parameters include mechanical properties of the cortical bone, cancellous bone, titanium alloy (Ti6Al4V), and bite force. The layout of the screws was designed in 6 models. Criteria for evaluating the biomechanical performance of screw fixation strength include maximum stress and strain of von Mises cortical bone around the screws. The Monte-Carlo method was used for finite element simulation. Results: The most critical screw in all models is screw No.1, which by increasing the number of screws and correcting the layout shape, the values of maximum stress and strain in the bone around screw No.1 has decreased by 26.7% and 46.3%, respectively, and increased the reliability of the screw connection performance by 25% and 28%, respectively. Conclusion: Finally, in the reconstruction of a large lateral mandibular defect by the customized prosthesis, the strength of the prosthesis to connect to the remaining mandible bone can be improved by increasing the number and modifying the layout of the screws. Keywords: Mandible reconstruction; Customized prosthesis; Probabilistic finite element method; Reliability.
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[19] De Silva, C.W. ed., 2005. Vibration and shock handbook. CRC press.
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[22] Li P, Shen L, Li J, Liang R, Tian W, and Tang W. Optimal design of an individual endoprosthesis for the reconstruction of extensive mandibular defects with finite element analysis. Journal of Cranio-Maxillofacial Surgery. 2014. 42(1): 73-78. https://doi.org/10.1016/j.jcms.2013.02.005.
[23] Modarres M, Kaminskiy MP, and Krivtsov V. Reliability engineering and risk analysis: a practical guide. 2016. CRC press.
[24] An YH, and Draughn RA eds. Mechanical testing of bone and the bone-implant interface. 1999.CRC press.
[25] Mellal A, Wiskott HWA, Botsis J, Scherrer SS, and Belser UC. Stimulating effect of implant loading on surrounding bone: comparison of three numerical models and validation by in vivo data. Clinical oral implants research. 2004; 15(2): 239-248. https://doi.org/10.1111/j.1600-0501.2004.01000.x.
[26] Kayabaşı O, Yüzbasıoğlu E, and Erzincanlı F. Static, dynamic and fatigue behaviors of dental implant using finite element method. Advances in engineering software. 2006; 37(10): 649-658. https://doi.org/10.1016/j.advengsoft.2006.02.004.
[27] Park SM, Lee JW, and Noh G. Which plate results in better stability after segmental mandibular resection and fibula free flap reconstruction? Biomechanical analysis. Oral surgery, oral medicine, oral pathology and oral radiology. 2018. 126(5): 380-389. https://doi.org/10.1016/j.oooo.2018.05.048.
[2] Lee S, Goh BT, Tideman H, Stoelinga PJW, and Jansen JA. Modular endoprosthesis for mandibular body reconstruction: a clinical, micro-CT and histologic evaluation in eight Macaca fascicularis. International journal of oral and maxillofacial surgery. 2009; 38(1): 40-47. https://doi.org/10.1016/j.ijom.2008.11.020.
[3] Gurtner GC, and Evans GR. Advances in head and neck reconstruction. Plastic and reconstructive surgery. 2000. 106(3): 672-682.
[4] Head C, Alam D, Sercarz JA, Lee JT, Rawnsley JD, Berke GS, and Blackwell KE. Microvascular flap reconstruction of the mandible: a comparison of bone grafts and bridging plates for restoration of mandibular continuity. Otolaryngology-Head and Neck Surgery. 2003. 129(1): 48-54. https://doi.org/10.1016/S0194-59980300480-7.
[5] Cannady SB, Lamarre E, and Wax MK. Microvascular reconstruction: evidence-based procedures. Facial Plastic Surgery Clinics. 2015. 23(3): pp.347-356. DOI:https://doi.org/10.1016/j.fsc.2015.04.007
[6] Markwardt J, Pfeifer G, Eckelt U, and Reitemeier B. Analysis of complications after reconstruction of bone defects involving complete mandibular resection using finite element modelling. Oncology Research and Treatment. 2007. 30(3): 121-126. https://doi.org/10.1159/000098848.
[7] Kimura A, Nagasao T, Kaneko T, Tamaki T, Miyamoto J, and Nakajima T. Adaquate fixation of plates for stability during mandibular reconstruction. Journal of Cranio-Maxillofacial Surgery. 2006; 34(4): 193-200. https://doi.org/10.1016/j.jcms.2006.01.003.
[8] KARGARNEJAD S, GHALICHI F, POURGOL-MOHAMMAD M, OSKUI I, and GARAJEI A. BIOMECHANICAL EVALUATION OF RECONSTRUCTED EXTENSIVE MANDIBULAR DEFECTS BY DIFFERENT MODELS USING FINITE ELEMENT METHOD. Journal of Mechanics in Medicine and Biology.2020. 20: 2050053. https://doi.org/10.1142/S0219519420500530.
[9] Fantini M, De Crescenzio F, Ciocca L. Design and manufacturing of customized surgical devices for mandibular rehabilitation. International Journal on Interactive Design and Manufacturing (IJIDeM). 2013; 7:227-37. https://doi.org/10.1007/s12008-012-0177-5.
