Mechanical Fatigue Performance of Patient-Specific Polymer Plates in Oncologic Mandible Reconstruction
Mandible defects are conventionally reconstructed using titanium plates. However, titanium causes metallic artifacts which impair radiological imaging. This study aims at evaluating mechanical fatigue of radiolucent fiber-reinforced polyetheretherketone (f-PEEK), polyetheretherketone (PEEK), polyeth...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-06-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/12/3308 |
| _version_ | 1797486131496878080 |
|---|---|
| author | Julian Lommen Lara Schorn Christoph Sproll Norbert R. Kübler Luis Fernando Nicolini Ricarda Merfort Ayimire Dilimulati Frank Hildebrand Majeed Rana Johannes Greven |
| author_facet | Julian Lommen Lara Schorn Christoph Sproll Norbert R. Kübler Luis Fernando Nicolini Ricarda Merfort Ayimire Dilimulati Frank Hildebrand Majeed Rana Johannes Greven |
| author_sort | Julian Lommen |
| collection | DOAJ |
| description | Mandible defects are conventionally reconstructed using titanium plates. However, titanium causes metallic artifacts which impair radiological imaging. This study aims at evaluating mechanical fatigue of radiolucent fiber-reinforced polyetheretherketone (f-PEEK), polyetheretherketone (PEEK), polyetherketoneketone (PEKK), and polyphenylsulfone (PPSU) polymer plates for mandible reconstruction. A total of 30 plates (titanium [n = 6], f-PEEK [n = 6], PEEK [n = 6], PEKK [n = 6], PPSU [n = 6]) were implanted in synthetic mandibulectomized polyurethane mandibles. Servo-pneumatic mechanical testing with cyclic application of 30–300 N at 3 Hz was conducted. Bite forces were 70% on the unresected and 30% on the resected side. Total number of cycles was set to 250,000. Testing was aborted in case of plate or screw failure. Axial load to failure was tested with a speed of 1 mm/s. Kruskal–Wallis and Dunn’s post hoc tests were used. Titanium, f-PEEK, and PEEK showed no failure in fatigue testing and PPSU (<i>p</i> < 0.001) failed against titanium, f-PEEK, PEEK, and PEKK. Titanium allowed the highest load to failure compared to f-PEEK (<i>p</i> = 0.049), PEEK (<i>p</i> = 0.008), PEKK (<i>p</i> < 0.001), and PPSU (<i>p</i> = 0.007). f-PEEK, PEEK, and PEKK withstood expected physiological bite force. Although titanium plates provided the highest fatigue strength, f-PEEK and PEEK plates showed no failure over 250,000 chewing cycles indicating sufficient mechanical strength for mandible reconstruction. |
| first_indexed | 2024-03-09T23:28:50Z |
| format | Article |
| id | doaj.art-fb255e0992c8455fb620043b0e1eb345 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:28:50Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-fb255e0992c8455fb620043b0e1eb3452023-11-23T17:13:51ZengMDPI AGJournal of Clinical Medicine2077-03832022-06-011112330810.3390/jcm11123308Mechanical Fatigue Performance of Patient-Specific Polymer Plates in Oncologic Mandible ReconstructionJulian Lommen0Lara Schorn1Christoph Sproll2Norbert R. Kübler3Luis Fernando Nicolini4Ricarda Merfort5Ayimire Dilimulati6Frank Hildebrand7Majeed Rana8Johannes Greven9Department of Oral-, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstr. 5, 40225 Dusseldorf, GermanyDepartment of Oral-, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstr. 5, 40225 Dusseldorf, GermanyDepartment of Oral-, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstr. 5, 40225 Dusseldorf, GermanyDepartment of Oral-, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstr. 5, 40225 Dusseldorf, GermanyDepartment of Orthopedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstreet 30, 52074 Aachen, GermanyDepartment of Orthopedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstreet 30, 52074 Aachen, GermanyDepartment of Orthopedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstreet 30, 52074 Aachen, GermanyDepartment of Orthopedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstreet 30, 52074 Aachen, GermanyDepartment of Oral-, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstr. 5, 40225 Dusseldorf, GermanyDepartment of Orthopedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstreet 