Finite Element Analysis and Biomechanical Testing to Analyze Fracture Displacement of Alveolar Ridge Splitting

Andres Stricker,Daniel Widmer,Dieter Wahl,Boyko Gueorguiev,Peter Varga,Fabian Duttenhoefer

doi:10.1155/2018/3579654

Andres Stricker, Daniel Widmer + Show 4 more

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https://doi.org/10.1155/2018/3579654

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Abstract

The alveolar ridge splitting technique enables reconstruction of atrophied alveolar ridges prior implantation. However, in cases of severe atrophy, there is an unpredictable risk of fracturing the buccal lamella during the expansion. Currently, there is no preoperative assessment to predict the maximum distraction of the lamella. The aim of this study was to develop a biomechanical model to mimic the alveolar ridge splitting and a finite element (FE) model to predict the experimental results. The biomechanical testing was conducted on porcine mandibles. To build the FE model high resolution peripheral quantitative computer tomography scans of one specimen was performed after the osteotomy outline, but before the lamella displacement. A servo-electric testing machine was used for the axial tension test to split the lamellae. Results showed, in line with clinical observations, that the lamellae broke primarily at the base of the splits with a median displacement of 1.27 mm. The FE model could predict fracture force and fracture displacement. Fracture force showed a nonlinear correlation with the height of the bone lamella. In conclusion, good correspondence between mechanical testing and virtual FE analysis showed a clinically relevant approach that may help to predict maximum lamella displacement to prevent fractures in the future.

Highlights

Implant-based dental rehabilitation of the severely atrophied alveolar ridge requires advanced augmentation techniques prior to implant placement
Further studies are required to demonstrate the capabilities of the finite element (FE) model on a larger sample set
It could be assumed that there is a difference of fracture behavior related to the thickness of the buccal lamella to be displaced, but lamellar thickness was not measured for all samples

Summary

Introduction

Implant-based dental rehabilitation of the severely atrophied alveolar ridge requires advanced augmentation techniques prior to implant placement. In comparison to onlay bone grafts the ridge splitting technique offers similar success rates when vertically sufficient but horizontally insufficient alveolar ridges are reconstructed This method avoids a second surgery site and decreases treatment time due to simultaneous implant placement (Altiparmak et al 2017). In cases of advanced atrophy, the success of the procedure is endangered by the high risk of fracturing the severely resorbed and fragile buccal lamella during expansion (Scipioni et al 1994, [6,7,8,9,10,11,12]) This risk may be alleviated by preoperative prediction of the maximum possible magnitude of distraction prior to fracture. At this finite element analysis (FEA) may provide the adequate instrument to analyse the ridge splitting technique

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Results

Conclusion