Improving mandibular reconstruction by using topology optimization, patient specific design and additive manufacturing?-A biomechanical comparison against miniplates on human specimen.

In this study, topology optimized, patient specific osteosynthesis plates (TOPOS-implants) are evaluated for the mandibular reconstruction using fibula segments. These shape optimized implants are compared to a standard treatment with miniplates (thickness: 1.0 mm, titanium grade 4) in biomechanical...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Jan J Lang, Mirjam Bastian, Peter Foehr, Michael Seebach, Jochen Weitz, Constantin von Deimling, Benedikt J Schwaiger, Carina M Micheler, Nikolas J Wilhelm, Christian U Grosse, Marco Kesting, Rainer Burgkart
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d7b005acd82c462bb1fc13bb328ebce3
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:d7b005acd82c462bb1fc13bb328ebce3
record_format	dspace
spelling	oai:doaj.org-article:d7b005acd82c462bb1fc13bb328ebce32021-12-02T20:10:58ZImproving mandibular reconstruction by using topology optimization, patient specific design and additive manufacturing?-A biomechanical comparison against miniplates on human specimen.1932-620310.1371/journal.pone.0253002https://doaj.org/article/d7b005acd82c462bb1fc13bb328ebce32021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253002https://doaj.org/toc/1932-6203In this study, topology optimized, patient specific osteosynthesis plates (TOPOS-implants) are evaluated for the mandibular reconstruction using fibula segments. These shape optimized implants are compared to a standard treatment with miniplates (thickness: 1.0 mm, titanium grade 4) in biomechanical testing using human cadaveric specimen. Mandible and fibula of 21 body donors were used. Geometrical models were created based on automated segmentation of CT-scans of all specimens. All reconstructions, including cutting guides for osteotomy as well as TOPOS-implants, were planned using a custom-made software tool. The TOPOS-implants were produced by electron beam melting (thickness: 1.0 mm, titanium grade 5). The fibula-reconstructed mandibles were tested in static and dynamic testing in a multi-axial test system, which can adapt to the donor anatomy and apply side-specific loads. Static testing was used to confirm mechanical similarity between the reconstruction groups. Force-controlled dynamic testing was performed with a sinusoidal loading between 60 and 240 N (reconstructed side: 30% reduction to consider resected muscles) at 5 Hz for up to 5 · 105 cycles. There was a significant difference between the groups for dynamic testing: All TOPOS-implants stayed intact during all cycles, while miniplate failure occurred after 26.4% of the planned loading (1.32 · 105 ± 1.46 · 105 cycles). Bone fracture occurred in both groups (miniplates: n = 3, TOPOS-implants: n = 2). A correlation between bone failure and cortical bone thickness in mandible angle as well as the number of bicortical screws used was demonstrated. For both groups no screw failure was detected. In conclusion, the topology optimized, patient specific implants showed superior fatigue properties compared to miniplates in mandibular reconstruction. Additionally, the patient specific shape comes with intrinsic guiding properties to support the reconstruction process during surgery. This demonstrates that the combination of additive manufacturing and topology optimization can be beneficial for future maxillofacial surgery.Jan J LangMirjam BastianPeter FoehrMichael SeebachJochen WeitzConstantin von DeimlingBenedikt J SchwaigerCarina M MichelerNikolas J WilhelmChristian U GrosseMarco KestingRainer BurgkartPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0253002 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jan J Lang Mirjam Bastian Peter Foehr Michael Seebach Jochen Weitz Constantin von Deimling Benedikt J Schwaiger Carina M Micheler Nikolas J Wilhelm Christian U Grosse Marco Kesting Rainer Burgkart Improving mandibular reconstruction by using topology optimization, patient specific design and additive manufacturing?-A biomechanical comparison against miniplates on human specimen.
description	In this study, topology optimized, patient specific osteosynthesis plates (TOPOS-implants) are evaluated for the mandibular reconstruction using fibula segments. These shape optimized implants are compared to a standard treatment with miniplates (thickness: 1.0 mm, titanium grade 4) in biomechanical testing using human cadaveric specimen. Mandible and fibula of 21 body donors were used. Geometrical models were created based on automated segmentation of CT-scans of all specimens. All reconstructions, including cutting guides for osteotomy as well as TOPOS-implants, were planned using a custom-made software tool. The TOPOS-implants were produced by electron beam melting (thickness: 1.0 mm, titanium grade 5). The fibula-reconstructed mandibles were tested in static and dynamic testing in a multi-axial test system, which can adapt to the donor anatomy and apply side-specific loads. Static testing was used to confirm mechanical similarity between the reconstruction groups. Force-controlled dynamic testing was