30, 52074 Aachen, GermanyMandible defects are conventionally reconstructed using titanium plates. However, titanium causes metallic artifacts which impair radiological imaging. This study aims at evaluating mechanical fatigue of radiolucent fiber-reinforced polyetheretherketone (f-PEEK), polyetheretherketone (PEEK), polyetherketoneketone (PEKK), and polyphenylsulfone (PPSU) polymer plates for mandible reconstruction. A total of 30 plates (titanium [n = 6], f-PEEK [n = 6], PEEK [n = 6], PEKK [n = 6], PPSU [n = 6]) were implanted in synthetic mandibulectomized polyurethane mandibles. Servo-pneumatic mechanical testing with cyclic application of 30–300 N at 3 Hz was conducted. Bite forces were 70% on the unresected and 30% on the resected side. Total number of cycles was set to 250,000. Testing was aborted in case of plate or screw failure. Axial load to failure was tested with a speed of 1 mm/s. Kruskal–Wallis and Dunn’s post hoc tests were used. Titanium, f-PEEK, and PEEK showed no failure in fatigue testing and PPSU (<i>p</i> < 0.001) failed against titanium, f-PEEK, PEEK, and PEKK. Titanium allowed the highest load to failure compared to f-PEEK (<i>p</i> = 0.049), PEEK (<i>p</i> = 0.008), PEKK (<i>p</i> < 0.001), and PPSU (<i>p</i> = 0.007). f-PEEK, PEEK, and PEKK withstood expected physiological bite force. Although titanium plates provided the highest fatigue strength, f-PEEK and PEEK plates showed no failure over 250,000 chewing cycles indicating sufficient mechanical strength for mandible reconstruction.https://www.mdpi.com/2077-0383/11/12/3308reconstruction platesegmental mandibulectomypolymer platemechanical propertiespolyetheretherketonepolyetherketoneketone |
| spellingShingle | Julian Lommen Lara Schorn Christoph Sproll Norbert R. Kübler Luis Fernando Nicolini Ricarda Merfort Ayimire Dilimulati Frank Hildebrand Majeed Rana Johannes Greven Mechanical Fatigue Performance of Patient-Specific Polymer Plates in Oncologic Mandible Reconstruction Journal of Clinical Medicine reconstruction plate segmental mandibulectomy polymer plate mechanical properties polyetheretherketone polyetherketoneketone |
| title | Mechanical Fatigue Performance of Patient-Specific Polymer Plates in Oncologic Mandible Reconstruction |
| title_full | Mechanical Fatigue Performance of Patient-Specific Polymer Plates in Oncologic Mandible Reconstruction |
| title_fullStr | Mechanical Fatigue Performance of Patient-Specific Polymer Plates in Oncologic Mandible Reconstruction |
| title_full_unstemmed | Mechanical Fatigue Performance of Patient-Specific Polymer Plates in Oncologic Mandible Reconstruction |
| title_short | Mechanical Fatigue Performance of Patient-Specific Polymer Plates in Oncologic Mandible Reconstruction |
| title_sort | mechanical fatigue performance of patient specific polymer plates in oncologic mandible reconstruction |
| topic | reconstruction plate segmental mandibulectomy polymer plate mechanical properties polyetheretherketone polyetherketoneketone |
| url | https://www.mdpi.com/2077-0383/11/12/3308 |
| work_keys_str_mv | AT julianlommen mechanicalfatigueperformanceofpatientspecificpolymerplatesinoncologicmandiblereconstruction AT laraschorn mechanicalfatigueperformanceofpatientspecificpolymerplatesinoncologicmandiblereconstruction AT christophsproll mechanicalfatigueperformanceofpatientspecificpolymerplatesinoncologicmandiblereconstruction AT norbertrkubler mechanicalfatigueperformanceofpatientspecificpolymerplatesinoncologicmandiblereconstruction AT luisfernandonicolini mechanicalfatigueperformanceofpatientspecificpolymerplatesinoncologicmandiblereconstruction AT ricardamerfort mechanicalfatigueperformanceofpatientspecificpolymerplatesinoncologicmandiblereconstruction AT ayimiredilimulati mechanicalfatigueperformanceofpatientspecificpolymerplatesinoncologicmandiblereconstruction AT frankhildebrand mechanicalfatigueperformanceofpatientspecificpolymerplatesinoncologicmandiblereconstruction AT majeedrana mechanicalfatigueperformanceofpatientspecificpolymerplatesinoncologicmandiblereconstruction AT johannesgreven mechanicalfatigueperformanceofpatientspecificpolymerplatesinoncologicmandiblereconstruction |