Three-dimensional Finite Element Analysis of Implant Prosthesis After Mandibular Reconstruction by Upper Distal Free Double-Barrel Fibula.

OBJECTIVE

This study aimed to compare the biomechanics of implant prostheses and peri-implant bone among 6 different mandibular reconstruction models based on patient data involving the use of an upper free-end double-barrel fibula.

METHODS

This study was an observational study. Five models were reconstructed using fibular-supported and implant-supported partial dentures. Two of these models were double-barrel fibula models with different gaps between the upper and lower segments. The other 2 were single-layered fibular models (the fibula was placed at the inferior or superior mandibular borders). The fifth model was a double-barrel fibula with a free distal end on the upper segment. In addition, a typical mandibular model was created for comparison. Two fixed partial-denture models were used in this study. The von Mises stress and strain of the models were analyzed.

RESULTS

The maximum stress decreased with increasing gap between the upper and lower fibula. The distal free-end double-barrel fibula showed a potential to reduce the maximum stress around the implant apex while increasing it around the implant neck compared with a fixed distal-end double-barrel fibula.

CONCLUSIONS

Utilizing a free distal end on the upper fibula may be a viable option for mandibular reconstruction, especially when the fibula length is limited.