Biomechanical In Vitro Study on the Stability of Patient-Specific CAD/CAM Mandibular Reconstruction Plates: A Comparison Between Selective Laser Melted, Milled, and Hand-Bent Plates.

Content Provider	Europe PMC
Author	Kasper, Robin Winter, Karsten Pietzka, Sebastian Schramm, Alexander Wilde, Frank
Copyright Year	2020
Description	Study Design: An experimental in vitro study. Objective: Plate fractures are a recurrent problem in alloplastic mandibular reconstruction. Hypothetically it can be assumed that computer-aided design (CAD)/computer-aided manufacturing (CAM) reconstruction plates have a higher stability than conventional hand-bent plates. The aim of the study was to compare additive and subtractive fabricated CAD/CAM mandibular reconstruction plates as well as conventional plates with regard to their biomechanical properties. Methods: In a chewing simulator, plates of 2 conventional locking plate systems and 2 CAD/CAM-fabricated plate systems were compared. The plates were loaded in a fatigue test. The maximum number of cycles until plate fracture and the plate stiffness were compared. Results: While all conventional plates fractured at a maximum load between 150 and 210 N (Newton) after a number of cycles between 40 000 and 643 000, none of the CAD/CAM plates broke despite a nearly doubled load of 330 N and 2 million cycles. Both CAD/CAM systems proved to be significantly superior to the hand-bent plates. There was no difference between the 2 CAD/CAM systems. Conclusions: Concerning the risk of plate fracture, patient-specific CAD/CAM reconstruction plates appear to have a significant advantage over conventional hand-bent plates in alloplastic mandibular reconstruction.
Abstract	Study Design: An experimental in vitro study. Objective: Plate fractures are a recurrent problem in alloplastic mandibularreconstruction. Hypothetically it can be assumed that computer-aided design(CAD)/computer-aided manufacturing (CAM) reconstruction plates have a higherstability than conventional hand-bent plates. The aim of the study was tocompare additive and subtractive fabricated CAD/CAM mandibularreconstruction plates as well as conventional plates with regard to theirbiomechanical properties. Methods: In a chewing simulator, plates of 2 conventional locking plate systems and 2CAD/CAM-fabricated plate systems were compared. The plates were loaded in afatigue test. The maximum number of cycles until plate fracture and theplate stiffness were compared. Results: While all conventional plates fractured at a maximum load between 150 and 210N (Newton) after a number of cycles between 40 000 and 643 000, none of theCAD/CAM plates broke despite a nearly doubled load of 330 N and 2 millioncycles. Both CAD/CAM systems proved to be significantly superior to thehand-bent plates. There was no difference between the 2 CAD/CAM systems. Conclusions: Concerning the risk of plate fracture, patient-specific CAD/CAMreconstruction plates appear to have a significant advantage overconventional hand-bent plates in alloplastic mandibular reconstruction.
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ISSN	19433875
Volume Number	14
DOI	10.1177/1943387520952684
PubMed Central reference number	PMC8108099
Issue Number	2
PubMed reference number	33995834
Journal	Craniomaxillofacial Trauma & Reconstruction [Craniomaxillofac Trauma Reconstr]
e-ISSN	19433883
Language	English
Publisher	SAGE Publications
Publisher Date	2020-08-28
Publisher Place	Sage UK: London, England
Access Restriction	Open
Rights License	© The Author(s) 2020
Subject Keyword	mandibular reconstruction CAD-CAM patient-specific implants biomechanics
Content Type	Text
Resource Type	Article
Subject	Otorhinolaryngology Oral Surgery Surgery