{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T22:35:01Z","timestamp":1789684501871,"version":"4.0.1"},"reference-count":43,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,12]],"date-time":"2025-01-12T00:00:00Z","timestamp":1736640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Materials"],"abstract":"<jats:p>Mandibular reconstruction is essential for restoring both function and aesthetics after segmental resection due to tumoral pathology. This study aimed to conduct a comparative analysis of three reconstruction strategies for defects resulting from segmental mandibular resection, utilizing finite element analysis (FEA). Methods: A digital model of the mandible was created from CBCT data and optimized for FEA. Three reconstruction scenarios were simulated: fixation with a titanium plate, reconstruction with an autogenous fibular graft stabilized with the same titanium plate, and fixation with a customized PEEK plate. Various plate thicknesses were analyzed to determine the stress and deformation patterns under masticatory loads. Results: Titanium plates provided superior mechanical stability but showed stress concentrations near screw fixation points. The addition of autogenous bone grafts reduced stress on the plate and improved structural integrity. PEEK plates exhibited reduced stress shielding and better load distribution, but thinner designs were prone to deformation. Minimum recommended thicknesses of 1.2 mm for titanium plates and 1.8 mm for PEEK plates were identified by FEA. Conclusions: This study highlights the importance of material selection and patient-specific design in mandibular reconstruction. Autogenous bone grafts combined with titanium plates demonstrated the best biomechanical outcomes, while PEEK plates offer a promising alternative, particularly for patients where grafting is contraindicated.<\/jats:p>","DOI":"10.3390\/ma18020314","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T06:42:15Z","timestamp":1736750535000},"page":"314","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A Comparative Finite Element Analysis of Titanium, Autogenous Bone, and Polyetheretherketone (PEEK)-Based Solutions for Mandibular Reconstruction"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9062-0064","authenticated-orcid":false,"given":"Ionut Gabriel","family":"Ghionea","sequence":"first","affiliation":[{"name":"Manufacturing Engineering Department, Faculty of Industrial Engineering and Robotics, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8727-0414","authenticated-orcid":false,"given":"Cristian Ioan","family":"Tarba","sequence":"additional","affiliation":[{"name":"Manufacturing Engineering Department, Faculty of Industrial Engineering and Robotics, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6635-6091","authenticated-orcid":false,"given":"Corina Marilena","family":"Cristache","sequence":"additional","affiliation":[{"name":"Department of Dental Techniques, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 8, Eroii Sanitari Blvd., 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iulian","family":"Filipov","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina Adriana","family":"Beuran","sequence":"additional","affiliation":[{"name":"Department of Dental Techniques, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 8, Eroii Sanitari Blvd., 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Aftabi, H., Zaraska, K., Eghbal, A., McGregor, S., Prisman, E., Hodgson, A., and Fels, S. (2024). Computational models and their applications in biomechanical analysis of mandibular reconstruction surgery. Comput. Biol. Med., 169.","DOI":"10.1016\/j.compbiomed.2023.107887"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Sozzi, D., Cassoni, A., De Ponti, E., Moretti, M., Pucci, R., Spadoni, D., Canzi, G., Novelli, G., and Valentini, V. (2022). Effectiveness of Resective Surgery in Complex Ameloblastoma of the Jaws: A Retrospective Multicenter Observational Study. Cancers, 14.","DOI":"10.3390\/cancers14194608"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Gupta, L., Mishra, A., Gurav, S.V., Dholam, K., Pal, A., and Kumar, A. (J. Prosthet. Dent., 2024). Factors associated with mandibular deviation and proposed classification and treatment guidelines for applying mandibular guidance: A retrospective analysis of 185 patients with segmental mandibulectomy, J. Prosthet. Dent., Online ahead of print.","DOI":"10.1016\/j.prosdent.2024.08.017"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"s40463-023","DOI":"10.1186\/s40463-023-00639-4","article-title":"Advanced mandibular reconstruction with fibular free flap and alloplastic TMJ prosthesis with digital planning","volume":"52","author":"Pyne","year":"2023","journal-title":"J. Otolaryngol.-Head Neck Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.21037\/fomm-20-43","article-title":"Narrative review: Fibula free flap, indications, tips, and pitfalls","volume":"3","author":"Weyh","year":"2021","journal-title":"Front. Oral Maxillofac. