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Li J, Xu CT, Li Y, Liang Y, Wu W, Li CY. Biomechanical evaluation of various rigid internal fixation modalities for condylar-base-associated multiple mandibular fractures: A finite element analysis. Med Biol Eng Comput 2024:10.1007/s11517-024-03102-2. [PMID: 38698188 DOI: 10.1007/s11517-024-03102-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/17/2024] [Indexed: 05/05/2024]
Abstract
Condylar-base-associated multiple mandibular fractures are more prevalent than single ones. Direct trauma to mandibular symphysis, body or angle are prone to induce indirect condylar fracture. However, little is known about the effects of various rigid internal fixation modalities in condylar base for relevant multiple mandibular fractures, especially when we are confused in the selection of operative approach. Within the finite element analysis, straight-titanium-plate implanting positions in condylar base contained posterolateral zone (I), anterolateral zone (II), and intermediate zone (III). Von Mises stress (SS) in devices and bone and mandibular displacement (DT) were solved, while maximum values (SSmax and DTmax) were documented. For rigid internal fixation in condylar-base-and-symphysis fractures, I + II modality exhibited least SSmax in screws and cortical bone and least DTmax, I + III modality exhibited least SSmax in plates. For rigid internal fixation in condylar-base-and-contralateral-body fractures, I + III modality exhibited least SSmax in screws and cortical bone, I + II modality exhibited least SSmax in plates and least DTmax. For rigid internal fixation in condylar-base-and-contralateral-angle fractures, I + III modality exhibited least DTmax. The findings suggest that either I + II or I + III modality is a valid guaranty for rigid internal fixation of condylar base fractures concomitant with symphysis, contralateral body or angle fractures.
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Affiliation(s)
- Jie Li
- School of Dentistry, Stomatological Hospital, Tianjin Medical University, No. 12, Qixiangtai Road, Heping District, Tianjin, 300070, China
- Department of Stomatology, General Hospital, Tianjin Medical University, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Chong-Tao Xu
- Department of Stomatology, General Hospital, Tianjin Medical University, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Ying Li
- School of Dentistry, Stomatological Hospital, Tianjin Medical University, No. 12, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yuan Liang
- Department of Stomatology, General Hospital, Tianjin Medical University, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Wei Wu
- Department of Stomatology, General Hospital, Tianjin Medical University, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Chang-Yi Li
- School of Dentistry, Stomatological Hospital, Tianjin Medical University, No. 12, Qixiangtai Road, Heping District, Tianjin, 300070, China.
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Gupta A, Dutta A, Dutta K, Mukherjee K. Biomechanical influence of plate configurations on mandible subcondylar fracture fixation: a finite element study. Med Biol Eng Comput 2023; 61:2581-2591. [PMID: 37233860 DOI: 10.1007/s11517-023-02854-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023]
Abstract
Mandible subcondylar fractures have very high complication rate, yet there is no consensus on suitable plate design for optimal patient outcomes. Our study is aimed at comparing single mini, trapezoid, lambda, strut and double mini plates. A finite-element (FE) model of intact mandible was developed based on healthy CT-scan data, which was further virtually osteotomized and fixated with plates. The cortical and cancellous bones were assigned region-specific orthotropic and heterogenous isotropic material properties respectively. The models were subjected to six load cases representing the mastication cycle. Under opposite lateralities, the tensile and compressive mandibular strain distributions were found as the opposite, with tensile strains at the posterior border under ipsilateral molar clenching (RMOL) resulting in lesser mandibular strain in reconstructed mandible with single mini plate under RMOL but highest mandibular strain under the contralateral molar clenching (LMOL). Owing to the reduced mandibular strains under LMOL than RMOL, the contralateral chewing is preferred during the immediate post-surgery period for patients. Under LMOL, the peak von Mises stresses in the plate decreased with increase in the number of screws. Furthermore, the presence of two arms in double mini and trapezoid plates seems beneficial to neutralise the tensile and compressive strains across load cases.
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Affiliation(s)
- Anoushka Gupta
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India
| | - Abir Dutta
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India
- Department of Ortho and MSK Science, University College London, London, UK
| | - Kaushik Dutta
- Department of Oral Medicine and Radiology, Guru Nanak Institute of Dental Sciences and Research, Kolkata, India
| | - Kaushik Mukherjee
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India.
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Li J, Jiao J, Luo T, Wu W. Biomechanical evaluation of various internal fixation patterns for unilateral mandibular condylar base fractures: A three-dimensional finite element analysis. J Mech Behav Biomed Mater 2022; 133:105354. [DOI: 10.1016/j.jmbbm.2022.105354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/24/2022] [Accepted: 06/29/2022] [Indexed: 10/17/2022]
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