1
|
Wang YC, Wu YC, Chen RF, Cheng NC, Lee SS. Simplified Fabrication of a Lingual Splint for Management of Mandibular Fractures. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5919. [PMID: 38903138 PMCID: PMC11186805 DOI: 10.1097/gox.0000000000005919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/01/2024] [Indexed: 06/22/2024]
Abstract
Lingual splints have been used to treat mandibular fractures, particularly in cases of complicated mandibular fractures, and serve as a noninvasive adjunctive procedure for reduction and fixation. Furthermore, when used in conjunction with open reduction and internal fixation, the lingual splint provides feasible external fixation against displacing forces exerted by the robust musculature of the mandible. However, the conventional method for lingual splint fabrication is performed preoperatively, and the procedure is time-consuming. This technical note describes a simplified and efficient technique for the intraoperative manufacture of a lingual splint for mandibular fractures using a thermoplastic material, polycaprolactone. Our results demonstrated satisfactory fixation outcomes, reduced lingual splint fabrication time, and superior cost-effectiveness, offering an alternative option for adjunctive external fixation of mandibular fractures.
Collapse
Affiliation(s)
- Yu-Chi Wang
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yi-Chia Wu
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Regenerative Medicine and Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Rong-Fu Chen
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Nai-Chen Cheng
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Su-Shin Lee
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Regenerative Medicine and Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
2
|
Ay N, Yildirimturk Dogan S, Sirin Y. The biomechanical stability of miniplate osteosynthesis configurations in bilateral mandibular angle fractures. J Oral Sci 2023; 65:265-269. [PMID: 37648469 DOI: 10.2334/josnusd.23-0164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
PURPOSE The present study investigated the biomechanical stability of three miniplate osteosynthesis configurations used for internal fixation of bilateral mandibular angle fracture (BMAF). METHODS Standard fracture lines were created in 72 polyurethane mandibles and stabilized with 2.0-mm, 4-hole standard titanium miniplates and monocortical screws. The group descriptions and miniplate configurations were: 2Plates (1-1), 3Plates (1-2) and 4Plates (2-2). The mandibles were subjected to either incisal or molar loads (from both sides in the 3Plates group) up to a force of 120 N. The displacements of the constructs were recorded at each force increment of 10 N. ANOVA and Tukey's post-hoc tests were used for statistical analysis. RESULTS The 2Plates group showed higher displacement under both loading conditions (P < 0.05 for each). The same group reached displacement levels of 1 mm and 3 mm during molar loading and 1 mm, 3 mm, and 5 mm during incisal loading at lower force magnitudes relative to others (P < 0.05 for each). CONCLUSION Bone-plate constructs for BMAFs stabilized with three or four standard miniplates are more likely to provide similar resistance when subjected to incisal or molar loads, in contrast to the two-miniplate configuration, which is relatively more prone to displacement.
Collapse
Affiliation(s)
- Nida Ay
- Graduate School of Health Sciences, Department of Oral and Maxillofacial Surgery, Istanbul University
| | | | - Yigit Sirin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University
| |
Collapse
|
3
|
Tharakan M, Kumar L K S, Chandrachood M. An In vitro study of biomechanical comparison between titanium 4-hole 3D plates and titanium conventional 4-hole miniplates for internal fixation of mandibular angle fractures. J Oral Biol Craniofac Res 2022; 12:683-686. [PMID: 36071928 PMCID: PMC9441330 DOI: 10.1016/j.jobcr.2022.08.022] [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: 02/03/2022] [Revised: 08/14/2022] [Accepted: 08/20/2022] [Indexed: 11/24/2022] Open
Abstract
Background Fracture fixation, in the present times, is classically done using mini plates. The position and number of plates to fixate a mandibular angle fracture have been and are still extensively researched and reported in the literature. A more recent addition is 3D mini plates. Aim To compare and evaluate the biomechanical behavior of one 2.0 mm titanium 3D miniplate fixation plate (4- hole) and one 2.0 mm titanium 4-hole miniplate in internal fixation of mandibular angle fractures. Objective To measure load at break, maximum load, and displacement at maximal load for internal fixation done with 3D mini plates and conventional mini plates respectively. Methods Five dry cadaveric mandibles were sectioned into 10 hemi-mandibles. Each cadaveric mandible was sectioned at the angle of mandible to simulate unfavorable mandibular angle fracture. The obtained hemimandible were divided into experimental groups (GROUP 1 and GROUP 2) with 5 samples in each group, plated with a linear miniplate and 3D miniplate respectively. Maximal load, Load at break, and displacement at maximum load were the only obtained parameters for comparison. Results Conventional miniplate showed greater mean maximum load values of 174.93 N±54.45 compared to 3D mini plates which recorded a mean maximum load value of 106.96 N ± 23.86. Load at break and displacement at maximum load were found to be both insignificant. Conclusion The results in this study showed statistically no significant difference with any of the above parameters except maximal load, between the two groups evaluated. Conventional linear miniplate according to Champy's lines of osteosynthesis can be used successfully for providing satisfactory osteosynthesis with the definitive advantage of cost-effectiveness.
