Design and fabrication of mandibular customized implants by CAD/CAM method and 3-D printing

Abstract

Maxillofacial surgeons face great challenges in the reconstruction of extensive mandibular defects, especially cancer patients. The function of the mandibular reconstruction system and aesthetics are the most important factors that have a significant effect on the quality of life of patients after recovery. In this study, a customized implant was designed and implemented using additive manufacturing method to treat a patient with a lateral mandibular tumor using the CAD/CAM technique. The anatomy of the patient's mandible and the geometry of the defect site were taken into account while designing the customized implant. The reconstruction system performance was evaluated using COMSOL V5.4, a finite element method. Inclusion criteria include maximum von-Mises stress and deformation implant as well as maximum von-Mises stress and strain in cortical bone around screws. Finite element results showed that the maximum von-Mises stress of the plate was 106 MPa and plate deformation was 54.42 μm. Also, the maximum von-Mises strain and stress of cortical bone around screws were 1940 μm/m and 44 MPa, respectively. After evaluating the biomechanical behavior of the customized implant, it can be concluded that this system has sufficient flexibility and stability and the facial aesthetics will be maintained after recovery. Therefore, the success rate of surgery can be increased by using customized implants in the reconstruction of large mandibular defects while maintaining the aesthetic appearance of the patient.