AccScience Publishing / IJB / Online First / DOI: 10.36922/ijb.2553
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RESEARCH ARTICLE

Early monitoring for 3D-printed patient-specific mandible reconstructive implant biomechanical behavior under different occlusal conditions using a wireless module system

Cheng-Hsien Wu1,2 Hsiao-Kuan Wu3 Pei-Jung Tsai4 Chun-Li Lin5*
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1 Oral & Maxillofacial Surgery, Department of Dentistry, Taipei Veterans General Hospital, Taipei, Taiwan
2 Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
3 Department of Exercise and Health Science, National Taipei University Nursing and Health Sciences, Taipei, Taiwan
4 Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
5 Department of Biomedical Engineering, Medical Device Innovation & Translation Center, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
IJB 2024, 10(3), 2553 https://doi.org/10.36922/ijb.2553
Submitted: 27 December 2023 | Accepted: 19 February 2024 | Published: 25 March 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Three-dimensional (3D) printing technology used to manufacture patient-specific, large-scale medical implants has become increasingly prevalent. Nevertheless, early biomechanics monitoring can enhance the implantation success rate. This study developed a wireless module system (WMS) for strain gauge measurement that can be placed within the implant to achieve early biomechanical behavior detection for an experimental 3D-printed metal model of a patient-specific segmental implant (MMPSI) after surgery. This WMS includes a chip, a circuit board, and a battery, all with dimensions smaller than 20 mm × 12 mm × 8 mm. This system can connect to strain gauges and interface with a mobile application for measuring and transmitting strain data. The WMS functionality was confirmed through cantilever beam experiments. Premature failure was detected using this WMS installed in an experimental 3D-printed MMPSI and through in vitro fatigue biomechanical testing under different occlusal forces applied on the plastic-simulated mandibular model. The WMS validation results indicated that the strain gauge measurement error compared to theoretical values was within 17%. Biomechanical fatigue results addressed the higher strain received and greater cyclic loads were recorded when occlusal force was applied onto the premolar under identical force application conditions because the premolar was closer to the strain gauge attachment location, resulting in a longer lever arm compared to the molar. This study concluded that the developed WMS for strain measurement can be installed in a patient-specific 3D-printed implant with enough internal space to detect early biomechanical behavior after surgery. Current results of in vitro fatigue test for segmental defect indicated that occlusal situation can be adjusted to reduce implantation failure risk.