Collapse
Affiliation(s)
- Mathew Tharakan
- Dept of Oral and Maxillofacial Surgery, PMS College of Dental Science and Research, Kerala, India
| | - Surej Kumar L K
- Dept of Oral and Maxillofacial Surgery, PMS College of Dental Science and Research, Kerala, India
| | - Meghna Chandrachood
- Dept of Oral and Maxillofacial Surgery, PMS College of Dental Science and Research, Kerala, India
| |
Collapse
|
4
|
Mehari Abraha H, Iriarte‐Diaz J, Reid RR, Ross CF, Panagiotopoulou O. Fracture Fixation Technique and Chewing Side Impact Jaw Mechanics in Mandible Fracture Repair. JBMR Plus 2021; 6:e10559. [PMID: 35079674 PMCID: PMC8770999 DOI: 10.1002/jbm4.10559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/17/2021] [Accepted: 09/07/2021] [Indexed: 12/04/2022] Open
Abstract
Lower jaw (mandible) fractures significantly impact patient health and well‐being due to pain and difficulty eating, but the best technique for repairing the most common subtype—angle fractures—and rehabilitating mastication is unknown. Our study is the first to use realistic in silico simulation of chewing to quantify the effects of Champy and biplanar techniques of angle fracture fixation. We show that more rigid, biplanar fixation results in lower strain magnitudes in the miniplates, the bone around the screws, and in the fracture zone, and that the mandibular strain regime approximates the unfractured condition. Importantly, the strain regime in the fracture zone is affected by chewing laterality, suggesting that both fixation type and the patient's post‐fixation masticatory pattern—ipsi‐ or contralateral to the fracture— impact the bone healing environment. Our study calls for further investigation of the impact of fixation technique on chewing behavior. Research that combines in vivo and in silico approaches can link jaw mechanics to bone healing and yield more definitive recommendations for fixation, hardware, and postoperative rehabilitation to improve outcomes. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Hyab Mehari Abraha
- Monash Biomedicine Discovery Institute, Department of Anatomy and Developmental Biology Monash University Melbourne Australia
| | | | - Russell R Reid
- Department of Surgery, Section of Plastic Surgery The University of Chicago Medical Centre Chicago IL USA
| | - Callum F Ross
- Department of Organismal Biology and Anatomy University of Chicago Chicago IL USA
| | - Olga Panagiotopoulou
- Monash Biomedicine Discovery Institute, Department of Anatomy and Developmental Biology Monash University Melbourne Australia
| |
Collapse
|
5
|
Sargunam ED, Deepak C, Sivashanmugam SS, Ramakrishnan M. Dental Impression Compound for Mandibular Bilateral Parasymphysis Fracture Reduction. J Maxillofac Oral Surg 2021. [DOI: 10.1007/s12663-020-01506-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
6
|
Krennmair S, Winterhalder P, Hunger S, Rupperti S, Holberg C. The Effects of Frontal Trauma on 4 Interforaminal Dental Implants: A 3-Dimensional Finite Element Analysis Comparing Splinted and Unsplinted Implant Configurations. J Oral Maxillofac Surg 2020; 78:961-972. [PMID: 31951811 DOI: 10.1016/j.joms.2019.