Loss of bone in the mandible as a result from for example resection of bone tumors or trauma, can in more complex cases be reconstructed using a reconstruction plate to provide stability between the remaining mandible stumps. Different studies on reconstruction plates present a fracture rate of 2.8-9.8 %. The rate of plate fracture and plate loosening increases the need to improve the design of the reconstruction plate. A useful tool to find new designs for structures is topology optimization. Topology optimization is a mathematical based method where it is possible to define an optimization problem for a specific load case. Based on the defined problem, the solver calculates the most appropriate design to reach the final goal. The aim of this work is to investigate, describe, and discuss how new designs for reconstruction plates used for bridging large mandibular defects can be achieved by using topology optimization as a tool.