Mandible defects and its deformities are serious complications and its precise reconstruction is one of the most challenging tasks in oral maxillofacial surgery. The commercially available standard mandible implants are manually bended before surgery to custom fit the patient’s jaw. A slight mismatch in the plate and bone alignment may result in the implant failure. However, with the integration of computer-aided design, rapid prototyping, and advanced imaging systems (computed tomography or magnetic resonance imaging), it is possible to produce a customized mandible implant that can precisely fit the patient’s jaw. The aim of this article is to compare a new design of customized mandible implant (sinewave plate) and compare it with the commonly used straight implant design. The finite element–simulated results reveal that the commonly used straight reconstruction plates are more prone to loosening of the screws due to its higher strain concentration on the screw hole when compared to newly designed sinewave reconstruction plate. Moreover, the straight plate is more sensitive to the chewing load variations and develops almost 20% increase in the stresses when compared to sinewave plate. The study reveals that the sinewave reconstruction plate can significantly enhance the stability and safety of the mandible implant.

1. Ritvik, DGD, Mehta, P. Mandibular reconstruction in 2004: an analysis of different techniques. Curr Opin Otolaryngol Amp Head Neck Surg 2004; 12: 288293. Google Scholar, Crossref, Medline
2. Oshida, Y, Tuna, EB, Aktören, O. Dental implant systems. Int J Mol Sci 2010; 11: 15801678. Google Scholar, Crossref, Medline
3. Markwardt, J, Weber, T, Modler, N. One vs. two piece customized implants to reconstruct mandibular continuity defects: a preliminary study in pig cadavers. J Cranio Maxill Surg 2014; 42: 790795. Google Scholar, Crossref, Medline
4. Bujtár, P, Simonovics, J, Váradi, K. The biomechanical aspects of reconstruction for segmental defects of the mandible: a finite element study to assess the optimisation of plate and screw factors. J Cranio Maxill Surg 2014; 42: 855862. Google Scholar, Crossref, Medline
5. Louis, PJ, Gutta, R, Said-Al-Naief, N. Reconstruction of the maxilla and mandible with particulate bone graft and titanium mesh for implant placement. J Oral Maxill Surg 2008; 66: 235245. Google Scholar, Crossref, Medline
6. Larosa, MA, Jardini, AL, Zavaglia, C. Microstructural and mechanical characterization of a custom-built implant manufactured in titanium alloy by direct metal laser sintering. Adv Mech Eng 2014; 6: 945819. Google Scholar, Link
7. Koike, M, Martinez, K, Guo, L. Evaluation of titanium alloy fabricated using electron beam melting system for dental applications. J Mater Process Technol 2011; 211: 14001408. Google Scholar, Crossref
8. Ayoub, N, Ghassemi, A, Rana, M. Evaluation of computer-assisted mandibular reconstruction with vascularized iliac crest bone graft compared to conventional surgery: a randomized prospective clinical trial. Trials 15: 114. Google Scholar, Crossref, Medline
9. Leondes, CT. Computer design and manufacturing systems, techniques and applications in biomedical systems. In: Leondes, CT (ed.) Computational methods in biophysics, biomaterials, biotechnology and medical systems. New York, NY: Springer, 2002, pp.554594. Google Scholar, Crossref
10. Jardini, AL, Larosa, MA, Filho, RM. Cranial reconstruction: 3D biomodel and custom-built implant created using additive manufacturing. J Cranio Maxill Surg 2014; 42: 18771884. Google Scholar, Crossref, Medline
11. Toro, C, Robiony, M, Costa, F. Feasibility of preoperative planning using anatomical facsimile models for mandibular reconstruction. Head Face Med 2007; 3: 5. Google Scholar, Crossref, Medline
12. Merdji, A, Bachir Bouiadjra, B, Achour, T. Stress analysis in dental prosthesis. Comput Mater Sci 2010; 49: 126133. Google Scholar, Crossref
13. Djebbar, N, Serier, B, Bouiadjra, BB. Analysis of the effect of load direction on the stress distribution in dental implant. Mater Des 2010; 31: 20972101. Google Scholar, Crossref
14. Merdji, A, Bachir Bouiadjra, B, Ould Chikh, B. Stress distribution in dental prosthesis under an occlusal combined dynamic loading. Mater Des 2012; 36: 705713. Google Scholar, Crossref
15. Baggi, L, Cappelloni, I, Maceri, F. Stress-based performance evaluation of osseointegrated dental implants by finite-element simulation. Simul Model Pract Theory 2008; 16: 971987. Google Scholar, Crossref
16. Jędrusik-Pawłowska, M, Kromka-Szydek, M, Katra, M. Mandibular reconstruction—biomechanical strength analysis (FEM) based on a retrospective clinical analysis of selected patients. Acta Bioeng Biomech Wroc Univ Technol 2013; 15: 2331. Google Scholar, Medline
17. Ilavarasi, PU, Anburajan, M. Design and finite element analysis of mandibular prosthesis. In: 3rd international conference on electronics computer technology (ICECT), vol. 3, Kanyakumari, India, 8–10 April 2011, pp.325329. New York: IEEE. Google Scholar
18. El-Anwar, MI, Mohammed, MS. Comparison between two low profile attachments for implant mandibular overdentures. J Genet Eng Biotechnol 2014; 12: 4553. Google Scholar, Crossref
19. Arcam. Ti6Al4V ELI titanium alloy, http://www.arcam.com/wp-content/uploads/Arcam-Ti6Al4V-ELI-Titanium-Alloy.pdf (14 January 2014). Google Scholar
20. Akiko, K, Nagasao, T, Kaneko, T. A comparative study of most suitable miniplate fixation for mandibular symphysis fracture using a finite element model. Keio J Med 2006; 55: 18. Google Scholar, Crossref, Medline
21. Johnson, AA, Tezduyar, TE. Mesh generation and update strategies for parallel computation of 3D flow problems. In: Atluri, SN, Yagawa, PG, Cruse, DT (eds) Computational mechanics ’95. Berlin, Heidelberg: Springer, 1995, pp.911916. Google Scholar, Crossref
22. Kurniawan, D, Nor, FM, Lee, HY. Finite element analysis of bone-implant biomechanics: refinement through featuring various osseointegration conditions. Int J Oral Maxill Surg 2012; 41: 10901096. Google Scholar, Crossref, Medline
23. Szucs, A, Bujtár, P, Sándor, GKB. Finite element analysis of the human mandible to assess the effect of removing an impacted third molar. J Can Dent Assoc 2010; 76: a72. Google Scholar
24. Johansson, AS, Westberg, K-G, Edin, BB. Task-dependent control of the jaw during food splitting in humans. J Neurophysiol 2014; 111: 26142623. Google Scholar, Crossref, Medline
25. Vinyard, CJ, Wall, CE, Williams, SH. Patterns of variation across primates in jaw-muscle electromyography during mastication. Integr Comp Biol 2008; 48: 294311. Google Scholar, Crossref, Medline
26. Perry, JMG, Hartstone-Rose, A, Logan, RL. The jaw adductor resultant and estimated bite force in primates. Anat Res Int 2011; 2011: e929848. Google Scholar, Medline
27. Vinyard, CJ, Taylor, AB. A preliminary analysis of the relationship between jaw-muscle architecture and jaw-muscle electromyography during chewing across primates. Anat Rec 2010; 293: 572582. Google Scholar, Crossref