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/09/2019] [Accepted: 12/09/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE With increased implant-prosthodontic rehabilitation for mandibular edentulism together with the increased life expectancy and activity of the elderly population, a greater number of implant patients may be at risk of facial trauma. The aim of this 3-dimensional (3D) finite element analysis (FEA) was to evaluate the biomechanical effects of the edentulous mandible (EM) with and without implants exposed to frontal facial trauma including assessment of the fracture risk of different mandibular areas. MATERIALS AND METHODS By use of a 3D FEA, our experimental study design comprised 3 different models (model A, EM; model B, EM with 4 unsplinted interforaminal implants; and model C, EM with 4 splinted interforaminal implants) exposed to application of symphyseal frontal trauma of 2 MPa. In 3 defined regions of interest (ROIs) (ROI 1, symphyseal area; ROI 2, mental foraminal area; and ROI 3, condylar neck), the effective stress was measured at predefined sites in the superficial cortical mandibular area. The stress values of all ROIs evaluated were compared within each model (intramodel) as well as between the 3 models (intermodel). RESULTS For all models evaluated, a frontal traumatic load generated the highest stress levels in the condylar neck. However, for both models with implants (models B and C), the stress values were reduced significantly (P < .01) in the condylar neck region (ROI 3) but increased significantly (P < .001) in the mental foraminal area (ROI 2) compared with the EM model without implants. For the symphyseal area (ROI 1) evaluated, the unsplinted 4-implant model (model B) presented significantly (P < .001) higher stress values than the splinted implant model (model C) when frontal forces were applied. CONCLUSIONS Regardless of splinting or lack of splinting of 4 interforaminal implants, force absorption or transmission may shift the predominant risk factor from the condylar neck to the corpus or foramen mandibulae. However, splinting of 4 interforaminal implants may be beneficial in reducing the risk of bone fracture by providing protection for anterior risk situations.
Collapse
Affiliation(s)
- Stefan Krennmair
- Research Fellow, NumBioLab, Department of Orthodontics, Ludwig Maximilian University of Munich, Munich, Germany.
| | - Philipp Winterhalder
- Resident, Department of Oral Maxillofacial Surgery, RWTH Aachen University, Aachen, Germany
| | - Stefan Hunger
- Resident, Department of Oral Maxillofacial Surgery, Johannes Kepler University Linz, Linz, Austria
| | - Stefan Rupperti
- Research Fellow, NumBioLab, Department of Orthodontics, Ludwig Maximilian University of Munich, Munich, Germany
| | - Christof Holberg
- Professor, Head of NumBioLab, Department of Orthodontics, Ludwig Maximilian University of Munich, Munich, Germany
| |
Collapse
|
7
|
Bohluli B, Mohammadi E, Oskui IZ, Moaramnejad N. Treatment of mandibular angle fracture: Revision of the basic principles. Chin J Traumatol 2019; 22:117-119. [PMID: 31003853 PMCID: PMC6488520 DOI: 10.1016/j.cjtee.2019.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 11/15/2018] [Accepted: 11/30/2018] [Indexed: 02/04/2023] Open
Abstract
Biodynamics of mandibular angle fractures has been extensively discussed in the literature in search for the best way to fixate and expedite recovery of trauma patients. Pioneers like Michelet and Champy had the greatest impact on evolving of osteosynthesis in maxillofacial traumatology; they introduced their basic principles frequently used to describe the biomechanics of mandibular fixation. Their concept states when a physiologic load is applied on mandibular teeth a negative tension will be created at superior border and a positive pressure will appear at inferior border. These simple definitions are the basis for the advent of fixation modalities in mandibular angle fracture. This article sought to reassess these principals based on load location via finite elements method.
