Contour identical implants to bridge mandibular continuity defects--individually generated by LaserCUSING®--A feasibility study in animal cadavers

Axolotl mandible regeneration occurs through mechanical gap closure and a shared regenerative program with the limb

The mandible plays an essential part in human life and, thus, defects in this structure can dramatically impair the quality of life in patients. Axolotls, unlike humans, are capable of regenerating their lower jaws; however, the underlying mechanisms and their similarities to those in limb regeneration are unknown. In this work, we used morphological, histological and transcriptomic approaches to analyze the regeneration of lateral resection defects in the axolotl mandible. We found that this structure can regenerate all missing tissues in 90 days through gap minimization, blastema formation and, finally, tissue growth, differentiation and integration. Moreover, transcriptomic comparisons of regenerating mandibles and limbs showed that they share molecular phases of regeneration, that these similarities peak during blastema stages and that mandible regeneration occurs at a slower pace. Altogether, our study demonstrates the existence of a shared regenerative program used in two different regenerating body structures with different embryonic origins in the axolotl and contributes to our understanding of the minimum requirements for a successful regeneration in vertebrates, bringing us closer to understand similar lesions in human mandibles.

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.