Effect of Carbon Fiber Reinforced Peek on Stabilization of Sagittal Split Ramus Osteotomy Fixation and Stresses on Temporomandibular Joint: 3d Finite Element Analysis Study

This study aimed to compare carbon fiber-reinforced polyetheretherketone (CFR-PEEK) plates and screws with conventional titanium plates and screws for mandibular orthognathic surgery models.

Sagittal split ramus osteotomy (SSRO) was simulated in a 3D finite element model of the mandible. Eight fixation groups with 3 different designs (miniplate, hybrid, and inverted-L) were created using titanium and CFR-PEEK materials. The displacement values in the osteotomy lines, the von Mises stress values on the fixation devices, and the maximum tensile and compressive stress values on the bone in contact with the screws and the temporomandibular joints (TMJ) were compared.

The displacement in the osteotomy line in the models using the CFR-PEEK polymer was higher than in the titanium models. The stress on the miniplate and screws in the CFR-PEEK models was lower than that in the titanium models. The maximum stress on the miniplates was found close to the fracture line in the distal segment. The stress on the TMJ of the CFR-PEEK models was higher than that of the titanium models.

When the fixation designs were compared regardless of the material, the lowest displacement value (CFR-PEEK: 0.268 mm; Titanium: 0.253 mm), the highest screw stress (CFR-PEEK: 372.9 MPa; Titanium: 1185.5 MPa), and the lowest bone stress (CFR-PEEK: 57.216 MPa; Titanium:64.022 MPa) were observed in the models using the inverted-L technique for fixation.

The results suggest that CFR-PEEK plates and screws reduce stress on the fixation systems and the associated bone while increasing stress on the TMJ.