Collapse
Affiliation(s)
- Behnam Bohluli
- Department of Oral and Maxillofacial Surgery, University of Toronto, Canada
| | - Ebrahim Mohammadi
- Department of Oral and Maxillofacial Surgery, Babol University of Medical Science, Babol, Iran
| | - Iman zoljanah Oskui
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Nima Moaramnejad
- Department of Oral and Maxillofacial Surgery, Aydin University, Istanbul, Turkey,Corresponding author.
| |
Collapse
|
8
|
Titanium Lag Screw Versus Miniplate Fixation in the Treatment of Anterior Mandibular Fractures. J Oral Maxillofac Surg 2019; 77:1031-1039. [PMID: 30763527 DOI: 10.1016/j.joms.2019.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 01/05/2019] [Accepted: 01/05/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE The use of plates for open reduction and internal fixation of mandibular fractures has become a widely accepted method in the past 3 decades. However, the anterior mandible is well suited to lag screw fixation owing to the thickness of its bony cortices. Hence, the purpose of the present study was to comparatively evaluate clinical outcomes of fixation using lag screws and miniplates in anterior mandibular fractures. PATIENTS AND METHODS Fifty patients reporting to the department of oral and maxillofacial surgery with noncomminuted anterior mandibular fractures were randomly divided into 2 groups of 25 patients each. Patients in group A were treated with 2.5-mm lag screws 22 to 26 mm in length and those in group B were treated with 2.0-mm 4-hole miniplates with a gap using monocortical screws. Subsequent follow-up was performed at 3, 6, 12, and 24 weeks postoperatively. The primary determinants included radiographic analysis of the fracture gap and biting efficiency of the patients in groups A and B. The secondary determinants included evaluation of duration of surgery, occlusion before and after injury, and postoperative complications. Results were evaluated using χ2 and unpaired t tests. RESULTS The mean age of the patients in this study was 29.1 ± 8.32 years (range, 18 to 67 yr). The mean postoperative fracture gap was considerably larger in group B. The mean duration of surgery (minutes) was 37.60 ± 9.30 for group A and 47 ± 6.55 for group B. The difference was statistically significant (P = .001). The lag screw group showed faster improvement in biting efficiency compared with the miniplate group. CONCLUSIONS Lag screw fixation was found to have good stability and rigidity, was inexpensive, and was less time consuming in treating anterior mandibular fractures compared with miniplates.
Collapse
|
9
|
Fontana SC, Smith RB, Nazir N, Andrews BT. Biomechanical assessment of fixation methods for segmental mandible reconstruction with fibula in the polyurethane model. Microsurgery 2016; 36:330-3. [PMID: 27059150 DOI: 10.1002/micr.30052] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 02/15/2016] [Accepted: 03/17/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND A variety of plating techniques are employed by microsurgeons to provide rigid fixation for vascularized bone constructs of the mandible. The aim of this study was to biomechanically compare three commonly utilized plating techniques for rigid fixation of fibula bone flaps in reconstructing lateral segmental mandibular defects. MATERIALS AND METHODS Polyurethane mandibles with 3-cm segmental defects were reconstructed using polyurethane fibula models. Three fixation techniques were compared (n = 5 models per group): Group 1 used two 2.0-mm miniplates at each osteotomy site, Group 2 used a single 2.3-mm plate, and Group 3 used a single 2.7-mm plate. Biomechanical testing of maximum force and displacement at failure for each plating technique was assessed and statistical comparison performed. RESULTS The average displacement for Group 1 was 14.08 ± 1.42 mm, Group 2 was 5.79 ± 0.89 mm, and Group 3 was 6.03 ± 1.59 mm. Group 1 had significantly greater (P < 0.05) displacement when compared with Group 2 and 3. Analysis of variance demonstrated the three groups varied significantly in mean displacement (0 < 0.01). The average force before failure for Group 1 was 616.4 ± 33.83N, Group 2 was 737.8 ± 72.57N, and Group 3 was 681.0 ± 67.98N. Group 2 withstood significantly greater force than Group 1 (P < 0.05), and withstood greater force than Group 3, although the difference was not significant. Analysis of variance showed the three groups varied significantly in mean force at failure (P < 0.05). CONCLUSION Reconstruction using a single 2.3-mm plate provided the best rigid fixation for lateral segmental defects of the mandible. © 2016 Wiley Periodicals, Inc. Microsurgery 36:330-333, 2016.
