{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T12:45:18Z","timestamp":1786193118108,"version":"build-2736575974"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T00:00:00Z","timestamp":1786147200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T00:00:00Z","timestamp":1786147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009827","name":"Alexandria University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009827","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The patient specific 3D plate model demonstrated lower maximum von Mises stress within the fixation plate (326.19\u00a0MPa) compared with the conventional two miniplate system (417.48\u00a0MPa). Maximum principal stress in cortical bone was higher in the patient specific plate model (121.03\u00a0MPa) compared with the conventional fixation model (87.759\u00a0MPa). Total displacement was greater in the patient specific plate model (157.32\u00a0\u03bcm) than in the conventional system (131.47\u00a0\u03bcm). However, displacement values in both models remained within reported ranges considered acceptable for fracture healing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12903-026-09471-4","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T23:23:31Z","timestamp":1786145011000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Finite element analysis of patient specific three-dimensional titanium plate versus conventional two miniplate fixation for mandibular angle fractures"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0236-8468","authenticated-orcid":false,"given":"Asmaa M.","family":"Abd Elfattah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa M.","family":"Eldibany","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ragab S.","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3573-447X","authenticated-orcid":false,"given":"Mona S.","family":"Oraby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,8]]},"reference":[{"key":"9471_CR1","first-page":"2127","volume":"7","author":"S Yadav","year":"2013","unstructured":"Yadav S, Tyagi S, Puri N, Kumar P, Kumar P. Qualitative and quantitative assessment of relationship between mandibular third molar and angle fracture on North Indian population: Aclinicoradiographic study. Eur J Dent. 2013;7:2127.","journal-title":"Eur J Dent"},{"key":"9471_CR2","doi-asserted-by":"publisher","first-page":"9981004","DOI":"10.1016\/j.ijom.2015.02.022","volume":"44","author":"P Boffano","year":"2015","unstructured":"Boffano P, Kommers SC, Karagozoglu KH, Gallesio C, Forouzanfar T. Mandibular trauma: a twocentre study. Int J Oral Maxillofac Surg. 2015;44:9981004.","journal-title":"Int J Oral Maxillofac Surg"},{"key":"9471_CR3","first-page":"1421","volume":"6","author":"M Champy","year":"1978","unstructured":"Champy M, lode JP, Schmitt R, Jaeger JH, Muster D. mandibular osteosynthesis by miniature screwed plates \u2013Michelet technique II. J Oral Maxillofac Surg. 1978;6:1421.","journal-title":"J Oral Maxillofac Surg"},{"key":"9471_CR4","doi-asserted-by":"publisher","first-page":"47","DOI":"10.4103\/0975-5950.85853","volume":"2","author":"R Singh","year":"2011","unstructured":"Singh R, Agrawal A, Pal U, Singh G. Single miniplate osteosynthesis in angle fracture. Natl J Maxillofac Surg. 2011;2:47.","journal-title":"Natl J Maxillofac Surg"},{"key":"9471_CR5","doi-asserted-by":"publisher","first-page":"24352","DOI":"10.1016\/S0901-5027(99)80152-0","volume":"28","author":"E Ellis III","year":"1999","unstructured":"Ellis E 3. Treatment methods for fractures of the mandibular angle. Int J Oral Maxillofac Surg. 1999;28:24352.","journal-title":"Int J Oral Maxillofac Surg"},{"key":"9471_CR6","doi-asserted-by":"publisher","first-page":"2235","DOI":"10.1016\/j.bjoms.2006.08.016","volume":"45","author":"A Siddiqui","year":"2007","unstructured":"Siddiqui A, Markose G, Moos KF, McMahon J, Ayoub AF. One miniplate versus two in the management of mandibularangle fractures: a prospective randomised study. Br J Oral Maxillofac Surg. 2007;45:2235.","journal-title":"Br J Oral Maxillofac Surg"},{"key":"9471_CR7","doi-asserted-by":"publisher","first-page":"34753","DOI":"10.4103\/njms.njms_10_24","volume":"16","author":"G Khemka","year":"2025","unstructured":"Khemka G, Bhola N, Jadhav A, Borle R, Jain A, Dalmia S. What is a better modality of fixation in mandibular angle fractures, single miniplate or two miniplates? A singleblind comparative study. Natl J Maxillofac Surg. 2025;16:34753.","journal-title":"Natl J Maxillofac Surg"},{"key":"9471_CR8","doi-asserted-by":"publisher","first-page":"164654","DOI":"10.1016\/j.jcms.2016.07.027","volume":"44","author":"P Wusiman","year":"2016","unstructured":"Wusiman P, Yarbag A, Wurouzi G, Mijiti A, Moming A. Three-dimensional versus standard miniplate fixation in management of mandibular fractures: A systematic review and