performed with a sinusoidal loading between 60 and 240 N (reconstructed side: 30% reduction to consider resected muscles) at 5 Hz for up to 5 · 105 cycles. There was a significant difference between the groups for dynamic testing: All TOPOS-implants stayed intact during all cycles, while miniplate failure occurred after 26.4% of the planned loading (1.32 · 105 ± 1.46 · 105 cycles). Bone fracture occurred in both groups (miniplates: n = 3, TOPOS-implants: n = 2). A correlation between bone failure and cortical bone thickness in mandible angle as well as the number of bicortical screws used was demonstrated. For both groups no screw failure was detected. In conclusion, the topology optimized, patient specific implants showed superior fatigue properties compared to miniplates in mandibular reconstruction. Additionally, the patient specific shape comes with intrinsic guiding properties to support the reconstruction process during surgery. This demonstrates that the combination of additive manufacturing and topology optimization can be beneficial for future maxillofacial surgery.
format	article
author	Jan J Lang Mirjam Bastian Peter Foehr Michael Seebach Jochen Weitz Constantin von Deimling Benedikt J Schwaiger Carina M Micheler Nikolas J Wilhelm Christian U Grosse Marco Kesting Rainer Burgkart
author_facet	Jan J Lang Mirjam Bastian Peter Foehr Michael Seebach Jochen Weitz Constantin von Deimling Benedikt J Schwaiger Carina M Micheler Nikolas J Wilhelm Christian U Grosse Marco Kesting Rainer Burgkart
author_sort	Jan J Lang
title	Improving mandibular reconstruction by using topology optimization, patient specific design and additive manufacturing?-A biomechanical comparison against miniplates on human specimen.
title_short	Improving mandibular reconstruction by using topology optimization, patient specific design and additive manufacturing?-A biomechanical comparison against miniplates on human specimen.
title_full	Improving mandibular reconstruction by using topology optimization, patient specific design and additive manufacturing?-A biomechanical comparison against miniplates on human specimen.
title_fullStr	Improving mandibular reconstruction by using topology optimization, patient specific design and additive manufacturing?-A biomechanical comparison against miniplates on human specimen.
title_full_unstemmed	Improving mandibular reconstruction by using topology optimization, patient specific design and additive manufacturing?-A biomechanical comparison against miniplates on human specimen.
title_sort	improving mandibular reconstruction by using topology optimization, patient specific design and additive manufacturing?-a biomechanical comparison against miniplates on human specimen.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/d7b005acd82c462bb1fc13bb328ebce3
work_keys_str_mv	AT janjlang improvingmandibularreconstructionbyusingtopologyoptimizationpatientspecificdesignandadditivemanufacturingabiomechanicalcomparisonagainstminiplatesonhumanspecimen AT mirjambastian improvingmandibularreconstructionbyusingtopologyoptimizationpatientspecificdesignandadditivemanufacturingabiomechanicalcomparisonagainstminiplatesonhumanspecimen AT peterfoehr improvingmandibularreconstructionbyusingtopologyoptimizationpatientspecificdesignandadditivemanufacturingabiomechanicalcomparisonagainstminiplatesonhumanspecimen AT michaelseebach improvingmandibularreconstructionbyusingtopologyoptimizationpatientspecificdesignandadditivemanufacturingabiomechanicalcomparisonagainstminiplatesonhumanspecimen AT jochenweitz improvingmandibularreconstructionbyusingtopologyoptimizationpatientspecificdesignandadditivemanufacturingabiomechanicalcomparisonagainstminiplatesonhumanspecimen AT constantinvondeimling improvingmandibularreconstructionbyusingtopologyoptimizationpatientspecificdesignandadditivemanufacturingabiomechanicalcomparisonagainstminiplatesonhumanspecimen AT benediktjschwaiger improvingmandibularreconstructionbyusingtopologyoptimizationpatientspecificdesignandadditivemanufacturingabiomechanicalcomparisonagainstminiplatesonhumanspecimen AT carinammicheler improvingmandibularreconstructionbyusingtopologyoptimizationpatientspecificdesignandadditivemanufacturingabiomechanicalcomparisonagainstminiplatesonhumanspecimen AT nikolasjwilhelm improvingmandibularreconstructionbyusingtopologyoptimizationpatientspecificdesignandadditivemanufacturingabiomechanicalcomparisonagainstminiplatesonhumanspecimen AT christianugrosse improvingmandibularreconstructionbyusingtopologyoptimizationpatientspecificdesignandadditivemanufacturingabiomechanicalcomparisonagainstminiplatesonhumanspecimen AT marcokesting improvingmandibularreconstructionbyusingtopologyoptimizationpatientspecificdesignandadditivemanufacturingabiomechanicalcomparisonagainstminiplatesonhumanspecimen AT rainerburgkart improvingmandibularreconstructionbyusingtopologyoptimizationpatientspecificdesignandadditivemanufacturingabiomechanicalcomparisonagainstminiplatesonhumanspecimen
_version_	1718374975262425088

Improving mandibular reconstruction by using topology optimization, patient specific design and additive manufacturing?-A biomechanical comparison against miniplates on human specimen.

Ejemplares similares