Abstract
This study performs a structural optimization of anatomical thin titanium mesh (ATTM) plate and optimal designed ATTM plate fabricated using additive manufacturing (AM) to verify its stabilization under fatigue testing. Finite element (FE) analysis was used to simulate the structural bending resistance of a regular ATTM plate. The Taguchi method was employed to identify the significance of each design factor in controlling the deflection and determine an optimal combination of designed factors. The optimal designed ATTM plate with patient-matched facial contour was fabricated using AM and applied to a ZMC comminuted fracture to evaluate the resting maxillary micromotion/strain under fatigue testing. The Taguchi analysis found that the ATTM plate required a designed internal hole distance to be 0.9 mm, internal hole diameter to be 1 mm, plate thickness to be 0.8 mm, and plate height to be 10 mm. The designed plate thickness factor primarily dominated the bending resistance up to 78% importance. The averaged micromotion (displacement) and strain of the maxillary bone showed that ZMC fracture fixation using the miniplate was significantly higher than those using the AM optimal designed ATTM plate. This study concluded that the optimal designed ATTM plate with enough strength to resist the bending effect can be obtained by combining FE and Taguchi analyses. The optimal designed ATTM plate with patient-matched facial contour fabricated using AM provides superior stabilization for ZMC comminuted fractured bone segments.
Highlights
The mid-facial anatomy is mostly composed of bones of different thickness and forms a cavity structure
This study investigates the structural strength of the regular anatomical thin titanium mesh (ATTM) plate for multifactorial designed factors with different levels using a finite element (FE) approach
The optimal designed ATTM plate with the lowest deflection and output by additive manufacturing (AM) for zygomatic-maxillary complex (ZMC) fracture application was found as the combination of internal hole distance to 0.9 mm, internal hole diameter to 1 mm, plate thickness to 0.8 mm, and plate height to 10 mm
Summary
The mid-facial anatomy is mostly composed of bones of different thickness and forms a cavity structure. This area can be divided into maxilla, zygomatic bone, nasoorbital and nasal ethmoid sinus (nasoethmoid, NOE), and so forth. The zygomatic-maxillary complex (ZMC) fracture, one of the severe mid-face traumas, involves fracture(s) of the zygoma or adjacent bones, such as the maxilla, orbit, or temporal bone and is the second most frequently fractured bone of the craniofacial skeleton [1]. Open reduction and rigid internal fixation surgical repair techniques involve extensive exposure and reduction of the ZMC through a combination of coronal approaches and mini-titanium plate fixation to at least 3 of the 4 buttresses is the standard goal of clinical treatment [2,3,4]. Open reduction and miniplate fixation are currently the presumed state-of-the-art repair option for complex ZMC fracture reduction, leading to incorrect ZMC bone fracture segments position realignment, making satisfactory mid-face symmetry difficult to obtain [5, 6]
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