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e371","DOI":"10.1016\/j.joms.2012.01.016","article-title":"Microvascular reconstruction of the mouth, jaws, and face: Experience of an australian oral and maxillofacial surgery unit","volume":"70","author":"Hoffman","year":"2012","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s12663-019-01323-9","article-title":"Patient-Specific Mandibular Reconstruction Plates Increase Accuracy and Long-Term Stability in Immediate Alloplastic Reconstruction of Segmental Mandibular Defects","volume":"19","author":"Zeller","year":"2020","journal-title":"J. Maxillofac. Oral Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/S0002-9610(05)80549-5","article-title":"Definitive mandibular replacement using reconstruction plates","volume":"160","author":"Saunders","year":"1990","journal-title":"Am. J. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s12663-015-0766-5","article-title":"Mandibular Reconstruction: Overview","volume":"15","author":"Kumar","year":"2015","journal-title":"J. Maxillofac. Oral Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s11282-023-00730-6","article-title":"Phantom study for CT artifacts of dental titanium implants and zirconia upper structures: The effects of occlusal plane angle setting and SEMAR algorithm","volume":"40","author":"Kitami","year":"2024","journal-title":"Oral Radiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12880-021-00554-y","article-title":"Comparison of different CT metal artifact reduction strategies for standard titanium and carbon-fiber reinforced polymer implants in sheep cadavers","volume":"21","author":"Huber","year":"2021","journal-title":"BMC Med. Imaging"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s41747-023-00354-9","article-title":"Metal artifact reduction on musculoskeletal CT: A phantom and clinical study","volume":"7","author":"Midthun","year":"2023","journal-title":"Eur. Radiol. Exp."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Lommen, J., Schorn, L., Sproll, C., K\u00fcbler, N.R., Nicolini, L.F., Merfort, R., Dilimulati, A., Hildebrand, F., Rana, M., and Greven, J. (2022). Mechanical Fatigue Performance of Patient-Specific Polymer Plates in Oncologic Mandible Reconstruction. J. Clin. Med., 11.","DOI":"10.3390\/jcm11123308"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10856-016-5731-4","article-title":"Polyetheretherketone (PEEK) for medical applications","volume":"27","author":"Panayotov","year":"2016","journal-title":"J. Mater. Sci. Mater. Med."},{"key":"ref_16","first-page":"263461","article-title":"Evaluation of a New PEEK Mandibular Reconstruction Plate Design for Continuity Defect Therapy by Finite Element Analysis","volume":"2","author":"Mehle","year":"2016","journal-title":"Int. J. New Technol. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1016\/j.joms.2005.11.065","article-title":"Surgical Management of Ameloblastoma in the Mandible: Segmental Mandibulectomy and Immediate Reconstruction With Free Fibula or Deep Circumflex Iliac Artery Flap (Evaluation of the Long-Term Esthetic and Functional Results)","volume":"64","author":"Vayvada","year":"2006","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Gasparro, R., Giordano, F., Campana, M.D., Aliberti, A., Landolfo, E., Dolce, P., Sammartino, G., and di Lauro, A.E. (2024). The Effect of Conservative vs. Radical Treatment of Ameloblastoma on Recurrence Rate and Quality of Life: An Umbrella Review. J. Clin. Med., 13.","DOI":"10.3390\/jcm13175339"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1016\/j.joms.2024.03.030","article-title":"Surgical Resection and Reconstruction of Ameloblastoma: A 13-Year Retrospective Review","volume":"82","author":"Chen","year":"2024","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Xue, R., Lai, Q., Xing, H., Zhong, C., Zhao, Y., Zhu, K., Deng, Y., and Liu, C. (2024). Finite element analysis and clinical application of 3D-printed Ti alloy implant for the reconstruction of mandibular defects. BMC Oral Health, 24.","DOI":"10.1186\/s12903-024-03857-y"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Shen, Y.W., Tsai, Y.S., Hsu, J.T., Shie, M.Y., Huang, H.L., and Fuh, L.J. (2022). Biomechanical Analyses of Porous Designs of 3D-Printed Titanium Implant for Mandibular Segmental Osteotomy Defects. Materials, 15.","DOI":"10.3390\/ma15020576"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"249","DOI":"10.3233\/THC-191809","article-title":"Finite element analysis of stress distribution on reconstructed mandibular models for autogenous bone grafts","volume":"28","author":"Kucukguven","year":"2020","journal-title":"Technol. Health Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"100005","DOI":"10.1016\/j.dentre.2021.100005","article-title":"Custom 3D printed titanium reconstruction plate with in-situ tissue engineering for the reconstruction and dental rehabilitation of a severely infected atrophic mandible. A review of technique","volume":"1","author":"Melville","year":"2021","journal-title":"Dent. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"98","DOI":"10.3390\/std11030009","article-title":"Custom-Made 3D Titanium Plate for Mandibular Reconstruction in Surgery of Ameloblastoma: A Novel Case Report","volume":"11","author":"Chakraborty","year":"2022","journal-title":"Surg. Tech. Dev."