OJRM  Vol.4 No.4 , December 2015
Three-Dimensional Finite Elemental Analysis of Bone Stress near an Implant Placed at the Border between Mandible and Fibular Graft in Mandibular Reconstruction
ABSTRACT
Purpose: The aim of the present study was to use finite elemental analysis (FEA) to evaluate bone stress near an implant placed at the border between the mandible and fibular graft in mandibular reconstruction. Materials and Methods: A fibular model (FM) and transplantation model (TM) were constructed for FEA. In TM, mandible was on the mesial side and the fibular graft was on the distal side. The implant was positioned at the center of both bone models. In TM, it was placed on the border between the mandible and fibular graft. A 10-mm implant was used in the monocortical model and a 15-mm implant was used in the bicortical model. The loading force was set at 100 N, the angle was set at 90°, and the loading position was set as center, mesial, or distal on the upper surface of the prosthesis. Von Mises equivalent stress values of the bone near the implant collar and apex at the middle line between buccal and lingual side were measured. Results: In all models, stress values were significantly lower with center loading than with distal loading and mesial loading. In center loading, the stress values were significantly lower in the bicortical model than in the monocortical model. There were no significant differences in stress values between FM and TM in all conditions. Conclusions: Bone stress was least with the center loading position, which was further decreased by bicortical fixation. There was no increase in mechanical stress associated with placing an implant at the border between the mandible and the fibular graft.

Cite this paper
Ken, Y. , Noriko, T. and Shohei, K. (2015) Three-Dimensional Finite Elemental Analysis of Bone Stress near an Implant Placed at the Border between Mandible and Fibular Graft in Mandibular Reconstruction. Open Journal of Regenerative Medicine, 4, 35-45. doi: 10.4236/ojrm.2015.44005.
References
[1]   Ormianer, Z., Palti, A., Demiralp, B., Heller, G., Lewinstein, I. and Khayat, P.G. (2012) Implant-Supported First Molar Restorations: Correlation of Finite Element Analysis with Clinical Outcomes. The International Journal of Oral & Maxillofacial Implants, 27, e1-e12.

[2]   Fazi, G., Tellini, S., Vangi, D. and Branchi, R. (2011) Three-Dimensional Finite Element Analysis of Different Implant Configurations for a Mandibular Fixed Prosthesis. The International Journal of Oral & Maxillofacial Implants, 26, 752-759.

[3]   Lan, T.H., Pan, C.Y., Lee, H.E., Huang, H.L. and Wang, C.H. (2010) Bone Stress Analysis of Various Angulations of Mesiodistal Implants with Splinted Crowns in the Posterior Mandible: A Three-Dimensional Finite Element Study. The International Journal of Oral & Maxillofacial Implants, 25, 763-770.

[4]   Caglar, A., Bal, B.T., Karakoca, S., Aydin, C., Yilmaz, H. and Sarisoy, S. (2011) Three-Dimensional Finite Element Analysis of Titanium and Yttrium-Stabilized Zirconium Dioxide Abutments and Implants. The International Journal of Oral & Maxillofacial Implants, 26, 961-969.

[5]   Pierrisnard, L., Hure, G., Barquins, M. and Chappard, D. (2002) Two Dental Implants Designed for Immediate Loading: A Finite Element Analysis. The International Journal of Oral & Maxillofacial Implants, 17, 353-362.

[6]   Pessoa, R.S., Coelho, P.G., Muraru, L., Marcantonio, E., Vaz, L.G., Vander Sloten, J., et al. (2011) Influence of Implant Design on the Biomechanical Environment of Immediately Placed Implants: Computed Tomography-Based Nonlinear Three-Dimensional Finite Element Analysis. The International Journal of Oral & Maxillofacial Implants, 26, 1279-1287.

[7]   Winter, W., Mohrle, S., Holst, S. and Karl, M. (2010) Parameters of Implant Stability Measurements Based on Resonance Frequency and Damping Capacity: A Comparative Finite Element Analysis. The International Journal of Oral & Maxillofacial Implants, 25, 532-539.