Keywords
3D-printed implant
Wireless
Biomechanics
Patient-specific
Mandibular defect
Funding
This study was supported in part by NSTC project 112-2221-E-A49-009-MY3and111-2327-B-A49-006, Taiwan.
Conflict of interest
The authors declare no conflicts of interest.
References
  1. Lim HK, Choi YJ, Choi WC, Song IS, Lee UL. Reconstruction of maxillofacial bone defects using patient-specific long-lasting titanium implants. Sci Rep. 2022;12:7538. doi: 10.1038/s41598-022-11200-0
  2. Cheng KJ, Liu YF, Wang R, et al. Topological optimization of 3D printed bone analog with PEKK for surgical mandibular reconstruction. J Mech Behav Biomed Mater. 2020;107:103758. doi: 10.1016/j.jmbbm.2020.103758
  3. Jung HW, Lee BS, Kwon YD, et al. Retrospective clinical study of mandible fractures. J Korean Assoc Oral Maxillofac Surg. 2014;40(1):21-26. doi: 10.5125/jkaoms.2014.40.1.21
  4. Maurer P, Eckert AW, Kriwalsky MS, Schubert J. Scope and limitations of methods of mandibular reconstruction: a long-term follow-up. Br J Oral Maxillofac Surg. 2010;48(2):100- 104. doi: 10.1016/j.bjoms.2009.07.005
  5. Lee SW, Kim HG, Ham MJ, Hong DGK, Kim SG, Rotaru H. Custom implant for reconstruction of mandibular continuity defect. J Oral Maxillofac Surg. 2018;76:1370-1376. doi: 10.1016/j.joms.2017.12.003
  6. Patel A, Harrison P, Cheng A, Bray B, Bell RB. Fibular reconstruction of the maxilla and mandible with immediate implant-supported prosthetic rehabilitation: jaw in a day. Oral Maxillofac Surg Clin North Am. 2019;31:369-986. doi: 10.1016/j.coms.2019.03.002
  7. Toure G, Gouet E. Use of a 3-dimensional custom-made porous titanium prosthesis for mandibular body reconstruction with prosthetic dental rehabilitation and lipofilling. J Oral Maxillofac Surg. 2019;77:1305-1313. doi: 10.1016/j.joms.2018.12.026
  8. Zhang L, Liu Z, Li B, et al. Evaluation of computer-assisted mandibular reconstruction with vascularized fibular flap compared to conventional surgery. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;121(2):139-148. doi: 10.1016/j.oooo.2015.10.005
  9. Wilkman T, Apajalahti S, Wilkman E, Törnwall J, Lassus P. A comparison of bone resorption over time: an analysis of the free scapular, iliac crest, and fibular microvascular flaps in mandibular reconstruction. J Oral Maxillofac Surg. 2017;75(3):616-621. doi: 10.1016/j.joms.2016.09.009
  10. Kawasaki G, Imayama N, Yoshitomi I, Furukawa K, Umeda M. Clinical study of reconstruction plates used in the surgery for mandibular discontinuity defect. In Vivo. 2019;33(1):191-194. doi: 10.21873/invivo.11458
  11. van Kootwijk A, Moosabeiki V, Saldivar MC, et al. Semi-automated digital workflow to design and evaluate patient-specific mandibular reconstruction implants. J Mech Behav Biomed Mater. 2022;132:105291. doi: 10.1016/j.jmbbm.2022.105291
  12. Lin CL, Wang YT, Chang CM, Wu CH, Tsai WH. Design criteria for patient-specific mandibular continuity defect reconstructed implant with lightweight structure using weighted topology optimization and validated with biomechanical fatigue testing. Int J Bioprint. 2022;8(1):437. doi: 10.18063/ijb.v8i1.437
  13. Li CH, Wu CH, Lin CL. Design of a patient-specific mandible reconstruction implant with dental prosthesis for metal 3D printing using integrated weighted topology optimization and finite element analysis. J Mech Behav Biomed Mater. 2020;105:103700. doi: 10.1016/j.jmbbm.2020.103700
  14. Subash P, Nerurkar SA, Krishnadas A, Vinay V, Iyer S, Manju V. Patient specific alloplastic implant reconstruction of mandibular defects-safe practice recommendations and guidelines. J Maxillofac Oral Surg. 2023;22(Suppl 1):28-36. doi: 10.1007/s12663-023-01881-z
  15. Bedogni A, Bettini G, Bedogni G, et al. Safety of boneless reconstruction of the mandible with a CAD/CAM designed titanium device: the replica cohort study. Oral Oncol. 2021;112:105073. doi: 10.1016/j.oraloncology.2020.105073 
  16. Cozzolino F, Apicella D, Wang G, Apicella A, Sorrentino R. Implant-to-bone force transmission: a pilot study for in vivo strain gauge measurement technique. J Mech Behav Biomed Mater. 2019;90:173-181. doi: 10.1016/j.jmbbm.2018.10.014
  17. Arami A, Delaloye JR, Rouhani H, Jolles BM, Aminian K. Knee implant loosening detection: a vibration analysis investigation. Ann Biomed Eng. 2018;46(1):97-107. doi: 10.1007/s10439-017-1941-2
  18. Seide K, Aljudaibi M, Weinrich N, et al. Telemetric assessment of bone healing with an instrumented internal fixator: a preliminary study. J Bone Joint Surg Br. 2012;94(3):398-404. doi: 10.1302/0301-620X.94B3.27550
  19. Schupp W, Arzdorf M, Linke B, Gutwald R. Biomechanical testing of different osteosynthesis systems for segmental resection of the mandible. J Oral Maxillofac Surg. 2007;65:924-930. doi: 10.1016/j.joms.2006.06.306
  20. Lin CL, Wang JC, Chang WJ. Biomechanical interactions in tooth-implant‐supported fixed partial dentures with variations in the number of splinted teeth and connector type: a finite element analysis. Clin Oral Implants Res. 2008;19:107–117. doi: 10.1111/j.1600-0501.2007.01363.x
  21. Ren R, Spaan J, Jordan A, Shafiro A, Su EP. Novel use of an accelerometer to assess load asymmetry over time after hip resurfacing arthroplasty. J Arthroplasty. 2023;38(7S):S58-S64. doi: 10.1016/j.arth.2023.04.015
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International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing