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Evaluating the Effect of Minimizing Screws on Stabilization of Symphysis Mandibular Fracture by 3D Finite Element Analysis

Kharmanda, Ghias LU and Kharma, Mohamed Yaser (2017) In Journal of Maxillofacial and Oral Surgery 16(2). p.205-211
Abstract

Purpose: The objective of this work is to integrate structural optimization and reliability concepts into mini-plate fixation strategy used in symphysis mandibular fractures. The structural reliability levels are next estimated when considering a single failure mode and multiple failure modes. Patients and Methods: A 3-dimensional finite element model is developed in order to evaluate the ability of reducing the negative effect due to the stabilization of the fracture. Topology optimization process is considered in the conceptual design stage to predict possible fixation layouts. In the detailed design stage, suitable mini-plates are selected taking into account the resulting topology and different anatomical considerations. Several... (More)

Purpose: The objective of this work is to integrate structural optimization and reliability concepts into mini-plate fixation strategy used in symphysis mandibular fractures. The structural reliability levels are next estimated when considering a single failure mode and multiple failure modes. Patients and Methods: A 3-dimensional finite element model is developed in order to evaluate the ability of reducing the negative effect due to the stabilization of the fracture. Topology optimization process is considered in the conceptual design stage to predict possible fixation layouts. In the detailed design stage, suitable mini-plates are selected taking into account the resulting topology and different anatomical considerations. Several muscle forces are considered in order to obtain realistic predictions. Since some muscles can be cut or harmed during the surgery and cannot operate at its maximum capacity, there is a strong motivation to introduce the loading uncertainties in order to obtain reliable designs. The structural reliability is carried out for a single failure mode and multiple failure modes. Results: The different results are validated with a clinical case of a male patient with symphysis fracture. In this case while use of the upper plate fixation with four holes, only two screws were applied to protect adjacent vital structure. This behavior does not affect the stability of the fracture. Conclusion: The proposed strategy to optimize bone plates leads to fewer complications and second surgeries, less patient discomfort, and shorter time of healing.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
3D finite elements, Mandible fractures, Mini-plate fixation, Structural optimization
in
Journal of Maxillofacial and Oral Surgery
volume
16
issue
2
pages
7 pages
publisher
Springer
external identifiers
  • scopus:85074199289
ISSN
0972-8279
DOI
10.1007/s12663-016-0903-9
language
English
LU publication?
yes
id
d5a43577-347d-4457-b181-42047da71eef
date added to LUP
2019-11-14 16:00:50
date last changed
2022-02-16 01:07:35
@article{d5a43577-347d-4457-b181-42047da71eef,
  abstract     = {{<p>Purpose: The objective of this work is to integrate structural optimization and reliability concepts into mini-plate fixation strategy used in symphysis mandibular fractures. The structural reliability levels are next estimated when considering a single failure mode and multiple failure modes. Patients and Methods: A 3-dimensional finite element model is developed in order to evaluate the ability of reducing the negative effect due to the stabilization of the fracture. Topology optimization process is considered in the conceptual design stage to predict possible fixation layouts. In the detailed design stage, suitable mini-plates are selected taking into account the resulting topology and different anatomical considerations. Several muscle forces are considered in order to obtain realistic predictions. Since some muscles can be cut or harmed during the surgery and cannot operate at its maximum capacity, there is a strong motivation to introduce the loading uncertainties in order to obtain reliable designs. The structural reliability is carried out for a single failure mode and multiple failure modes. Results: The different results are validated with a clinical case of a male patient with symphysis fracture. In this case while use of the upper plate fixation with four holes, only two screws were applied to protect adjacent vital structure. This behavior does not affect the stability of the fracture. Conclusion: The proposed strategy to optimize bone plates leads to fewer complications and second surgeries, less patient discomfort, and shorter time of healing.</p>}},
  author       = {{Kharmanda, Ghias and Kharma, Mohamed Yaser}},
  issn         = {{0972-8279}},
  keywords     = {{3D finite elements; Mandible fractures; Mini-plate fixation; Structural optimization}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{2}},
  pages        = {{205--211}},
  publisher    = {{Springer}},
  series       = {{Journal of Maxillofacial and Oral Surgery}},
  title        = {{Evaluating the Effect of Minimizing Screws on Stabilization of Symphysis Mandibular Fracture by 3D Finite Element Analysis}},
  url          = {{http://dx.doi.org/10.1007/s12663-016-0903-9}},
  doi          = {{10.1007/s12663-016-0903-9}},
  volume       = {{16}},
  year         = {{2017}},
}