[8]   Hong, H.R., Pae, A., Kim, Y., Paek, J., Kim, H.S. and Kwon, K.R. (2012) Effect of Implant Position, Angulation, and Attachment Height on Peri-Implant Bone Stress Associated with Mandibular Two-Implant Overdentures: A Finite Element Analysis. The International Journal of Oral & Maxillofacial Implants, 27, e69-e76.

[9]   Huang, H.L., Fuh, L.J., Ko, C.C., Hsu, J.T. and Chen, C.C. (2009) Biomechanical Effects of a Maxillary Implant in the Augmented Sinus: A Three-Dimensional Finite Element Analysis. The International Journal of Oral & Maxillofacial Implants, 24, 455-462.

[10]   Choi, K.S., Park, S.H., Lee, J.H., Jeon, Y.C., Yun, M.J. and Jeong, C.M. (2012) Stress Distribution on Scalloped Implants with Different Microthread and Connection Configurations Using Three-Dimensional Finite Element Analysis. The International Journal of Oral & Maxillofacial Implants, 27, e29-e38.

[11]   Fang, Q.G., Shi, S., Zhang, X., Li, Z.N., Liu, F.Y. and Sun, C.F. (2013) Assessment of the Quality of Life of Patients with Oral Cancer after Pectoralis Major Myocutaneous Flap Reconstruction with a Focus on Speech. Journal of Oral and Maxillofacial Surgery, 71, e1-e5.
http://dx.doi.org/10.1016/j.joms.2013.07.011

[12]   Chiapasco, M., Romeo, E., Coggiola, A. and Brusati, R. (2011) Long-Term Outcome of Dental Implants Placed in Revascularized Fibula Free Flaps Used for the Reconstruction of Maxillo-Mandibular Defects Due to Extreme Atrophy. Clinical Oral Implants Research, 22, 83-91.
http://dx.doi.org/10.1111/j.1600-0501.2010.01999.x

[13]   Anne-Gaelle, B., Samuel, S., Julie, B., Renaud, L. and Pierre, B. (2011) Dental Implant Placement after Mandibular Reconstruction by Microvascular Free Fibula Flap: Current Knowledge and Remaining Questions. Oral Oncology, 47, 1099-1104.
http://dx.doi.org/10.1016/j.oraloncology.2011.07.016

[14]   Kurz, L.T., Garfin, S.R. and Booth, R.E. (1989) Harvesting Autogenous Iliac Bone Grafts. A Review of Complications and Techniques. Spine, 14, 1324-1331.
http://dx.doi.org/10.1097/00007632-198912000-00009

[15]   Boyd, J.B., Rosen, I., Rotstein, L., Freeman, J., Gullane, P., Manktelow, R., et al. (1990) The Iliac Crest and the Radial Forearm Flap in Vascularized Oromandibular Reconstruction. The American Journal of Surgery, 159, 301-308.
http://dx.doi.org/10.1016/S0002-9610(05)81223-1

[16]   Hidalgo, D.A. (1991) Aesthetic Improvements in Free-Flap Mandible Reconstruction. Plastic and Reconstructive Surgery, 88, 574-587.
http://dx.doi.org/10.1097/00006534-199110000-00003

[17]   Swartz, W.M., Banis, J.C., Newton, E.D., Ramasastry, S.S., Jones, N.F. and Acland, R. (1986) The Osteocutaneous Scapular Flap for Mandibular and Maxillary Reconstruction. Plastic and Reconstructive Surgery, 77, 530-545.
http://dx.doi.org/10.1097/00006534-198604000-00003

[18]   Reychler, H. and Iriarte Ortabe, J. (1994) Mandibular Reconstruction with the Free Fibula Osteocutaneous Flap. International Journal of Oral and Maxillofacial Surgery, 23, 209-213.
http://dx.doi.org/10.1016/S0901-5027(05)80372-8

[19]   Wu, J.C., Chen, C.S., Yip, S.W. and Hsu, M.L. (2012) Stress Distribution and Micromotion Analyses of Immediately Loaded Implants of Varying Lengths in the Mandible and Fibular Bone Grafts: A Three-Dimensional Finite Element Analysis. The International Journal of Oral & Maxillofacial Implants, 27, e77-e84.

