Resistance of Mandibular Polyurethane Replicas to Fracture after Removal of Blocks from the Symphysis and Ramus

Background: When block grafts are harvested intraorally, the donor sites may act as stress concentrators and alter the structural integrity of the mandible. Purpose: The study aimed to compare displacement and load failure between intact polyurethane mandibular replicas and similar replicas from which blocks were taken at the symphysis or the ramus. It also aimed to identify trends of load failure. Materials and Methods: Thirty-five mandibular replicas were tested to failure with an electromagnetic material testing unit. The variables evaluated in this investigation were maximal load, displacement at maximal load, and fracture location. Results: Statistically significant differences in maximal load were detected between groups (P = 0.0008). Differences between fracture locations were also statistically significant (P < 0.0001). The mandibles from which blocks were removed at the symphysis were significantly more likely to break at a lower maximal load than were the control mandibles (P = 0.0010) or the mandibles from which blocks were removed at the ramus (P = 0.0162). They were also more likely than the control group to break at a lower displacement at maximal load (P = 0.0145). Conclusions: Location of the donor site significantly influences the structural integrity of mandibular replicas. In addition, the donor site significantly affects the location of mandibular fractures.