Three-Dimensional Simulation of Mandibular Distraction Osteogenesis: Mechanobiological Analysis

Distraction osteogenesis is a surgical process for reconstruction of skeletal deformities, which has been widely investigated from the clinical perspective. However, little has been analyzed about the capability of numerical models to predict the clinical outcome generated by distraction. Therefore, this article presents a finite element analysis of the mechanobiological behavior of a pediatric patient’s mandible with hemifacial microsomia during the distraction process. It focuses on the three-dimensional simulation of a long bone defect in the ramus of the mandible and introduces additional aspects to be considered in the computational simulation as compared to the bidimensional simulation. The evolution of the different tissues within the gap is evaluated and in order to check the effectiveness of the model, the predicted numerical outcome will be compared from a qualitative point of view with radiographies provided by the surgeons. It is shown that the morphology of the mandible changed in a similar manner than that observed clinically. These results reveal that three-dimensional models are useful tools in the predictive assessment of mandibular distraction osteogenesis.

[1]  B. Melsen,et al.  Using the finite element method to model the biomechanics of the asymmetric mandible before, during and after skeletal correction by distraction osteogenesis , 2005, Computer methods in biomechanics and biomedical engineering.

[2]  H. Frost,et al.  A brief review for orthopedic surgeons: Fatigue damage (microdamage) in bone (its determinants and clinical implications) , 1998, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[3]  E. Reina-Romo,et al.  Modeling distraction osteogenesis: analysis of the distraction rate , 2009, Biomechanics and modeling in mechanobiology.

[4]  J. Gateno,et al.  Computer Planning for Distraction Osteogenesis , 2000, Plastic and reconstructive surgery.

[5]  Jan Feijen,et al.  Micromechanical testing of individual collagen fibrils. , 2006, Macromolecular bioscience.

[6]  Thomas A Einhorn,et al.  Fracture healing as a post‐natal developmental process: Molecular, spatial, and temporal aspects of its regulation , 2003, Journal of cellular biochemistry.

[7]  P. Dawson,et al.  A microstructural model for the anisotropic drained stiffness of articular cartilage. , 1990, Journal of biomechanical engineering.

[8]  N. Sasaki,et al.  Elongation mechanism of collagen fibrils and force-strain relations of tendon at each level of structural hierarchy. , 1996, Journal of biomechanics.

[9]  Elizabeth G Loboa,et al.  Mechanobiology of mandibular distraction osteogenesis: Finite element analyses with a rat model , 2005, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[10]  L E Lanyon,et al.  Dynamic strain similarity in vertebrates; an alternative to allometric limb bone scaling. , 1984, Journal of theoretical biology.

[11]  M L Samchukov,et al.  Biomechanical considerations of mandibular lengthening and widening by gradual distraction using a computer model. , 1998, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[12]  S. Cowin Bone poroelasticity. , 1999, Journal of biomechanics.

[13]  Theo H Smit,et al.  Estimation of the poroelastic parameters of cortical bone. , 2002, Journal of biomechanics.

[14]  D B Burr,et al.  In vivo measurement of human tibial strains during vigorous activity. , 1996, Bone.

[15]  E Reina-Romo,et al.  Biomechanical response of a mandible in a patient affected with hemifacial microsomia before and after distraction osteogenesis. , 2010, Medical engineering & physics.

[16]  W. Hayes,et al.  The compressive behavior of bone as a two-phase porous structure. , 1977, The Journal of bone and joint surgery. American volume.

[17]  Damien Lacroix,et al.  Development of a dynamic mechano-regulation model based on shear strain and fluid flow to optimize distraction osteogenesis , 2006 .

[18]  Robert J. Gorlin,et al.  Syndromes of the Head and Neck , 1976 .

[19]  M J Gómez-Benito,et al.  Influence of fracture gap size on the pattern of long bone healing: a computational study. , 2005, Journal of theoretical biology.

[20]  F. A. Peyton,et al.  Elastic and Mechanical Properties of Human Dentin , 1958, Journal of dental research.

[21]  M. J. Gómez-Benito,et al.  Growth mixture model of distraction osteogenesis: effect of pre-traction stresses , 2010, Biomechanics and modeling in mechanobiology.

[22]  C. Pappalettere,et al.  The Influence of Expansion Rates on Mandibular Distraction Osteogenesis: A Computational Analysis , 2007, Annals of Biomedical Engineering.

[23]  Rik Huiskes,et al.  Bone regeneration during distraction osteogenesis: mechano-regulation by shear strain and fluid velocity. , 2007, Journal of biomechanics.

[24]  Birte Melsen,et al.  Three-Dimensional Finite Element Analysis of the Mandible and Temporomandibular Joint on Simulated Occlusal Forces before and after Vertical Ramus Elongation by Distraction Osteogenesis , 2005, The Journal of craniofacial surgery.

[25]  Patrick J. Prendergast,et al.  Tissue differentiation and bone regeneration in an osteotomized mandible: a computational analysis of the latency period , 2008, Medical & Biological Engineering & Computing.

[26]  J. Levick Flow through interstitium and other fibrous matrices. , 1987, Quarterly journal of experimental physiology.

[27]  M L Samchukov,et al.  Mineralization dynamics of regenerate bone during mandibular osteodistraction. , 2001, International journal of oral and maxillofacial surgery.

[28]  V. A. Gibson,et al.  Model of flexural fatigue damage accumulation for cortical bone , 1997, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[29]  M Cozzani,et al.  Mechanical behavior of an osteotomized mandible with distraction orthodontic devices. , 2006, Journal of biomechanics.

[30]  J L Lewis,et al.  A composites theory predicts the dependence of stiffness of cartilage culture tissues on collagen volume fraction. , 1999, Journal of biomechanics.

[31]  L. Kaban,et al.  Histology of the porcine mandibular distraction wound. , 2005, International journal of oral and maxillofacial surgery.

[32]  E Reina-Romo,et al.  An Interspecies Computational Study on Limb Lengthening , 2010, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.