[20]   Hakim, S.G., Jeske, G., Jacobsen, H.C. and Sieg, P. (2012) The Eligibility of the Free Fibula Graft for Masticatory Rehabilitation Using Monocortical Implants Insertion—A Morphologic and Biomechanical Study. Clinical Oral Investigations, 16, 673-678.
http://dx.doi.org/10.1007/s00784-011-0582-3

[21]   Kourkouta, S., Dedi, K.D., Paquette, D.W. and Mol, A. (2009) Interproximal Tissue Dimensions in Relation to Adjacent Implants in the Anterior Maxilla: Clinical Observations and Patient Esthetic Evaluation. Clinical Oral Implants Research, 20, 1375-1385.
http://dx.doi.org/10.1111/j.1600-0501.2009.01761.x

[22]   Yokoyama, S., Wakabayashi, N., Shiota, M. and Ohyama, T. (2004) The Influence of Implant Location and Length on Stress Distribution for Three-Unit Implant-Supported Posterior Cantilever Fixed Partial Dentures. Journal of Prosthetic Dentistry, 91, 234-240.
http://dx.doi.org/10.1016/j.prosdent.2003.12.017

[23]   Vinicius de Oliveira, M., de Moraes, P.H., Olate, S., Alonso, M.B., Watanabe, P.C., Haiter-Neto, F., et al. (2012) Morphometric Study of Mandibular Ramus Related to Sagittal Ramus Split Osteotomy and Osteosynthesis. Journal of Craniofacial Surgery, 23, 1484-1487.
http://dx.doi.org/10.1097/SCS.0b013e318256664d

[24]   Roberts, M., Yuan, J., Graham, J., Jacobs, R. and Devlin, H. (2011) Changes in Mandibular Cortical Width Measurements with Age in Men and Women. Osteoporosis International, 22, 1915-1925.
http://dx.doi.org/10.1007/s00198-010-1410-3

[25]   Park, Y.S. and Kwon, H.B. (2013) Three-Dimensional Finite Element Analysis of Implant-Supported Crown in Fibula Bone Model. Journal of Advanced Prosthodontics, 5, 326-332.
http://dx.doi.org/10.4047/jap.2013.5.3.326

[26]   Farah, J.W., Craig, R.G. and Meroueh, K.A. (1989) Finite Element Analysis of Three- and Four-Unit Bridges. Journal of Oral Rehabilitation, 16, 603-611.
http://dx.doi.org/10.1111/j.1365-2842.1989.tb01384.x

[27]   Mericske-Stern, R., Assal, P., Mericske, E. and Bürgin, W. (1995) Occlusal Force and Oral Tactile Sensibility Measured in Partially Edentulous Patients with ITI Implants. The International Journal of Oral & Maxillofacial Implants, 10, 345-353.

[28]   Guan, H., van Staden, R., Loo, Y.C., Johnson, N., Ivanovski, S. and Meredith, N. (2009) Influence of Bone and Dental Implant Parameters on Stress Distribution in the Mandible: A Finite Element Study. The International Journal of Oral & Maxillofacial Implants, 24, 866-876.

[29]   Branemark, P.I., Hansson, B.O., Adell, R., Breine, U., Lindstrom, J., Hallén, O., et al. (1977) Osseointegrated Implants in the Treatment of the Edentulous Jaw. Experience from a 10-Year Period. Scandinavian Journal of Plastic and Reconstructive Surgery. Supplementum, 16, 1-132.