Collapse
Affiliation(s)
- Stefani C Fontana
- Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, KS
| | - Russell B Smith
- Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center, Omaha, NE
| | - Niaman Nazir
- Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, KS
| | - Brian T Andrews
- Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, KS
| |
Collapse
|
10
|
Thor A. Preoperative Planning of Virtual Osteotomies Followed by Fabrication of Patient Specific Reconstruction Plate for Secondary Correction and Fixation of Displaced Bilateral Mandibular Body Fracture. Craniomaxillofac Trauma Reconstr 2016; 9:188-94. [PMID: 27162581 DOI: 10.1055/s-0036-1572492] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
This paper describes the course of treatment of a severely diplaced bilateral mandibular body fracture, where the first osteosynthesis failed. The subject developed an open bite due to a posterior rotation of the distal part of the mandible and anterior rotation of the proximal parts of the mandible. This situation was evaluated with CBCT and the facial skeleton was segmented using computer software. Correct occlusion was virtually established by bilateral virtual osteotomies in the fracture areas of the mandible. After segmentation, the mandible was virtually rotated back into position and the open bite was closed. A patient specific mandibular reconstruction plate was outlined and fabricated from the new virtual situation and the plate was thereafter installed utilizing the preoperative plan. Osteotomy- and drill-guides was used and thus simplified the surgery resulting in uneventful healing. Virtual planning and patient specific implants and guides were valuable in this case of secondary reconstructive trauma surgery.
Collapse
Affiliation(s)
- Andreas Thor
- Department for Surgical Sciences, Plastic and Oral & Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
| |
Collapse
|
11
|
Santos LSDM, Rossi AC, Freire AR, Matoso RI, Caria PHF, Prado FB. Finite-element analysis of 3 situations of trauma in the human edentulous mandible. J Oral Maxillofac Surg 2014; 73:683-91. [PMID: 25577458 DOI: 10.1016/j.joms.2014.10.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 10/02/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Maxillofacial trauma resulting from falls in elderly patients is a major social and health care concern. Most of these traumatic events involve mandibular fractures. The aim of this study was to analyze stress distributions from traumatic loads applied on the symphyseal, parasymphyseal, and mandibular body regions in the elderly edentulous mandible using finite-element analysis (FEA). MATERIALS AND METHODS Computerized tomographic analysis of an edentulous macerated human mandible of a patient approximately 65 years old was performed. The bone structure was converted into a 3-dimensional stereolithographic model, which was used to construct the computer-aided design (CAD) geometry for FEA. The mechanical properties of cortical and cancellous bone were characterized as isotropic and elastic structures, respectively, in the CAD model. The condyles were constrained to prevent free movement in the x-, y-, and z-axes during simulation. This enabled the simulation to include the presence of masticatory muscles during trauma. Three different simulations were performed. Loads of 700 N were applied perpendicular to the surface of the cortical bone in the symphyseal, parasymphyseal, and mandibular body regions. The simulation results were evaluated according to equivalent von Mises stress distributions. RESULTS Traumatic load at the symphyseal region generated low stress levels in the mental region and high stress levels in the mandibular neck. Traumatic load at the parasymphyseal region concentrated the resulting stress close to the mental foramen. Traumatic load in the mandibular body generated extensive stress in the mandibular body, angle, and ramus. CONCLUSIONS FEA enabled precise mapping of the stress distribution in a human elderly edentulous mandible (neck and mandibular angle) in response to 3 different traumatic load conditions. This knowledge can help guide emergency responders as they evaluate patients after a traumatic event.
