{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T10:46:48Z","timestamp":1769510808862,"version":"3.49.0"},"reference-count":32,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T00:00:00Z","timestamp":1664236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Micromachines"],"abstract":"<jats:p>Nonunion is one of the most dreaded complications after operative treatment of mandible fractures or after mandible reconstruction using vascularized and non-vascularized bone grafts. Often diagnosis is made at advanced stage of disease when pain or complications occur. Devices that monitor fracture healing and bone regeneration continuously are therefore urgently needed in the craniomaxillofacial area. One promising approach is the strain measurement of plates. An advanced prototype of an implantable strain measurement device was tested after fixation to a locking mandible reconstruction plate in multiple compression experiments to investigate the potential functionality of strain measurement in the mandibular region. Compression experiments show that strain measurement devices work well under experimental conditions in the mandibular angle and detect plate deformation in a reliable way. For monitoring in the mandibular body, the device used in its current configuration was not suitable. Implant strain measurement of reconstruction plates is a promising methodical approach for permanent monitoring of bone regeneration and fracture healing in the mandible. The method helps to avoid or detect complications at an early point in time after operative treatment.<\/jats:p>","DOI":"10.3390\/mi13101602","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T01:51:49Z","timestamp":1664329909000},"page":"1602","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Feasibility of Implant Strain Measurement for Assessing Mandible Bone Regeneration"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3684-274X","authenticated-orcid":false,"given":"Ren\u00e9 Marcel","family":"Rothweiler","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7228-0804","authenticated-orcid":false,"given":"Sergej","family":"Zankovic","sequence":"additional","affiliation":[{"name":"G.E.R.N. Center for Tissue Replacement, Regeneration & Neogenesis, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, 79108 Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4697-5287","authenticated-orcid":false,"given":"Leonard Simon","family":"Brandenburg","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc-Anton","family":"Fuessinger","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3276-6505","authenticated-orcid":false,"given":"Christian","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pit Jacob","family":"Voss","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4893-7594","authenticated-orcid":false,"given":"Marc-Christian","family":"Metzger","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1288\/00005537-197607000-00003","article-title":"Nonunion of the Mandible","volume":"86","author":"Mathog","year":"1976","journal-title":"Laryngoscope"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1016\/j.acra.2018.06.009","article-title":"Postoperative CT of the Mandible Following Trauma: Review of Normal Appearances and Common Complications","volume":"26","author":"Reiter","year":"2019","journal-title":"Acad. Radiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.bjoms.2016.12.010","article-title":"Mandibular Reconstruction with Vascularised Bone Flaps: A Systematic Review over 25 Years","volume":"55","author":"Brown","year":"2017","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1016\/j.ijom.2018.03.017","article-title":"A Prospective Study Examining the Effects of Treatment Timing in the Management of Mandible Fractures","volume":"47","author":"Hurrell","year":"2018","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.jcms.2017.11.027","article-title":"Outcome and Complications after Treatment of Facial Fractures at Different Times in Polytrauma Patients","volume":"46","author":"Rothweiler","year":"2018","journal-title":"J. Craniomaxillofac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.ijom.2019.09.017","article-title":"Effect of Third Molars in the Line of Mandibular Angle Fractures on Postoperative Complications: Systematic Review and Meta-Analysis","volume":"49","author":"Fernandes","year":"2020","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1007\/s10006-018-0684-z","article-title":"Comparison of Single versus Two Non-Compression Miniplates in the Management of Unfavourable Angle Fracture of the Mandible: A Prospective Randomized Clinical Study","volume":"22","author":"Rai","year":"2018","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s10006-012-0374-1","article-title":"Fixation of Mandibular Angle Fractures: Clinical Studies","volume":"18","author":"Chrcanovic","year":"2014","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12903-018-0523-5","article-title":"Cone Beam Computed Tomography in Implant Dentistry: Recommendations for Clinical Use","volume":"18","author":"Jacobs","year":"2018","journal-title":"BMC Oral Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/j.bjoms.2010.09.023","article-title":"Early Detection of Bone Union with Transcutaneous Ultrasound in the Management of Non-Union of the Mandible","volume":"49","author":"Avery","year":"2011","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/S1350-4533(00)00062-X","article-title":"Concept, Design and Fabrication of Smart Orthopedic Implants","volume":"22","author":"Burny","year":"2000","journal-title":"Med. Eng. Phys."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"S101","DOI":"10.1016\/j.injury.2020.09.026","article-title":"Smart Implants in Fracture Care-Only Buzzword or Real Opportunity?","volume":"52","author":"Ernst","year":"2020","journal-title":"Injury"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Windolf, M., Heumann, M., Varjas, V., Constant, C., Ernst, M., Richards, R.G., Wilke, H.