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

摘要

PurposeHarvesting 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.MethodsFinite element analysis was performed for virtual harvesting of bone blocks of nine different sizes between 15x20 and 25x30mm and three different chewing loads (incisal, ipsilateral and contralateral). von Mises stress and first principal stress distributions were measured.Resultsvon Mises stress was distributed between 35.01 (10x15mm graft, incisal load) and 333.25MPa (30x20mm graft ipsilateral load), whereas first principal stress distributions were between 48.27 (10x15mm graft, incisal load) and 414.69MPa (30x20mm 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 133MPa was found after removing almost all grafts with a width of 20 or 30mm.ConclusionsIncisal 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.Clinical relevanceIpsilateral 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 20x15mm.