结构优化的个体化下颌骨重建板定向增材制造的生物力学验证。
Biomechanical validation of structural optimized patient-specific mandibular reconstruction plate orienting additive manufacturing.
机构信息
Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, Leuven 3000, Belgium.
Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, Leuven 3000, Belgium.
出版信息
Comput Methods Programs Biomed. 2022 Sep;224:107023. doi: 10.1016/j.cmpb.2022.107023. Epub 2022 Jul 14.
BACKGROUND AND OBJECTIVE
Owing to the unexpected in vivo fracture failure of the original design, structural optimized patient-specific mandibular reconstruction plates (PSMRPs) were created to boost the biomechanical performance of bridging segmental bony defect in the mandibular reconstruction after tumor resection. This work aimed to validate the biomechanical benefit of the structural optimized PSMRPs relative to the original design and compare the biomechanical performance between PSMRP1 with generic contour customization and PSMRP2 with a tangent arc upper margin in mandibular angle region.
METHODS
Finite Element Analysis (FEA) was used to evaluate the biomechanical behavior of mandibular reconstruction assemblies (MRAs) concerning these two structural optimized PSMRPs by simulating momentary left group clenching and incisal clenching tasks. Bonded contact was set between mandibular bone and fixation screws and between PSMRP and fixation screws in the MRA, while the frictionless connection was allocated between mandibular bone and PSMRP. The loads were applied on four principal muscles, including masseter, temporalis, lateral and medial pterygoid, whose magnitudes along the three orthogonal directions. The mandibular condyles were retrained in all three directions, and either the left molars or incisors area were restrained from moving vertically.
RESULTS
The peak von Mises stresses of structural optimized PSMRPs (264 MPa, 296 MPa) were way lower than that of the initial PSMRP design (393 MPa), with 33 and 25% reduction during left group clenching. The peak magnitude of von Mises stress, minimum principal stress, and maximum principal strain of PSMRP1 (264 MPa, 254 MPa; -297 MPa, -285 MPa; 0.0020, 0.0020) was lower than that of PSMRP2 (296 MPa, 286 MPa; -319 MPa, -306 MPa; 0.0022, 0.0020), while the peak maximum principal stress of PSMRP1 (275 MPa, 257 MPa) was higher than that of PSMRP2 (254 MPa, 235 MPa) during both left group clenching and incisal clenching tasks.
CONCLUSIONS
The structural optimized PSMRPs reveal their biomechanical advantage compared with the original design. The PSMRP1 presents better biomechanical performance to the patient-specific mandibular reconstruction than PSMRP2 as a result of its superior safety, preferable flexibility, and comparable stability. The PSMRP2 provides biomechanical benefit in reducing the maximum tension than PSMRP1, indicated by lower peak maximum principal stress, through tangent arc upper margin in mandibular angle region.
背景与目的
由于最初设计的意外体内骨折失效，创建了结构优化的患者特异性下颌骨重建板（PSMRP），以提高肿瘤切除后下颌骨重建中桥接节段性骨缺损的生物力学性能。本研究旨在验证相对于原始设计的结构优化 PSMRP 的生物力学优势，并比较 PSMRP1 与通用轮廓定制和 PSMRP2 在下颌角区域具有切线弧形上缘的生物力学性能。
方法
通过模拟左侧群组咬牙和切牙咬牙任务，使用有限元分析（FEA）来评估这两种结构优化的 PSMRP 对下颌骨重建组件（MRA）的生物力学行为。在 MRA 中，下颌骨和固定螺钉之间以及 PSMRP 和固定螺钉之间设置了粘合接触，而下颌骨和 PSMRP 之间则分配了无摩擦连接。将载荷施加到包括咬肌、颞肌、外侧和内侧翼外肌在内的四个主要肌肉上，其大小沿三个正交方向。下颌骨髁突在所有三个方向上都被重新约束，并且左侧磨牙或切牙区域被阻止垂直移动。
结果
结构优化的 PSMRP 的峰值 von Mises 应力（264 MPa、296 MPa）远低于初始 PSMRP 设计的 von Mises 应力（393 MPa），在左侧群组咬牙时分别降低了 33%和 25%。PSMRP1 的 von Mises 应力、最小主应力和最大主应变峰值（264 MPa、254 MPa；-297 MPa、-285 MPa；0.0020、0.0020）低于 PSMRP2（296 MPa、286 MPa；-319 MPa、-306 MPa；0.0022、0.0020），而 PSMRP1 在左侧群组咬牙和切牙咬牙任务中的峰值最大主应力（275 MPa、257 MPa）高于 PSMRP2（254 MPa、235 MPa）。
结论
与原始设计相比，结构优化的 PSMRP 显示出其生物力学优势。PSMRP1 由于其更高的安全性、更好的灵活性和相当的稳定性，为患者特异性下颌骨重建提供了更好的生物力学性能。PSMRP2 通过在下颌角区域具有切线弧形上缘，提供了降低最大张力的生物力学益处，表现为较低的峰值最大主应力。
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