-J., and Benneker, L.M. (2022). Continuous Rod Load Monitoring to Assess Spinal Fusion Status\u2013Pilot In Vivo Data in Sheep. Medicina, 58.","DOI":"10.3390\/medicina58070899"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Windolf, M., Varjas, V., Gehweiler, D., Schwyn, R., Arens, D., Constant, C., Zeiter, S., Richards, R.G., and Ernst, M. (2022). Continuous Implant Load Monitoring to Assess Bone Healing Status\u2014Evidence from Animal Testing. Medicina, 58.","DOI":"10.3390\/medicina58070858"},{"key":"ref_15","unstructured":"Windolf, M., Ernst, M., Schwyn, R., Perren, S.M., Mathis, H., Wilke, M., and Richards, R.G. (2014). A Biofeedback System for Continuous Monitoring of Bone Healing. Proceedings of the BIODEVICES, Sience and Technology Publications, Lda."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"110188","DOI":"10.1016\/j.jbiomech.2020.110188","article-title":"Clinical Feasibility of Fracture Healing Assessment through Continuous Monitoring of Implant Load","volume":"116","author":"Ernst","year":"2021","journal-title":"J. Biomech."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1053\/joms.2001.26726","article-title":"A Biomechanical Evaluation of Mandibular Angle Fracture Plating Techniques","volume":"59","author":"Haug","year":"2001","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/j.joms.2006.06.306","article-title":"Biomechanical Testing of Different Osteosynthesis Systems for Segmental Resection of the Mandible","volume":"65","author":"Schupp","year":"2007","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1089\/ten.teb.2015.0123","article-title":"Monitoring Healing Progression and Characterizing the Mechanical Environment in Preclinical Models for Bone Tissue Engineering","volume":"22","author":"Fountain","year":"2016","journal-title":"Tissue Eng. Part B Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.jcms.2006.01.004","article-title":"Analysis of Mechanical Stress in Reconstruction Plates for Bridging Mandibular Angle Defects","volume":"34","author":"Knoll","year":"2006","journal-title":"J. Craniomaxillofac. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1080\/10255842.2016.1240788","article-title":"Customized Mandibular Reconstruction Plates Improve Mechanical Performance in a Mandibular Reconstruction Model","volume":"20","author":"Gutwald","year":"2017","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1002\/ajpa.10225","article-title":"Functional significance of cortical bone distribution in anthropoid mandibles: An in vitro assessment of bone strain under combined loads","volume":"122","author":"Daegling","year":"2003","journal-title":"Am. J. Phys. Anthropol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1002\/ar.22597","article-title":"Comparing the Distribution of Strains with the Distribution of Bone Tissue in a Human Mandible: A Finite Element Study","volume":"296","author":"Fagan","year":"2013","journal-title":"Anat. Rec."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Cao, Z., Chen, P., Ma, Z., Li, S., Gao, X., Wu, R., Pan, L., and Shi, Y. (2019). Near-Field Communication Sensors. Sensors, 19.","DOI":"10.3390\/s19183947"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Kifle, Y., Wikner, J.J., Z\u00f6tterman, J., Ryd\u00e9n, L., and Farnebo, S. (2019, January 23\u201327). NFC Powered Implantable Temperature Sensor. Proceedings of the 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Berlin, Germany.","DOI":"10.1109\/EMBC.2019.8856607"},{"key":"ref_26","first-page":"1","article-title":"Wireless Battery-Free Body Sensor Networks Using near-Field-Enabled Clothing","volume":"11","author":"Lin","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"34","DOI":"10.4103\/njms.NJMS_76_16","article-title":"Comparative Evaluation of Bite Force Analytical Study Following Mandibular Osteosysthesis Using Three-Dimensional and Conventional Locking Miniplates","volume":"8","author":"Kinra","year":"2017","journal-title":"Natl. J. Maxillofac. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2877","DOI":"10.1016\/j.jbiomech.2016.06.036","article-title":"Fiber Bragg Grating Based Bite Force Measurement","volume":"49","author":"Umesh","year":"2016","journal-title":"J. Biomech."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1016\/j.joms.2010.10.014","article-title":"Prospective Randomized Clinical Trial Comparing Bite Force in 2-Mm Locking Plates versus 2-Mm Standard Plates in Treatment of Mandibular Fractures","volume":"69","author":"Agarwal","year":"2011","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1089\/ten.tea.2014.0426","article-title":"Autologously Generated Tissue-Engineered Bone Flaps for Reconstruction of Large Mandibular Defects in an Ovine Model","volume":"21","author":"Tatara","year":"2015","journal-title":"Tissue Eng. Part A"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.actbio.2016.09.013","article-title":"Reconstruction of Large Mandibular Defects Using Autologous Tissues Generated from in Vivo Bioreactors","volume":"45","author":"Tatara","year":"2016","journal-title":"Acta Biomater."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/j.jcms.2015.03.022","article-title":"Tricalcium Phosphate-Based Biocomposites for Mandibular Bone Regeneration--A Histological Study in Sheep","volume":"43","author":"Russmueller","year":"2015","journal-title":"J. Craniomaxillofac. Surg."}],"container-title":["Micromachines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-666X\/13\/10\/1602\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:40:08Z","timestamp":1760143208000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-666X\/13\/10\/1602"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,27]]},"references-count":32,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["mi13101602"],"URL":"https:\/\/doi.org\/10.3390\/mi13101602","relation":{},"ISSN":["2072-666X"],"issn-type":[{"value":"2072-666X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,27]]}}}