This study presents three-dimensional finite element models (FEMs) of mandibles with ameloblastomas (ABs), where stress distributions and deformations were examined before and after clinical surgery. The ameloblastoma tissue specimens were investigated using radiography and histopathological examinations. Through histopathological analysis, the tissue specimens were divided into four subtypes: fibrous cyst wall, intraluminal AB, intramural AB, and normal tissue. The histopathological analysis was performed under optical microscopy (OM), by examining the proliferation and tomography of the tissues. It was found that the intraluminal and intramural ameloblastoma tissue were severely proliferated and infiltrated. FEMs were constructed using a computer-aided reverse system, which uses computer topography (CT) images. For the model before clinical surgery (BS), the maximum deformation was on the intact side. On the other hand, the model after clinical surgery (AS) showed maximum deformation with an over 20% increase on the reconstructed side. Some of the most remarkable differences were that the stress increased approximately 2.42 times in the maxilla and 1.51 times in the mandible after surgery. The maximum stress was concentrated on the fixation screw of the reconstructed side near the interface between plates. This result shows the potential clinical benefits for superior biomechanical performance on ameloblastomas.
Chen-Tin Liu, Yen-Ru Chou, Chao-Chia Weng, Chia-Yu Wu, Keng-Liang Ou, Han-Yi Cheng