Collapse
Affiliation(s)
| | - Ana Cláudia Rossi
- Professor, Department of Morphology, Anatomy Area, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil.
| | - Alexandre Rodrigues Freire
- PhD Student, Department of Morphology, Anatomy Area, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Rodrigo Ivo Matoso
- PhD Student, Department of Morphology, Anatomy Area, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Paulo Henrique Ferreira Caria
- Associate Professor, Department of Morphology, Anatomy Area, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Felippe Bevilacqua Prado
- Professor, Department of Morphology, Anatomy Area, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| |
Collapse
|
12
|
Bujtár P, Simonovics J, Váradi K, Sándor GK, Avery C. The biomechanical aspects of reconstruction for segmental defects of the mandible: A finite element study to assess the optimisation of plate and screw factors. J Craniomaxillofac Surg 2014; 42:855-62. [DOI: 10.1016/j.jcms.2013.12.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 11/09/2013] [Accepted: 12/13/2013] [Indexed: 10/25/2022] Open
|
13
|
Superior border versus inferior border fixation in displaced mandibular angle fractures: prospective randomized comparative study. Int J Oral Maxillofac Surg 2014; 43:834-40. [DOI: 10.1016/j.ijom.2013.09.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 08/01/2013] [Accepted: 09/18/2013] [Indexed: 11/18/2022]
|
14
|
Trivellato P, Pepato A, Ribeiro M, Sverzut C, Trivellato A. In vitro evaluation of the resistance of a 2.0-mm titanium fixation system in the sectioned angle without continuity of the inferior border of the mandible. Int J Oral Maxillofac Surg 2014; 43:559-63. [DOI: 10.1016/j.ijom.2013.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 10/01/2013] [Accepted: 10/03/2013] [Indexed: 11/17/2022]
|
15
|
de Oliveira KP, de Moraes PH, da Silva JSP, de Queiroz WF, Germano AR. In vitro mechanical assessment of 2.0-mm system three-dimensional miniplates in anterior mandibular fractures. Int J Oral Maxillofac Surg 2013; 43:564-71. [PMID: 24239141 DOI: 10.1016/j.ijom.2013.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 10/04/2013] [Accepted: 10/08/2013] [Indexed: 11/29/2022]
Abstract
This study constituted a comparative assessment of the mechanical resistance of square and rectangular 2.0-mm system three-dimensional miniplates as compared to the standard configuration using two straight miniplates. 90 polyurethane replica mandibles were used for the mechanical trials. Groups 1, 2, and 3 simulated complete symphyseal fractures characterized by linear separation of the central incisors; groups 4, 5, and 6 simulated parasymphyseal fractures with an oblique configuration. Groups 1 and 4 represented the standard method with two straight miniplates set parallel to one another. Square miniplates were used in groups 2 and 5, and rectangular miniplates in groups 3 and 6. A universal testing machine set to a velocity of 10mm/min and delivering a vertical linear load to the first left molar was used to test each group. Maximum load values and load values with pre-established dislocation of 5mm were obtained and submitted to statistical analysis using a calculated reliability interval of 95%. The mechanical performances of the devices were similar, except in the case of rectangular plates used in the parasymphyseal fractures. The innovative fixation methods used showed significantly better results in the case of symphyseal fractures.
