Finite element analysis of patient specific three-dimensional titanium plate versus conventional two miniplate fixation for mandibular angle fractures

Abstract

Abstract Background Mandibular angle fractures are among the most common maxillofacial fractures and represent a biomechanically challenging region because of complex functional loading. Conventional two miniplate fixation is widely used to provide fracture stability; however, stress concentration within the fixation hardware may affect its biomechanical performance. Recent advances in computer-aided design and manufacturing (CAD/CAM) have enabled the development of patient specific fixation techniques designed to improve implant adaptation and optimize stress distribution. Objective This study aimed to compare the biomechanical behaviour of a patient specific three-dimensional (3D) titanium plate and conventional two miniplate fixation for mandibular angle fractures using finite element analysis (FEA). Materials and methods A three-dimensional mandibular model was reconstructed from computed tomography data obtained from a 25-year-old fully dentate male patient. Cortical and cancellous bone structures were generated using Mimics and Geomagic Design X software. Two fixation models and fixation hardware were assembled using SolidWorks software: Model A consisted of conventional two miniplate fixation, while Model B consisted of a patient specific three- dimensional titanium plate contoured along the tension zone of the mandible. The models were imported into ANSYS software for finite element analysis under simulated unilateral clenching conditions. Von Mises stress, maximum principal stress, and total displacement were evaluated under identical loading and boundary conditions. Results The patient specific 3D plate model demonstrated lower maximum von Mises stress within the fixation plate (326.19 MPa) compared with the conventional two miniplate system (417.48 MPa). Maximum principal stress in cortical bone was higher in the patient specific plate model (121.03 MPa) compared with the conventional fixation model (87.759 MPa). Total displacement was greater in the patient specific plate model (157.32 μm) than in the conventional system (131.47 μm). However, displacement values in both models remained within reported ranges considered acceptable for fracture healing. Conclusion Patient specific and conventional fixation techniques exhibited distinct biomechanical characteristics under simulated loading conditions. Both implant design and fixation configuration influence the biomechanical behaviour of mandibular angle fracture fixation.