Mechanical stress in plates for bridging reconstruction mandibular defects and purposes of double plate reinforcement.

PURPOSE: To evaluate the biomechanical performance of a commercially available bridging plate (2.4) as well as screws and bone simulating the reconstruction of hemimandibular defects and to indicate alternatives of reinforcement to prevent plate fractures either by strength or fatigue.
MATERIAL AND METHODS: Two common hemimandibular defects are investigated using computed finite element analysis (FEA) approach. Simplified and refined computational models are developed for the geometry of the screw. Conditions of non-locking and locking plate-screw interfaces are considered. Static loads of 120 N are applied. Von Mises stresses and fatigue are calculated. As reinforcement, a second complete or partial plate is placed onto the original plate.
RESULTS: Results demonstrate that reconstruction plates are often subjected to excessive stress that may lead to fracture either by strength or by fatigue. An attached complete or partial second plate is able to reduce stress in the plate, in screws and bone so that stress remains below the allowable limit of the materials.
CONCLUSION: A simplified technique of attaching a whole or sectioned second plate onto the original plate can reduce the stress calculated and may reduce the frequency of plate fractures for the patient's comfort, security and financial savings.