Mandible defects are conventionally reconstructed using
titanium plates. However,
titanium causes metallic artifacts which impair radiological imaging. This study aims at evaluating mechanical
fatigue of radiolucent fiber-reinforced
polyetheretherketone (f-
PEEK),
polyetheretherketone (
PEEK),
polyetherketoneketone (PEKK), and polyphenylsulfone (PPSU)
polymer plates for mandible reconstruction. A total of 30 plates (
titanium [n = 6], f-
PEEK [n = 6],
PEEK [n = 6], PEKK [n = 6], PPSU [n = 6]) were implanted in synthetic mandibulectomized
polyurethane mandibles. Servo-pneumatic mechanical testing with cyclic application of 30−300 N at 3 Hz was conducted.
Bite forces were 70% on the unresected and 30% on the resected side. Total number of cycles was set to 250,000. Testing was aborted in case of plate or screw failure. Axial load to failure was tested with a speed of 1 mm/s. Kruskal−Wallis and Dunn’s post hoc tests were used.
Titanium, f-
PEEK, and
PEEK showed no failure in
fatigue testing and PPSU (p < 0.001) failed against
titanium, f-
PEEK,
PEEK, and PEKK.
Titanium allowed the highest load to failure compared to f-
PEEK (p = 0.049),
PEEK (p = 0.008), PEKK (p < 0.001), and PPSU (p = 0.007). f-
PEEK,
PEEK, and PEKK withstood expected physiological
bite force. Although
titanium plates provided the highest
fatigue strength, f-
PEEK and
PEEK plates showed no failure over 250,000 chewing cycles indicating sufficient mechanical strength for mandible reconstruction.