Design and Biomechanical Evaluation of a Custom lateral mandible Titanium Prosthesis

摘要

A large mandibular discontinuity defect is most often due to severe trauma, infection or resection for neoplasm. Reconstruction plates have been popularly applied to bridge mandibular defects without bone grafting. The esthetics and continuity of the mandible with segmental defects could be rehabilitated successfully. However, the function is difficult to reconstructed using this type of plate. Furthermore, skin or mucosa perforation, plate fracture and loss of screw retention were the serious complications resulting in reconstruction failure. In this paper, a lateral biomechanical titanium mandibular prosthesis (BMMP) with new retention structure has been design. Problems of masticatory muscle attachment and other soft tissue overlay on the prosthesis have been considered. The biomechanical effect of the BMMP has been analysis by the three-dimensional finite element method (FEM). And the analysis of biomechanical effects of the retention on the BMMP was performed comparing with that of traditional reconstruction plate. Analysis results have shown that the BMMP was of better load conductibility and reliable retention. The function, continuity and esthetics of the mandible bone with a lateral defect were reconstructed successfully using the BMMP.