Project Details
Projekt
Towards mechanobiological optimized mandible reconstructions with a fibula free flap
Subject Area
Dentistry, Oral Surgery
Orthopaedics, Traumatology, Reconstructive Surgery
Orthopaedics, Traumatology, Reconstructive Surgery
Term
since 2021
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 465338425
Reconstruction of segmental mandibular defects due to trauma, tumor, or osteonecrosis is usually performed with autologous transplants, most commonly with a fibula free flap in combination with load-bearing titanium fixation plates. While the surgery itself appears to be widely successful with flap survival rates of up to 95%, a clinical challenge remains: frequently, these customized implant-based reconstructions show osseous non-unions between the flap segments and the mandible host bone. Studies on long bone fractures have shown a key role of mechanical signals on the bone healing process, where too little or too much mechanical stimulation can lead to delayed healing or even nonunion. Previous studies of our group suggest a connection between the biomechanics and bone biology and healing after mandible reconstruction. However, there is currently a gap in knowledge of what mechano-biological coupling exists in the regeneration of mandibular reconstructions. We aim to perform a combined in silico / in vivo approach to understanding the connection between mechanical stimuli and bone healing between mandible and fibula free flap depending on plate fixation. Therefore, a finite element based mandible reconstruction model will be created to perform computational modeling and analyses. In patients with mandible reconstruction (free flap + CAD/CAM reconstruction plate), functional, radiological, and histological analyses are performed.Specific objectives are: - to determine the impact of mandible resection and reconstruction on bite force and to use this data for an in silico mandible reconstruction model- to analyze bone healing in the interosteotomy gap after mandible reconstruction with a fibula free flap radiologically- to determine in vivo, mandibular kinematics and interfragmentary movements of reconstructed mandibles with CAD/CAM reconstruction plates with 3D fluoroscopy- to characterize structural differences between fibula and mandible bone and to investigate the healing outcome at the flap-mandible interface histologically- to determine the biomechanical conditions at the defect & bone/defect interfaces of reconstructed mandibles fixated with CAD/CAM reconstruction plates- to determine the mechanical regulation of the bone healing process in mandibular osteotomies stabilized with CAD/CAM reconstruction plates
DFG Programme
Research Grants
Co-Investigators
Dr.-Ing. Philippe Moewis, Ph.D.; Privatdozentin Dr. Katharina Schmidt-Bleek
