Subject-Specific Finite Element Modelling of Le Fort I Osteotomy Fixation: Biomechanical Insights Comparing Patient-Specific Implants and Conventional Miniplates
- 1Department of Oral and Maxillo-Facial Surgery, Head and Neck Institute, University Hospital Center of Nice, 31 avenue de Valombrose, 06100 Nice, France
- 2Nice Côte d’Azur Clinical Research Unit (UR2CA), 28 avenue Valombrose, 06107 Nice Cedex 2, France
- 3Department of Computational Mechanics Physics CEMEF, MINES ParisTech, PSL Research University, Centre de Mise en Forme des Matériaux (CEMEF), 06904 Sophia Antipolis, France
Abstract
Background: Stable fixation is essential to prevent relapse after Le Fort I osteotomy, particularly during the early postoperative period when the fixation system bears the full masticatory load. Patient-specific implants (PSI) have been increasingly used, but their biomechanical behavior under postoperative surgical conditions remains insufficiently investigated. The aim of this study was to evaluate PSI fixation using subject-specific finite element modelling based on real surgical plans. Methods: Two patient-specific models were developed from cone-beam computed tomography (CBCT) data of patients undergoing bimaxillary orthognathic surgery. For each case, two fixation strategies were simulated: a multiarm patient-specific plate and conventional L-shaped miniplates. Von Mises stress distribution and relative displacement were analyzed for fixation devices and bone segments. Results: PSI fixation reduced stress levels in plates and screws while maintaining comparable global stability. However, its effect on bone stress differed between the two models. In Patient 2, whose surgical plan included greater maxillary advancement and posterior impaction, PSI fixation was associated with higher bone stress and a micrometric increase in displacement. Conclusions: These findings highlight the influence of surgical movement on fixation biomechanics and support the integration of biomechanical personalization alongside anatomical planning in orthognathic surgery.
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BibTeX
@article{rios2026subjectspecific,
title = {{Subject-Specific Finite Element Modelling of Le Fort I Osteotomy Fixation: Biomechanical Insights Comparing Patient-Specific Implants and Conventional Miniplates}},
author = {Olina Rios and Sarah Latreche and Yannick Tillier and Charles Savoldelli},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207994},
url = {https://www.mdpi.com/2077-0383/15/20/7994},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Subject-Specific Finite Element Modelling of Le Fort I Osteotomy Fixation: Biomechanical Insights Comparing Patient-Specific Implants and Conventional Miniplates
AU - Olina Rios
AU - Sarah Latreche
AU - Yannick Tillier
AU - Charles Savoldelli
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207994
UR - https://www.mdpi.com/2077-0383/15/20/7994
AB - Background: Stable fixation is essential to prevent relapse after Le Fort I osteotomy, particularly during the early postoperative period when the fixation system bears the full masticatory load. Patient-specific implants (PSI) have been increasingly used, but their biomechanical behavior under postoperative surgical conditions remains insufficiently investigated. The aim of this study was to evaluate PSI fixation using subject-specific finite element modelling based on real surgical plans. Methods: Two patient-specific models were developed from cone-beam computed tomography (CBCT) data of patients undergoing bimaxillary orthognathic surgery. For each case, two fixation strategies were simulated: a multiarm patient-specific plate and conventional L-shaped miniplates. Von Mises stress distribution and relative displacement were analyzed for fixation devices and bone segments. Results: PSI fixation reduced stress levels in plates and screws while maintaining comparable global stability. However, its effect on bone stress differed between the two models. In Patient 2, whose surgical plan included greater maxillary advancement and posterior impaction, PSI fixation was associated with higher bone stress and a micrometric increase in displacement. Conclusions: These findings highlight the influence of surgical movement on fixation biomechanics and support the integration of biomechanical personalization alongside anatomical planning in orthognathic surgery.
SN - 2077-0383
ER -