Biomechanical Optimization of Bone Plates Used in Rigid Fixation of Mandibular Fractures

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Abstract

Purpose: To design and optimize a bone plate for fractures of the mandibular body that will provide maximum fracture stability with minimal implanted volume and patient intrusion. The design will be driven by the unique biomechanics specific to this fracture location. Materials and Methods: A finite element model of a fractured human mandible was created using tomography scans. Material properties were assigned to the cortical bone, cancellous bone, and dental region. Boundary conditions included simulating a unilateral molar clench and incisal loading. The bone plate design process included a shape optimization routine and design parameter analysis using the model. The optimized bone plate design was finally compared with standard bone plate configurations based on stress and strain measures. Results: For incisal loading, the newly designed InterFlex II plate has 69% of the fracture strain and only 34% of the plate stress of an 8-hole strut plate. For unilateral molar loading, those numbers improve even further to 59% and 27%, respectively. InterFlex II plate stresses are less than or equal to the paired plate configuration, and fracture strain is within 10% of the corresponding paired plate strain under both loading scenarios. In terms of mechanical performance, InterFlex II is in the same class as the commonly used paired plate configuration, despite having only 55% of the implanted volume. Conclusion: A design process focused on shape and design variable optimization can produce bone plates that provide maximum fracture stability with minimum implanted volume. © 2009 American Association of Oral and Maxillofacial Surgeons.

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Lovald, S. T., Wagner, J. D., & Baack, B. (2009). Biomechanical Optimization of Bone Plates Used in Rigid Fixation of Mandibular Fractures. Journal of Oral and Maxillofacial Surgery, 67(5), 973–985. https://doi.org/10.1016/j.joms.2008.12.032

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