Use of customized 3-dimensional printed mandibular prostheses with a dental implant pressure-reducing device in mandibular body defect: A finite element study performing multiresponse surface methodology

Chun-Feng Chen; Wei-Chin Huang; Sung-Ho Liu; Ling-Lin Wang; Pei-Feng Liu; Ping-Ho Chen; Chun-Ming Chen

doi:10.1016/j.jds.2023.09.011

Use of customized 3-dimensional printed mandibular prostheses with a dental implant pressure-reducing device in mandibular body defect: A finite element study performing multiresponse surface methodology

J Dent Sci. 2024 Jan;19(1):502-514. doi: 10.1016/j.jds.2023.09.011. Epub 2023 Sep 22.

Authors

Chun-Feng Chen^{1

2

3}, Wei-Chin Huang⁴, Sung-Ho Liu⁴, Ling-Lin Wang^{1

5}, Pei-Feng Liu⁶, Ping-Ho Chen¹, Chun-Ming Chen¹

Affiliations

¹ School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
² Department of Oral and Maxillofacial Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
³ Dental Laboratory Technology, Shu Zen College of Medicine & Management, Kaohsiung, Taiwan.
⁴ Laser and Additive Manufacturing Technology Center, Industrial Technology Research Institute, Kaohsiung, Taiwan.
⁵ KSVGH Originals & Enterprises, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
⁶ Department of Biomedical Science and Environmental Biology, College of Life Science, Kaohsiung Medical University, Kaohsiung, Taiwan.

Abstract

Background/purpose: Segmental body defects of the mandible result in the complete loss of the affected region. In our previous study, we investigated the clinical applicability of a customized mandible prosthesis (CMP) with a pressure-reducing device (PRD) in an animal study. In this study, we further incorporated dental implants into the CMP and explored the use of dental implant PRD (iPRD) designs.

Materials and methods: By employing a finite element analysis approach, we created 4 types of CMP: CMP, CMP with iPRD, CMP-PRD, and CMP-PRD with iPRD. We developed 2 parameters for the iPRD: cone length (CL) in the upper part and spring pitch (SP) in the lower part. Using the response surface methodology (RSM), we determined the most suitable structural assignment for the iPRD.

Results: Our results indicate that CMP-PRD had the highest von Mises stress value for the entire assembly (1076.26 MPa). For retentive screws and abutments, CMP with iPRD had the highest von Mises stress value (319.97 and 452.78 MPa, respectively). CMP-PRD had the highest principal stress (131.66 MPa) in the anterior mandible. The iPRD reduced principal stress in both the anterior and posterior mandible. Using the RSM, we generated 25 groups for comparison to achieve the most favorable results for the iPRD and we might suggest the CL to 12 mm and the SP to 0.4 mm in the further clinical trials.

Conclusion: Use of the PRD and iPRD in CMP may resolve the challenges associated with CMP, thereby promoting its usage in clinical practice.

Keywords: Customized mandible prothesis; Finite element analysis; Human experiment; Mandibular reconstruction; Pressure-reducing device; Response surface methodology.