Stress distribution in mandibular donor site after harvesting bone grafts of various sizes from the ascending ramus of a dentate mandible by finite element analysis
- 20 Downloads
Harvesting bone from the ascending ramus of the mandible is a common procedure. However, mandibular fracture may occur after grafting bone blocks. This study aimed to investigate the resulting force distribution of stress and strain in the mandibular donor site after harvesting bone grafts of different sizes and various loadings.
Finite element analysis was performed for virtual harvesting of bone blocks of nine different sizes between 15 × 20 and 25 × 30 mm and three different chewing loads (incisal, ipsilateral and contralateral). von Mises stress and first principal stress distributions were measured.
von Mises stress was distributed between 35.01 (10 × 15 mm graft, incisal load) and 333.25 MPa (30 × 20 mm graft ipsilateral load), whereas first principal stress distributions were between 48.27 (10 × 15 mm graft, incisal load) and 414.69 MPa (30 × 20 mm graft ipsilateral load). In general, the least stress was observed with incisal load followed by ipsilateral load and finally contralateral load. The critical value of 133 MPa was found after removing almost all grafts with a width of 20 or 30 mm.
Incisal loading led to less stress compared with contralateral and ipsilateral loads. Increasing graft size led to increasing weakness of the donor site. Graft width exerted a greater influence on stress development than its height.
Ipsilateral chewing and increasing width of the bone graft result in maximum stress in the mandibular donor side, and critical values regarding to the possibility of fractures are already to expect from a graft size of 20 × 15 mm.
KeywordsMandibular donor site Dentate mandible Finite element analysis Chewing load Stress distribution
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study, formal consent is not required.
The authors do not have any financial interests or commercial associations to disclose.
- 2.Misch CM, Misch CE, Resnik RR, Ismail YH (1992) Reconstruction of maxillary alveolar defects with mandibular symphysis grafts for dental implants: a preliminary procedural report. Int J Oral Maxillofac Implants 27:360–366Google Scholar
- 12.Murakami K, Yamamoto K, Tsuyuki M, Sugiura T, Tsutsumi S, Kirita T (2014) Theoretical efficacy of preventive measures for pathologic fracture after surgical removal of mandibular lesions based on a three-dimensional finite element analysis. J Oral Maxillofac Surg 72:833.e1–833.18CrossRefGoogle Scholar
- 14.Antic S, Vukicevic AM, Milasinovic M, Saveljic I, Jovicic G, Filipovic N, Rakocevic Z, Djuric M (2015) Impact of the lower third molar presence and position on the fragility of mandibular angle and condyle: a three-dimensional finite element study. J Craniomaxillofac Surg 43:870–878CrossRefGoogle Scholar
- 15.Kan B, Coskunses FM, Mutlu I, Ugur L, Meral DG (2015) Effects of inter-implant distance and implant length on the response to frontal traumatic force of two anterior implants in an atrophic mandible: three-dimensional finite element analysis. Int J Oral Maxillofac Surg 44:908–913CrossRefGoogle Scholar
- 18.Tada S, Stegaroiu R, Kitamura E, Miyakawa O, Kusakari H (2002) Influence of implant design and bone quality on stress/strain distribution in bone around implants: a 3-dimensional finite element analysis. Int J Oral Maxillofac Implants 18:357–368Google Scholar
- 21.Deguchi T, Nasu M, Murakami K, Yabuuchi T, Kamioka H, Takano-Yamamoto T (2006) Quantitative evaluation of cortical bone thickness with computed tomographic scanning for orthodontic implants. Am J Orthod Dentofac Orthop 129(721):e727–e712Google Scholar