metaanalysis. J Craniomaxillofac Surg. 2016;44:164654.","journal-title":"J Craniomaxillofac Surg"},{"key":"9471_CR9","first-page":"2197211","volume":"72","author":"EA AlMoraissi","year":"2014","unstructured":"AlMoraissi EA, Ellis E 3rd. What method for management of unilateral mandibular angle fractures has the lowest rate of postoperative complications? A systematic review and metaanalysis. J Oral Maxillofac Surg. 2014;72:2197211.","journal-title":"J Oral Maxillofac Surg"},{"key":"9471_CR10","doi-asserted-by":"publisher","first-page":"e23","DOI":"10.1016\/j.oooo.2019.12.025","volume":"130","author":"J Marschall","year":"2020","unstructured":"Marschall J, Flint RL, Kushner GM, Alpert B, Azevedo B. In\u2013house computer\u2013aided design and manufacturing versus traditional open reduction and internal fixation for mandibular trauma. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020;130:e23.","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"key":"9471_CR11","doi-asserted-by":"publisher","first-page":"277","DOI":"10.21608\/edj.2020.51973.1406","volume":"67","author":"MF Shehab","year":"2021","unstructured":"Shehab MF, Taalab D, Abdel Rasoul MA. Evaluation of virtual surgical planning and CAD\/CAM techniques in treatment of mandibular fractures via three-dimensional patient specific titanium plates: a case series. Egypt Dent J. 2021;67:277\u201384.","journal-title":"Egypt Dent J"},{"key":"9471_CR12","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1186\/s12938-017-0422-z","volume":"16","author":"YF Liu","year":"2017","unstructured":"Liu YF, Fan YY, Jiang XF, Baur DA. A customized fixation plate with novel structure designed by topological optimization for mandibular angle fracture based on finite element analysis. Biomed Eng Online. 2017;16:131.","journal-title":"Biomed Eng Online"},{"key":"9471_CR13","doi-asserted-by":"publisher","first-page":"9951005","DOI":"10.1007\/s12663-023-02027-x","volume":"22","author":"HO Saleh","year":"2023","unstructured":"Saleh HO, Moussa BG, Salah Eddin KA, Noman SA, Salah AM. Assessment of CAD\/CAM Customized V Pattern Plate Versus Standard Miniplates Fixation in Mandibular Angle Fracture (Randomized Clinical Trial). J Maxillofac Oral Surg. 2023;22:9951005.","journal-title":"J Maxillofac Oral Surg"},{"key":"9471_CR14","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1111\/edt.12841","volume":"39","author":"B Sancar","year":"2023","unstructured":"Sancar B, \u00c7etiner Y, Day\u0131 E. Evaluation of the pattern of fracture formation from trauma to the human mandible with finite element analysis. Part 2: the corpus and the angle regions. Dent Traumatol. 2023;39:437\u201347.","journal-title":"Dent Traumatol"},{"key":"9471_CR15","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s12938-021-00851-1","volume":"20","author":"X Xu","year":"2021","unstructured":"Xu X, Cheng KJ, Liu YF, Fan YY, Wang JH, Wang R, et al. Experimental validation of finite element simulation of a new customdesigned fixation plate to treat mandibular angle fracture. Biomed Eng Online. 2021;20:15.","journal-title":"Biomed Eng Online"},{"key":"9471_CR16","doi-asserted-by":"publisher","first-page":"11421","DOI":"10.1007\/s12663-022-01799-y","volume":"23","author":"A Subramanian","year":"2024","unstructured":"Subramanian A, Rudagi BM, Londhe P, Palande C. A Finite Element Analysis of Single, Double & Matrix Miniplate in Fracture of the Mandibular ANGLE Region: An In Vitro Study. J Maxillofac Oral Surg. 2024;23:11421.","journal-title":"J Maxillofac Oral Surg"},{"key":"9471_CR17","doi-asserted-by":"publisher","first-page":"2739","DOI":"10.1590\/1807-2577.0081","volume":"44","author":"VOR Arantes","year":"2015","unstructured":"Arantes VOR, Corr\u00eaa CB, Lunardi N, Boeck Neto RJ, SpinNeto R, Boeck EM. Insertion angle of orthodontic miniimplants and their biomechanical performance: finite element analysis. Rev Odontol UNESP. 2015;44:2739.","journal-title":"Rev Odontol UNESP"},{"key":"9471_CR18","doi-asserted-by":"publisher","first-page":"3118","DOI":"10.3390\/ma15093118","volume":"15","author":"JH Seo","year":"2022","unstructured":"Seo JH, Kim MS, Lee JH, EghanAcquah E, Jeong YH, Hong MH, et al. Biomechanical Efficacy and Effectiveness of Orthodontic Treatment with Transparent Aligners in Mild Crowding DentitionA Finite Element Analysis. Mater (Basel). 