Camilla Gironi, Federica Ruggiero, Nicholas Stoner, Laura Cercenelli, Silvia Schievano, Anna Maria Baietti, Fabrizio Neri, Achille Tarsitano, Emanuela Marcelli, Alessandro Borghi
Fibula free flaps are the gold standard for mandibular reconstruction, yet non-union remains a significant challenge. This study presents a patient-specific finite element and mechanobiological framework to evaluate early bone healing with reconstruction plates and miniplates. Postoperative CT-based models were subjected to clenching loads, and a mechano-regulation algorithm simulated callus differentiation based on strain stimuli. Both fixation strategies ensured mechanical stability, with stresses below material limits. However, under the simulated loading conditions, miniplates generated more uniform strain distributions, promoting earlier ossification and suggesting a more favorable mechanical environment for early bone healing.