One vs. two piece customized implants to reconstruct mandibular continuity defects: a preliminary study in pig cadavers

J Craniomaxillofac Surg. 2014 Sep;42(6):790-5. doi: 10.1016/j.jcms.2013.11.013. Epub 2013 Nov 16.

Abstract

Objectives: The reconstruction of mandibular continuity defects by bridging plates often leads to complications. Customized mandibular implants might be an alternative option. In the present study, the stability at the bone-implant-interface of customized two-piece implants was compared to one-piece implants.

Methods: Thirty pig mandibles were randomly divided into three groups. One group (A) was left untreated and served as reference. In groups B and C, a continuity defect was created in the left mandibular side. The defects were reconstructed by customized pure titanium implants, manufactured using the LaserCUSING(®) technology. Group B received a one-piece implant; in group C a two-piece implant was inserted to reconstruct the continuity defect. The bonding strength was examined statically and dynamically under standardized conditions. Digital Image Correlation was used for distortion measurement. Different dynamic measurements were performed for orientation purposes.

Results: The highest bonding strength was measured for the reference group. The two-piece implant showed an increased bonding strength when compared to the one-piece design. In all pig mandibles treated with individual implants a fracture occurred on the non-operated side. This indicates a high primary stability of the bone-implant-interface.

Conclusion: The two-piece individual mandibular implant manufactured by LaserCUSING(®) technology should be further analyzed in future studies.

Keywords: Bonding strength testing; Cadaver study; Customized mandibular implant; Loss of continuity; Pig mandible.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Biocompatible Materials / chemistry
  • Bone Plates*
  • Computer-Aided Design
  • Dental Stress Analysis / instrumentation
  • Imaging, Three-Dimensional / methods
  • Mandibular Fractures / physiopathology
  • Mandibular Reconstruction / instrumentation*
  • Osseointegration / physiology
  • Prosthesis Design*
  • Random Allocation
  • Stress, Mechanical
  • Swine
  • Titanium / chemistry
  • Tomography, X-Ray Computed / methods
  • User-Computer Interface

Substances

  • Biocompatible Materials
  • Titanium