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The purpose of this study was to investigate factors involved in stress on locking mini-plate/screws used in orthognathic surgery based on patient-specific 3-dimensional finite element analysis. Data were obtained from 10 patients undergoing mandibular advancement by bilateral sagittal split ramus osteotomy. All underwent osteosynthesis with 2.0-mm titanium locking mini-plate/screws. A 3-dimensional finite element model of the mandible was created for each patient and each model subjected to the same loading conditions, which produced different stress values on locking mini-plate/screws. When the contact area of the proximal and distal bone segments was narrower and bone mineral density (BMD) lower, the von Mises stress values on the plate/screws were higher (contact area, p&lt;0.01; BMD, p&lt;0.05). The present results suggest that bone contact area and BMD should be considered as plate stress factors.

Three-dimensional Finite Element Analysis of Bone Fixation in Bilateral Sagittal Split Ramus Osteotomy Using Individual Models