Mandibular finite element simulation as a tool for trauma surgery.
OBJECTIVE
Despite remarkable progress within the last decade, the treatment of mandibular fractures is still a highly discussed topic in oral and cranio-maxillofacial surgery. The possible traumatologic scenarios are characterized by high variability. A current project is focused on "resimulation" of traumatologic cases given by clinical radiographs by means of finite element method.


METHODS
The applied finite element model of the mandible is very refined, providing detailed dental anatomy especially of the periodontal ligament. The mandible was modelled as inhomogeneous and anisotropic. The temporomandibular joints were realized as simplified joint capsules, wherein the mandibular condyles are freely mobile with certain limitations. The user has the choice of 5 regions on the mandibular surface where the virtual injury can be inflicted. Power and direction of the impact force vector can be set at will. The masticatoy system including the digastrics and the mylohyoid muscles can be activated.


RESULTS
The situations given by radiographs could be "reproduced" by a simulation scenario characterized by high compressive strain at the location of fractures. If masticatory muscles were activated and teeth clenched, the stress/strain profiles were qualitatively changed.


CONCLUSIONS
The approach may be of benefit for optimized behavior with regard to certain sports or vocations. For forensic analysis, the method will contribute by elimination of scenarios not matching the given fracture locations. Nevertheless, the immediate purpose of our approach is a better understanding of the injured organ's condition. Fractures of bone as an adaptive biological tissue differ fundamentally from mechanical failure in engineering. Many of our trauma simulations showed elevated stress/strain around the fracture, leading to the suggestion of weakened bone there. This finding was confirmed by surgical observation.
Kober
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College for Applied Sciences, Faculty of Life Sciences, Hamburg, Germany. cornelia.kober@haw-hamburg.de
Stübinger
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Hellmich
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Sader
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R
Zeilhofer
H F
HF
D000222:Adaptation, Physiological / Q000502:physiology; D001696:Biomechanical Phenomena; D003198:Computer Simulation; D020342:Finite Element Analysis; D006801:Humans; D017746:Joint Capsule / Q000473:pathology; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008335:Mandibular Condyle / Q000473:pathology; D008337:Mandibular Fractures / Q000473:pathology / Q000601:surgery*; D008410:Masticatory Muscles / Q000503:physiopathology; D008954:Models, Biological; D009119:Muscle Contraction / Q000502:physiology; D009334:Neck Muscles / Q000503:physiopathology; D013314:Stress, Mechanical; D013704:Temporomandibular Joint / Q000473:pathology; D014584:User-Computer Interface