The aim of this study was used a weighted topology optimization method to design a patient-specific mandibular implant for reconstruction and restoration of appearance in patients with severe mandibular defects. A finite element (FE) model was constructed and the defect region was defined from the unilateral first premolar to the second molar. The reconstruction implant included main body, fixation wing and dental prosthesis. Standard topology optimization was performed using stress constraint to identify optimal fixation wing structure (denoted as WOS) with solid core main body. Two independent optimal main body with internal beam supporting structures defined as WOSA and WOSO optimized from the WOS model under axial and oblique conditions were then obtained, respectively. Final optimal model (WBOS) was generated using a weighted topology optimization that considered 60% and 40% contributions of WOSA and WOSO models, respectively. The WBOS model was fabricated using metal 3D printing and fixed on the resting acrylonitrile butadiene styrene (ABS) bone to perform fracture testing. Stress concentration were found in the upper area connected to the main body of the mesial wing and corresponding maximum values under axial/oblique loads were reduced from 778/925 MPa of the WOS model to 764/720 MPa of the WBOS model. The reduction in percentage variations of weight between original (91.1 g) and final optimal (24.5 g) models was 73.14% for fabricated 3D printing models. The WBOS model also exhibited a higher resistant force (2163 N) when compared with the original model (1678 N). This study developed a design strategy with weighted topology optimization and fabrication for producing patient-specific implants using metal 3D printing. The obtained reconstruction implant can provide good biomechanical performance and recovery of appearance for oral rehabilitation.

这项研究的目的是使用加权拓扑优化方法来设计针对特定患者的下颌植入物，以重建和恢复下颌严重缺损患者的外观。构造了一个有限元（FE）模型，并从单侧第一个前磨牙到第二个磨牙定义了缺陷区域。重建植入物包括主体，固定翼和假牙。使用应力约束进行标准拓扑优化，以识别具有坚固核心主体的最佳固定翼结构（表示为WOS）。然后分别获得了两个独立的最优主体，其内部梁支撑结构分别为WOSA模型和WOSO模型，分别在轴向和倾斜条件下进行了优化。使用加权拓扑优化生成最终的最佳模型（WBOS），加权优化分别考虑了WOSA和WOSO模型的60％和40％的贡献。WBOS模型是使用金属3D打印制成的，并固定在静止的丙烯腈丁二烯苯乙烯（ABS）骨头上以进行断裂测试。在与中翼机体主体相连的上部区域发现了应力集中，轴向/斜向载荷下的相应最大值从WOS模型的778/925 MPa降低到WBOS模型的764/720 MPa。对于制造的3D打印模型，原始模型（91.1 g）和最终最佳模型（24.5 g）之间的重量百分比变化减少了73.14％。与原始模型（1678 N）相比，WBOS模型还表现出更高的抵抗力（2163 N）。这项研究开发了一种具有加权拓扑优化和制造的设计策略，用于使用金属3D打印生产特定于患者的植入物。所获得的重建植入物可提供良好的生物力学性能并恢复口腔修复的外观。