2022;15:3118.","journal-title":"Mater (Basel)"},{"key":"9471_CR19","doi-asserted-by":"publisher","first-page":"65462","DOI":"10.1115\/1.2244575","volume":"128","author":"ST Lovald","year":"2006","unstructured":"Lovald ST, Khraishi T, Wagner J, Baack B, Kelly J, Wood J. Comparison of platescrew systems used in mandibular fracture reduction: finite element analysis. J Biomech Eng. 2006;128:65462.","journal-title":"J Biomech Eng"},{"key":"9471_CR20","doi-asserted-by":"publisher","first-page":"715","DOI":"10.4103\/ams.ams_205_23","volume":"14","author":"H Pandya","year":"2024","unstructured":"Pandya H, Patel H, Vithalani S, Bhavsar B, Shah U, Chunawala A. Finite Element Analysis of New Modified Three-dimensional Strut Miniplate versus Conventional Plating in Mandibular Symphysis and Angle Fractures An In vitro Study. Ann Maxillofac Surg. 2024;14:715.","journal-title":"Ann Maxillofac Surg"},{"key":"9471_CR21","doi-asserted-by":"publisher","first-page":"2316","DOI":"10.1016\/S0921-5093(97)00806-X","volume":"243","author":"M Niinomi","year":"1998","unstructured":"Niinomi M. Mechanical properties of biomedical titanium alloys. Mater Sci Eng A. 1998;243:2316.","journal-title":"Mater Sci Eng A"},{"key":"9471_CR22","doi-asserted-by":"publisher","first-page":"18143","DOI":"10.1038\/s41598-020-75299-9","volume":"10","author":"B Gareb","year":"2020","unstructured":"Gareb B, Roossien CC, van Bakelen NB, Verkerke GJ, Vissink A, Bos RR, et al. Comparison of the mechanical properties of biodegradable and titanium osteosynthesis systems used in oral and maxillofacial surgery. Sci Rep. 2020;10:18143.","journal-title":"Sci Rep"},{"key":"9471_CR23","doi-asserted-by":"publisher","first-page":"7889","DOI":"10.1080\/10255842.2022.2047952","volume":"26","author":"Y Li","year":"2023","unstructured":"Li Y, Li H, Lai Q, Xue R, Zhu K, Deng Y. Finite element analysis of 3Dprinted personalized titanium plates for mandibular angle fracture. Comput Methods Biomech Biomed Engin. 2023;26:7889.","journal-title":"Comput Methods Biomech Biomed Engin"},{"key":"9471_CR24","first-page":"43","volume-title":"Mechanical Testing of Bone and the Bone Implant Interface","author":"YH An","year":"1999","unstructured":"An YH, Draughn RA. Mechanical Testing of Bone and the Bone Implant Interface. 1st ed. London: CRC; 1999. p. 43.","edition":"1"},{"key":"9471_CR25","doi-asserted-by":"publisher","first-page":"11795","DOI":"10.1038\/s41598-024-62011-4","volume":"14","author":"O Daqiq","year":"2024","unstructured":"Daqiq O, Roossien CC, Wubs FW, van Minnen B. Biomechanical assessment of mandibular fracture fixation using finite element analysis validated by polymeric mandible mechanical testing. Sci Rep. 2024;14:11795.","journal-title":"Sci Rep"},{"key":"9471_CR26","doi-asserted-by":"publisher","first-page":"146474","DOI":"10.1016\/j.joms.2017.02.028","volume":"75","author":"A Ayali","year":"2017","unstructured":"Ayali A, Erkmen E. Biomechanical evaluation of different plating methods used in mandibular angle fractures with 3dimensional finite element analysis: favorable fractures. J Oral Maxillofac Surg. 2017;75:146474.","journal-title":"J Oral Maxillofac Surg"},{"key":"9471_CR27","first-page":"14552","volume":"25","author":"E Naeini","year":"2020","unstructured":"Naeini E, Sarkarat F, Jamilian A, Kalantar Motamedi MH. Comparative Evaluation of 7 Fixation Plates in Mandibular Angle Fractures Using Finite Element Analysis. Trauma Mon. 2020;25:14552.","journal-title":"Trauma Mon"},{"issue":"4","key":"9471_CR28","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1002\/jor.1100150414","volume":"15","author":"L Claes","year":"1997","unstructured":"Claes L, Augat P, Suger G, Wilke HJ. Influence of size and stability of the osteotomy gap on the success of fracture healing. J Orthop Res. 1997;15(4):577\u201384. https:\/\/doi.org\/10.1002\/jor.1100150414.","journal-title":"J Orthop Res"},{"key":"9471_CR29","doi-asserted-by":"publisher","first-page":"3609","DOI":"10.1016\/j.bjps.2016.10.026","volume":"70","author":"R Wang","year":"2017","unstructured":"Wang R, Liu Y, Wang JH, Baur DA. Effect of interfragmentary gap on the mechanical behavior of mandibular angle fracture with three fixation designs: a finite element analysis. J Plast Reconstr Aesthet Surg. 2017;70:3609.","journal-title":"J Plast Reconstr Aesthet Surg"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-026-09471-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-026-09471-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-026-09471-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T12:02:19Z","timestamp":1786190539000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12903-026-09471-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,8]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["9471"],"URL":"https:\/\/doi.org\/10.1186\/s12903-026-09471-4","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,8]]},"assertion":[{"value":"19 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Research Ethics Committee of the Faculty of Dentistry, Alexandria University (IRB No. 00010556102301\/2025). Written informed consent was obtained from the participant for the use of computed tomography data for research purposes.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent for publication was obtained from the participant.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1382"}}