Bone remodeling following mandibular reconstruction using fibula free flap

Keke Zheng, Nobuhiro Yoda, Junning Chen, Zhipeng Liao, Jingxiao Zhong, Chi Wu, Boyang Wan, Shigeto Koyama, Keiichi Sasaki, Christopher Peck, Michael Swain, Qing Li

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


To investigate bone remodelling responses to mandibulectomy, a joint external and internal remodelling algorithm is developed here by incorporating patient-specific longitudinal data. The primary aim of this study is to simulate bone remodelling activity in the conjunction region with a fibula free flap (FFF) reconstruction by correlating with a 28-month clinical follow-up. The secondary goal of this study is to compare the long-term outcomes of different designs of fixation plate with specific screw positioning. The results indicated that the overall bone density decreased over time, except for the Docking Site (namely DS1, a region of interest in mandibular symphysis with the conjunction of the bone union), in which the decrease of bone density ceased later and was followed by bone apposition. A negligible influence on bone remodeling outcome was found for different screw positioning. This study is believed to be the first of its kind for computationally simulating the bone turn-over process after FFF maxillofacial reconstruction by correlating with patient-specific follow-up.

Original languageEnglish
Article number110968
JournalJournal of Biomechanics
Publication statusPublished - 2022 Mar


  • Bone remodelling
  • Maxillofacial reconstruction
  • Placement design of fixation plate
  • Time-dependent remodelling algorithm. Clinical follow-up


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