[10] Parthasarathy J, Starly B, and Raman S. Computer aided biomodeling and analysis of patient specific porous titanium mandibular implants. Journal of Medical Devices. 2009; 3(3). https://doi.org/10.1115/1.3192104.
[11] Pinheiro M, and Alves JL. The feasibility of a custom-made endoprosthesis in mandibular reconstruction: implant design and finite element analysis. Journal of Cranio-Maxillofacial Surgery. 2015. 43(10): 2116-2128. https://doi.org/10.1016/j.jcms.2015.10.004.
[12] Kargarnejad S, Ghalichi F, Mohammad MP, and Garajei A. Evaluation of failure of a titanium conventional plate in mandibular reconstruction and improve the performance with fibula free flap. Journal of Craniomaxillofacial Research. 2020. pp.70-78. DOI: https://doi.org/10.18502/jcr.v7i2.4504 .
[13] Narra N, Valášek J, Hannula M, Marcián P, Sándor GK, Hyttinen J, and Wolff J. Finite element analysis of customized reconstruction plates for mandibular continuity defect therapy. Journal of biomechanics. 2014. 47(1): 264-268. https://doi.org/10.1016/j.jbiomech.2013.11.016.
[14] Kaymaz I, Bayrak O, Karsan O, Celik A, and Alsaran A. Failure analysis of the cement mantle in total hip arthroplasty with an efficient probabilistic method. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine. 2014. 228(4): 409-417. https://doi.org/10.1177/0954411914529428.
[15] Brown JS, Barry C, Ho M, and Shaw R. A new classification for mandibular defects after oncological resection. The Lancet Oncology. 2016; 17(1): 23-30. https://doi.org/10.1016/S1470-2045(15)00310-1.
[16] Kayabasi O, and Ekici B. Probabilistic design of a newly designed cemented hip prosthesis using finite element method. Materials & Design. 2008. 29(5): 963-971. https://doi.org/10.1016/j.matdes.2007.03.024.
[17] Petrie CS, and Williams JL. Probabilistic analysis of peri‐implant strain predictions as influenced by uncertainties in bone properties and occlusal forces. Clinical oral implants research. 2007. 18(5): 611-619. https://doi.org/10.1111/j.1600-0501.2007.01384.x.
[18] May B, Saha S, and Saltzman M. A three-dimensional mathematical model of temporomandibular joint loading. Clinical Biomechanics. 2001. 16(6): 489-495. https://doi.org/10.1016/S0268-0033(01)00037-7.
[19] De Silva, C.W. ed., 2005. Vibration and shock handbook. CRC press.
[20] Oskui IZ, Hashemi A, Jafarzadeh H, and Kato A. Finite element investigation of human maxillary incisor under traumatic loading: Static vs dynamic analysis. Computer methods and programs in biomedicine. 2018. 155: 121-125. https://doi.org/10.1016/j.cmpb.2017.12.007.
[21] Modarres M, Amiri M, and Jackson C. Probabilistic Physics of Failure Approach to Reliability: Modeling, Accelerated Testing, Prognosis and Reliability Assessment. 2017. John Wiley & Sons.
[22] Li P, Shen L, Li J, Liang R, Tian W, and Tang W. Optimal design of an individual endoprosthesis for the reconstruction of extensive mandibular defects with finite element analysis. Journal of Cranio-Maxillofacial Surgery. 2014. 42(1): 73-78. https://doi.org/10.1016/j.jcms.2013.02.005.
[23] Modarres M, Kaminskiy MP, and Krivtsov V. Reliability engineering and risk analysis: a practical guide. 2016. CRC press.
[24] An YH, and Draughn RA eds. Mechanical testing of bone and the bone-implant interface. 1999.CRC press.
[25] Mellal A, Wiskott HWA, Botsis J, Scherrer SS, and Belser UC. Stimulating effect of implant loading on surrounding bone: comparison of three numerical models and validation by in vivo data. Clinical oral implants research. 2004; 15(2): 239-248. https://doi.org/10.1111/j.1600-0501.2004.01000.x.
[26] Kayabaşı O, Yüzbasıoğlu E, and Erzincanlı F. Static, dynamic and fatigue behaviors of dental implant using finite element method. Advances in engineering software. 2006; 37(10): 649-658. https://doi.org/10.1016/j.advengsoft.2006.02.004.
[27] Park SM, Lee JW, and Noh G. Which plate results in better stability after segmental mandibular resection and fibula free flap reconstruction? Biomechanical analysis. Oral surgery, oral medicine, oral pathology and oral radiology. 2018. 126(5): 380-389. https://doi.org/10.1016/j.oooo.2018.05.048.
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| Issue | Vol 7, No 4 (Autumn 2020) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jcr.v7i4.5555 | |
| Keywords | ||
| Mandible reconstruction; Customized prosthesis; Probabilistic finite element method; Reliability. | ||
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How to Cite
1.
Kargarnejad S, Ghalichi F, Pourgol Mohammad M, Garajei A. Improving the biomechanical performance of screws fixation in a customized mandibular reconstruction prosthesis based on reliability measure. J Craniomaxillofac Res. 2021;7(4):195-202.
