Orassi Vincenzo, Duda Georg N, Heiland Max, Fischer Heilwig, Rendenbach Carsten, Checa Sara
Julius Wolff Institute, Charité - Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Front Bioeng Biotechnol. 2021 May 6;9:672176. doi: 10.3389/fbioe.2021.672176. eCollection 2021.
Mandibular fracture fixation and reconstruction are usually performed using titanium plates and screws, however, there is a need to improve current fixation techniques. Animal models represent an important step for the testing of new designs and materials. However, the validity of those preclinical models in terms of implant biomechanics remains largely unknown. In this study, we investigate the biomechanics of the sheep mandible as a preclinical model for testing the mechanical strength of fixation devices and the biomechanical environment induced on mandibular fractures. We aimed to assess the comparability of the biomechanical conditions in the sheep mandible as a preclinical model for human applications of fracture fixation devices and empower analyses of the effect of such defined mechanical conditions on bone healing outcome. We developed 3D finite element models of the human and sheep mandibles simulating physiological muscular loads and three different clenching tasks (intercuspal, incisal, and unilateral). Furthermore, we simulated fractures in the human mandibular body, sheep mandibular body, and sheep mandibular diastema fixated with clinically used titanium miniplates and screws. We compared, at the power stroke of mastication, the biomechanical environment (1) in the healthy mandibular body and (2) at the fracture sites, and (3) the mechanical solicitation of the implants as well as the mechanical conditions for bone healing in such cases. In the healthy mandibles, the sheep mandibular body showed lower mechanical strains compared to the human mandibular body. In the fractured mandibles, strains within a fracture gap in sheep were generally not comparable to humans, while similar or lower mechanical solicitation of the fixation devices was found between the human mandibular body fracture and the sheep mandibular diastema fracture scenarios. We, therefore, conclude that the mechanical environments of mandibular fractures in humans and sheep differ and our analyses suggest that the sheep mandibular bone should be carefully re-considered as a model system to study the effect of fixation devices on the healing outcome. In our analyses, the sheep mandibular diastema showed similar mechanical conditions for fracture fixation devices to those in humans.
下颌骨骨折固定与重建通常使用钛板和螺钉进行,然而,当前的固定技术仍有待改进。动物模型是测试新设计和材料的重要环节。然而,这些临床前模型在植入物生物力学方面的有效性在很大程度上仍不为人知。在本研究中,我们将绵羊下颌骨的生物力学作为一种临床前模型进行研究,以测试固定装置的机械强度以及下颌骨骨折所引发的生物力学环境。我们旨在评估绵羊下颌骨作为骨折固定装置人体应用临床前模型时生物力学条件的可比性,并对这种明确的机械条件对骨愈合结果的影响进行分析。我们建立了人类和绵羊下颌骨的三维有限元模型,模拟生理肌肉负荷以及三种不同的咬合任务(牙尖交错位、切牙位和单侧咬合)。此外,我们模拟了人类下颌骨体、绵羊下颌骨体以及用临床使用的微型钛板和螺钉固定的绵羊下颌骨间隙骨折。我们在咀嚼的动力冲程阶段,比较了(1)健康下颌骨体、(2)骨折部位的生物力学环境,以及(3)此类情况下植入物的机械应力和骨愈合的机械条件。在健康下颌骨中,与人类下颌骨体相比,绵羊下颌骨体的机械应变较低。在骨折的下颌骨中,绵羊骨折间隙内的应变通常与人类不可比,而在人类下颌骨体骨折和绵羊下颌骨间隙骨折情况下,固定装置的机械应力相似或更低。因此,我们得出结论,人类和绵羊下颌骨骨折的机械环境不同,我们的分析表明,应谨慎重新考虑将绵羊下颌骨作为研究固定装置对愈合结果影响的模型系统。在我们的分析中,绵羊下颌骨间隙显示出与人类骨折固定装置相似的机械条件。