Abstract
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.