Collapse
Affiliation(s)
- K P de Oliveira
- Department of Oral and Maxillofacial Surgery, Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
| | - P H de Moraes
- Department of Oral and Maxillofacial Surgery, Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - J S P da Silva
- Department of Oral and Maxillofacial Surgery, Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - W F de Queiroz
- Department of Oral and Maxillofacial Surgery, Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - A R Germano
- Department of Oral and Maxillofacial Surgery, Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
| |
Collapse
|
16
|
Braasch DC, Abubaker AO. Management of Mandibular Angle Fracture. Oral Maxillofac Surg Clin North Am 2013; 25:591-600. [DOI: 10.1016/j.coms.2013.07.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
17
|
Lee T, Sawhney R, Ducic Y. Miniplate Fixation of Fractures of the Symphyseal and Parasymphyseal Regions of the Mandible. JAMA FACIAL PLAST SU 2013; 15:121-5. [DOI: 10.1001/jamafacial.2013.307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Thomas Lee
- Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas (Drs Lee, Sawhney, and Ducic), and Departments of Otolaryngology–Head and Neck Surgery, University of Florida, Gainesville (Dr Sawhney), and University of Texas Southwestern Medical Center, Dallas (Dr Ducic)
| | - Raja Sawhney
- Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas (Drs Lee, Sawhney, and Ducic), and Departments of Otolaryngology–Head and Neck Surgery, University of Florida, Gainesville (Dr Sawhney), and University of Texas Southwestern Medical Center, Dallas (Dr Ducic)
| | - Yadranko Ducic
- Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas (Drs Lee, Sawhney, and Ducic), and Departments of Otolaryngology–Head and Neck Surgery, University of Florida, Gainesville (Dr Sawhney), and University of Texas Southwestern Medical Center, Dallas (Dr Ducic)
| |
Collapse
|
18
|
|
19
|
Finite Element Analysis: A Maxillofacial Surgeon's Perspective. J Maxillofac Oral Surg 2011; 11:206-11. [PMID: 23730071 DOI: 10.1007/s12663-011-0319-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 11/17/2011] [Indexed: 10/14/2022] Open
Abstract
The science of finite element analysis (FEA) is purely a mathematical way of solving complex problems in the universe. In medical field, this is an innovation in biomedical research and development, as it gives easier mathematical solution to biological problems. This article deals with the understanding of various basic material properties of bone like Young's modulus, yield strength, Bulk modulus, shear modulus, Poisson's ratio and density from a maxillofacial surgeon's perspective. Basic concepts in FEA, its application, advantages, disadvantages, and limitations in the field of maxillofacial surgery have been discussed. The importance of surgical fraternity to be in coordination with evolving technologies has been emphasized for the future of evidence based practice of oral and maxillofacial surgery.
Collapse
|
20
|
Gilardino MS, Chen E, Bartlett SP. Choice of internal rigid fixation materials in the treatment of facial fractures. Craniomaxillofac Trauma Reconstr 2011; 2:49-60. [PMID: 22110797 DOI: 10.1055/s-0029-1202591] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
21
|
Ji B, Wang C, Song F, Chen M, Wang H. A new biomechanical model for evaluation of fixation systems of maxillofacial fractures. J Craniomaxillofac Surg 2011; 40:405-8. [PMID: 21865052 DOI: 10.1016/j.jcms.2011.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 07/16/2011] [Accepted: 07/23/2011] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to develop a new type of biomechanical model for biomechanical researches of maxillofacial fractures and then evaluate it. Twenty synthetic polyurethane maxillary and mandibular models were used to simulate the mandible and maxilla. Springs were used to represent the forces of masseter, medial pterygoid, temporalis, and lateral pterygoid muscles acting on the models. Four masticatory conditions, namely clenching in the intercuspal position (ICP), incisal clenching (INC), left unilateral molar clenching (L-MOL, contralateral side of fracture) and right unilateral molar clenching (R-MOL, fracture side) were simulated. The strain on a miniplates placed across a simulated fracture was measured using strain gauges attached to the plate surface. During INC and L-MOL, the strain on the miniplates confirmed the findings of Champy. The upper miniplate was subjected to tension force and the lower miniplate to compression. When the bite point moved to the fracture, the tension-compression zone reversed, with the upper miniplate relatively compressed and the lower miniplate tension. During ICP, the tension-compression zone changed again, with both miniplates tension. In conclusion, we have successfully developed a model which is much closer to physiological conditions than models used previously. It is reliable and useful for biomechanical tests of mandibular fractures. Models including soft tissue need developing to further understand fracture healing biomechanics.
Collapse
Affiliation(s)
- Baohui Ji
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University, Chengdu 610041, China
| | | | | | | | | |
Collapse
|
22
|
|
23
|
|