[30]   De Bruyn, H., Bouvry, P., Collaert, B., De Clercq, C., Persson, G.R. and Cosyn, J. (2013) Long-Term Clinical, Microbiological, and Radiographic Outcomes of BronemarkTM Implants Installed in Augmented Maxillary Bone for Fixed Full-Arch Rehabilitation. Clinical Implant Dentistry and Related Research, 15, 73-82.
http://dx.doi.org/10.1111/j.1708-8208.2011.00359.x

[31]   Ivanoff, C.J., Sennerby, L. and Lekholm, U. (1996) Influence of Mono- and Bicortical Anchorage on the Integration of Titanium Implants. A Study in the Rabbit Tibia. International Journal of Oral and Maxillofacial Surgery, 25, 229-235.
http://dx.doi.org/10.1016/S0901-5027(96)80036-1

[32]   Kong, L., Sun, Y., Hu, K., Liu, Y., Li, D., Qiu, Z., et al. (2008) Selections of the Cylinder Implant Neck Taper and Implant End Fillet for Optimal Biomechanical Properties: A Three-Dimensional Finite Element Analysis. Journal of Biomechanics, 41, 1124-1130.
http://dx.doi.org/10.1016/j.jbiomech.2007.12.013

[33]   Lin, C.L., Wang, J.C., Ramp, L.C. and Liu, P.R. (2008) Biomechanical Response of Implant Systems Placed in the Maxillary Posterior Region under Various Conditions of Angulation, Bone Density, and Loading. The International Journal of Oral & Maxillofacial Implants, 23, 57-64.

[34]   Holberg, C., Winterhalder, P., Rudzki-Janson, I. and Wichelhaus, A. (2013) Finite Element Analysis of Mono- and Bicortical Mini-Implant Stability. The European Journal of Orthodontics, Published Online.
http://dx.doi.org/10.1093/ejo/cjt023

[35]   Qian, L., Todo, M., Matsushita, Y. and Koyano, K. (2009) Effects of Implant Diameter, Insertion Depth, and Loading Angle on Stress/Strain Fields in Implant/Jawbone Systems: Finite Element Analysis. The International Journal of Oral & Maxillofacial Implants, 24, 877-886.

[36]   Huang, H.L., Chang, Y.Y., Lin, D.J., Li, Y.F., Chen, K.T. and Hsu, J.T. (2011) Initial Stability and Bone Strain Evaluation of the Immediately Loaded Dental Implant: An in Vitro Model Study. Clinical Oral Implants Research, 22, 691-698.
http://dx.doi.org/10.1111/j.1600-0501.2010.01983.x

[37]   Xia, H., Wang, M., Ma, L., Zhou, Y., Li, Z. and Wang, Y. (2013) The Effect of Platform Switching on Stress in Peri-Implant Bone in a Condition of Marginal Bone Resorption: A Three-Dimensional Finite Element Analysis. The International Journal of Oral & Maxillofacial Implants, 28, e122-e127.
http://dx.doi.org/10.11607/jomi.2965

[38]   Hudieb, M. and Kasugai, S. (2011) Biomechanical Effect of Crestal Bone Osteoplasty before Implant Placement: A Three-Dimensional Finite Element Analysis. International Journal of Oral and Maxillofacial Surgery, 40, 200-206.
http://dx.doi.org/10.1016/j.ijom.2010.10.002

[39]   Chiapasco, M., Biglioli, F., Autelitano, L., Romeo, E. and Brusati, R. (2006) Clinical Outcome of Dental Implants Placed in Fibula-Free Flaps Used for the Reconstruction of Maxillo-Mandibular Defects Following Ablation for Tumors or Osteoradionecrosis. Clinical Oral Implants Research, 17, 220-228.
http://dx.doi.org/10.1111/j.1600-0501.2005.01212.x

[40]   Kramer, F.J., Dempf, R. and Bremer, B. (2005) Efficacy of Dental Implants Placed into Fibula-Free Flaps for Orofacial Reconstruction. Clinical Oral Implants Research, 16, 80-88.
http://dx.doi.org/10.1111/j.1600-0501.2004.01040.x

[41]   Hidalgo, D.A. (1989) Fibula Free Flap: A New Method of Mandible Reconstruction. Plastic and Reconstructive Surgery, 84, 71-79.
http://dx.doi.org/10.1097/00006534-198907000-00014

 
 
Top