Image-based patient-specific modelling in oral surgery

Accurate patient-specific modeling and finite element analysis are fundamental for achieving reliable results that can support pre-surgical planning, device design and biomechanical evaluation in oral surgery. This study presents a workflow for image-based patient-specific modeling applied to a guided bone regeneration clinical case. The workflow starts with image-based properties modeling, including bone density calibration, clinical image segmentation, and micro-mechanical bone modeling. Then, a custom device was designed, and a material was selected and its material properties were obtained through mechanical characterization. Lastly, a patient-specific finite element model was created with appropriate boundary conditions to evaluate the biomechanical behavior of the device and the bone state at interfaces with the device and screws. The work highlights the importance of bone density calibration and the modeling of anisotropic and nonhomogeneous bone properties in FEM to accurately evaluate the bone state after a guided bone regeneration surgery. This study has established a methodology for creating patient-specific models based on clinical imaging data in the context of oral surgery. This approach facilitates the biomechanical assessment of 3D-printed devices, as well as the interactions at the interfaces between device and bone, and screws and bone.