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Biomechanical influence of plate configurations on mandible subcondylar fracture fixation: a finite element study

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Abstract

Mandible subcondylar fractures have very high complication rate, yet there is no consensus on suitable plate design for optimal patient outcomes. Our study is aimed at comparing single mini, trapezoid, lambda, strut and double mini plates. A finite-element (FE) model of intact mandible was developed based on healthy CT-scan data, which was further virtually osteotomized and fixated with plates. The cortical and cancellous bones were assigned region-specific orthotropic and heterogenous isotropic material properties respectively. The models were subjected to six load cases representing the mastication cycle. Under opposite lateralities, the tensile and compressive mandibular strain distributions were found as the opposite, with tensile strains at the posterior border under ipsilateral molar clenching (RMOL) resulting in lesser mandibular strain in reconstructed mandible with single mini plate under RMOL but highest mandibular strain under the contralateral molar clenching (LMOL). Owing to the reduced mandibular strains under LMOL than RMOL, the contralateral chewing is preferred during the immediate post-surgery period for patients. Under LMOL, the peak von Mises stresses in the plate decreased with increase in the number of screws. Furthermore, the presence of two arms in double mini and trapezoid plates seems beneficial to neutralise the tensile and compressive strains across load cases.

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Authors and Affiliations

  1. Department of Mechanical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India

    Anoushka Gupta, Abir Dutta & Kaushik Mukherjee

  2. Department of Ortho and MSK Science, University College London, London, UK

    Abir Dutta

  3. Department of Oral Medicine and Radiology, Guru Nanak Institute of Dental Sciences and Research, Kolkata, India

    Kaushik Dutta

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  1. Anoushka Gupta
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  2. Abir Dutta
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Gupta, A., Dutta, A., Dutta, K. et al. Biomechanical influence of plate configurations on mandible subcondylar fracture fixation: a finite element study. Med Biol Eng Comput 61, 2581–2591 (2023). https://doi.org/10.1007/s11517-023-02854-7

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  • DOI: https://doi.org/10.1007/s11517-023-02854-7

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