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Tanaka, E. (2021). Biomechanical and tribological properties of the temporomandibular joint. Front. Oral Maxillofac. Med., 3.","DOI":"10.21037\/fomm-20-83"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"De Stefano, M., and Ruggiero, A. (2024). A Critical Review of Human Jaw Biomechanical Modeling. Appl. Sci., 14.","DOI":"10.3390\/app14093813"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Ghionea, I.G., Vatamanu, O.E.B., Cristescu, A.M., David, M., Stancu, I.C., Butnarasu, C., and Cristache, C.M. (2023). A Finite Element Analysis of a Tooth-Supported 3D-Printed Surgical Guide without Metallic Sleeves for Dental Implant Insertion. Appl. Sci., 13.","DOI":"10.3390\/app13179975"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Pinheiro, M., Willaert, R., Khan, A., Krairi, A., and Van Paepegem, W. (2021). Biomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-93564-3"},{"key":"ref_29","unstructured":"Ghionea, I.G. (2024). CATIA V5 Practical Studies Using Finite Element Analysis, CRC Press."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Ashcroft, I.A., and Mubashar, A. (2011). Numerical Approach: Finite Element Analysis. Handbook of Adhesion Technology, Springer.","DOI":"10.1007\/978-3-642-01169-6_25"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1007\/s00419-024-02571-z","article-title":"Finite element formulation for higher-order shear deformation beams using two-phase local\/nonlocal integral model","volume":"94","author":"Tang","year":"2024","journal-title":"Arch. Appl. Mech."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Hilber, N., Reichmann, O., Schwab, C., and Winter, C. (2013). Finite Element Methods for Parabolic Problems. Computational Methods for Quantitative Finance: Finite Element Methods for Derivative Pricing, Springer.","DOI":"10.1007\/978-3-642-35401-4"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.jcms.2006.01.003","article-title":"Adaquate fixation of plates for stability during mandibular reconstruction","volume":"34","author":"Kimura","year":"2006","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Seebach, M., Theurer, F., Foehr, P., von Deimling, C., Burgkart, R., and Zaeh, M.F. (2018). Design of Bone Plates for Mandibular Reconstruction Using Topology and Shape Optimization. Advances in Structural and Multidisciplinary Optimization, Springer.","DOI":"10.1007\/978-3-319-67988-4_154"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Lang, J.J., Bastian, M., Foehr, P., Seebach, M., Weitz, J., Von Deimling, C., Schwaiger, B.J., Micheler, C.M., Wilhelm, N.J., and Grosse, C.U. (2021). Improving mandibular reconstruction by using topology optimization, patient specific design and additive manufacturing?\u2014A biomechanical comparison against miniplates on human specimen. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0253002"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Kang, J., Zhang, J., Zheng, J., Wang, L., Li, D., and Liu, S. (2021). 3D-printed PEEK implant for mandibular defects repair\u2014A new method. J. Mech. Behav. Biomed. Mater., 116.","DOI":"10.1016\/j.jmbbm.2021.104335"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"S108","DOI":"10.1111\/adj.12596","article-title":"Reconstruction of major defects of the jaws","volume":"63","author":"Batstone","year":"2018","journal-title":"Aust. Dent. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.coms.2018.08.005","article-title":"Contemporary Osseous Reconstruction of the Mandible and the Maxilla","volume":"31","author":"Likhterov","year":"2019","journal-title":"Oral Maxillofac. Surg. Clin. North Am."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"6097","DOI":"10.62347\/OXAO9041","article-title":"Finite element comparison of titanium and polyetheretherketone materials for mandibular defect reconstruction","volume":"16","author":"Chen","year":"2024","journal-title":"Am. J. Transl. Res."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Cassari, L., Balducci, C., Messina, G.M.L., Iucci, G., Battocchio, C., Bertel\u00e0, F., Lucchetta, G., Coward, T., Silvio, L.D., and Marletta, G. (2024). Polyetheretherketone Double Functionalization with Bioactive Peptides Improves Human Osteoblast Response. Biomimetics, 9.","DOI":"10.3390\/biomimetics9120767"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Jones, E.A., Sigurj\u00f3nsson, \u00d3.E., Weng, X., Zhu, W., Chai, H., Wang, W., Yuan, X., and Zhu, C. (2022). Bio-Activated PEEK: Promising Platforms for Improving Osteogenesis through Modulating Macrophage Polarization. Bioengineering, 9.","DOI":"10.3390\/bioengineering9120747"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Dondani, J.R., Iyer, J., and Tran, S.D. (2023). Surface Treatments of PEEK for Osseointegration to Bone. Biomolecules, 13.","DOI":"10.3390\/biom13030464"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1016\/j.joms.2022.03.004","article-title":"Reduction of CT Artifacts Using Polyetheretherketone (PEEK), Polyetherketoneketone (PEKK), Polyphenylsulfone (PPSU), and Polyethylene (PE) Reconstruction Plates in Oral Oncology","volume":"80","author":"Lommen","year":"2022","journal-title":"J. Oral Maxillofac. Surg."}],"container-title":["Materials"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1996-1944\/18\/2\/314\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:27:11Z","timestamp":1759919231000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1996-1944\/18\/2\/314"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,12]]},"references-count":43,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["ma18020314"],"URL":"https:\/\/doi.org\/10.3390\/ma18020314","relation":{},"ISSN":["1996-1944"],"issn-type":[{"value":"1996-1944","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,12]]}}}