1
|
Telha W, Chen H, Al-Watary MQ, Sakran K, Wang Q, Zhu S, Jiang N. Comparison of the biomechanical behavior between commercial and 3D-printed patient-specific Ti6Al4V L-Shaped titanium plates following le fort i osteotomy using finite element analysis: A technical Note. Med Eng Phys 2024; 129:104176. [PMID: 38906569 DOI: 10.1016/j.medengphy.2024.104176] [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: 08/08/2023] [Revised: 04/25/2024] [Accepted: 05/06/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVE To evaluate and compare the biomechanical behavior of three-dimensionally (3D) printed patient-specific Ti6Al4V with commercially made titanium mini plates following Lefort-I osteotomy using finite element analysis. METHODS Le Fort I osteotomy was virtually simulated with a 5 mm maxillary advancement and mediolateral rotation in the coronal plane, resulting in a 3 mm gap on the left side's posterior. Two fixation methods were modeled using software to compare 3D-printed Ti6Al4V and commercial titanium mini plates, both featuring a 4-hole l-shape with thicknesses of 0.5 mm and 0.7 mm at the strategic piriform rim and zygomaticomaxillary buttress locations. Using ANSYS R19.2, finite element models were developed to assess the fixation plates and maxilla's stress, strain, and displacement responses under occlusal forces of 125, 250, and 500 N/mm². RESULTS This comparative analysis revealed slight variation in stress, strain, and displacement between the two models under varying loading conditions. Stress analysis indicated maximum stress concentrations at the vertical change in the left posterior area between maxillary segments, with the Ti6Al4V model exhibiting slightly higher stress values (187 MPa, 375 MPa, and 750 MPa) compared to the commercial titanium model (175 MPa, 351 MPa, and 702 MPa). Strain analysis showed that the commercial titanium model recorded higher strain values at the bending area of the l-shaped miniplate. Moreover, displacement analysis revealed a maximum of 3 mm in the left posterior maxilla, with the Ti6Al4V model demonstrating slightly lower displacement values under equivalent forces. CONCLUSION The maximum stress, strain, and segment displacement of both fixation models were predominantly concentrated in the area of the gap between the maxillary segments. Notably, both fixation models exhibited remarkably close values, which can be attributed to the similar design of the fixation plates.
Collapse
Affiliation(s)
- Wael Telha
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Haozhe Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Mohammed Qasem Al-Watary
- Oral and Maxillofacial Surgery Center, Guangdong Hanfei Plastic Surgery Hospital, Guangzhou City, Guangdong, China
| | - Karim Sakran
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Qi Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| |
Collapse
|
2
|
Ueki K, Gomi K, Takekawa T, Ono S, Takayama A, Yoshizawa K, Moroi A. Maxillary bone healing and CT value after Le Fort I osteotomy using absorbable plate system: A retrospective study. J Craniomaxillofac Surg 2024; 52:727-732. [PMID: 38582674 DOI: 10.1016/j.jcms.2024.03.024] [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: 10/12/2023] [Revised: 01/04/2024] [Accepted: 03/12/2024] [Indexed: 04/08/2024] Open
Abstract
This study aimed to evaluate maxillary bone healing and computed tomography (CT) values after Le Fort I osteotomy with sagittal split ramus osteotomy in patients with class II and III malocclusion. Four absorbable plates and screws were used to fix the maxillary segments in all patients. For 112 sides (58 patients), the bone defect areas at the anterior and posterior sites between the maxillary segments were measured using 3-dimensional CT views reconstructed over a constant CT value at 1 week and 1 year postoperatively. Subsequently, CT values at the upper, middle, and lower sites around the osteotomy line in the medial, middle, and lateral regions were measured. The bone defect area after 1 year increased at the anterior site in class III and at both the anterior and posterior sites in class II (P < 0.05). This study suggests that the increase in bone defect area was affected by lower CT values at the middle site of the middle and lateral regions in class II, and that bony defects between fragments in the maxilla could partially remain in both classes II and III within 1 year after Le Fort I osteotomy.
Collapse
Affiliation(s)
- Koichiro Ueki
- Department of Oral and Maxillofacial Surgery (Head: Prof. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
| | - Karen Gomi
- Department of Oral and Maxillofacial Surgery (Head: Prof. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Takahiro Takekawa
- Department of Oral and Maxillofacial Surgery (Head: Prof. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Sumire Ono
- Department of Oral and Maxillofacial Surgery (Head: Prof. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Akihiro Takayama
- Department of Oral and Maxillofacial Surgery (Head: Prof. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Kunio Yoshizawa
- Department of Oral and Maxillofacial Surgery (Head: Prof. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Akinori Moroi
- Department of Oral and Maxillofacial Surgery (Head: Prof. K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| |
Collapse
|
3
|
Mechanical Comparison of Four Different Types of Osteosynthesis in a 11-mm Advancement Le Fort I Osteotomy. J Craniofac Surg 2022; 33:1255-1259. [DOI: 10.1097/scs.0000000000008110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
4
|
Tomographic analysis of nasomaxillary and zygomaticomaxillary buttress bone thickness for the fixation of miniplates. Int J Oral Maxillofac Surg 2020; 50:1034-1039. [PMID: 33280988 DOI: 10.1016/j.ijom.2020.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/11/2020] [Accepted: 11/05/2020] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to evaluate the bone thickness of the nasomaxillary and zygomaticomaxillary buttresses to identify the most favourable region for the installation of miniplates. Bilateral tomographic images of 103 individuals were evaluated, for a total of 206 nasomaxillary and zygomaticomaxillary buttresses. Measurements of bone thickness were performed in the parasagittal reconstructions along three vertical lines on the nasomaxillary buttress (21 measurement points) and four vertical lines on the zygomaticomaxillary buttress (28 measurement points). The vertical line measurements for each buttress were compared using the Kruskal-Wallis test. Spearman's correlation coefficient was used to determine the correlation between the thicknesses obtained and patient sex and side (right/left). The level of significance adopted was 5%. The nasomaxillary and zygomaticomaxillary buttresses presented statistical differences in thickness at their respective points (P=0.001). The analysis of the nasomaxillary buttress showed that the thicker bone for the installation of miniplates follows the long axis of the upper canine at a distance of 3mm from the root apex. For the zygomaticomaxillary buttress, thicker bone to install miniplates was found distal to the distobuccal root of the first molar, at a distance of 3.5mm from the limit of the infraorbital foramen.
Collapse
|
5
|
Ueki K, Yoshizawa K, Moroi A. Bone healing after Le Fort I osteotomy with SSRO, using uHA/PLLA plates and screws, in class II and III patients. J Craniomaxillofac Surg 2019; 47:1338-1342. [PMID: 31337568 DOI: 10.1016/j.jcms.2019.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 06/10/2019] [Accepted: 06/19/2019] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The purpose of this study was to compare bone healing after Le Fort I osteotomy with sagittal split ramus osteotomy (SSRO) in class II and class III patients. PATIENTS AND METHODS The subjects consisted of 46 Japanese class II and III patients. Le Fort I osteotomy was performed in combination with SSRO. They were divided into two groups (23 class II cases and 23 class III cases). Four absorbable plates (uncalcined and unsintered hydroxyapatite and poly-l-lactic acid - uHA/PLLA) and screws were used to fix the maxillary segment in all patients, in the same manner. Postoperative computed tomography (CT) was analyzed for all patients at 1 week and 1 year postoperatively. The anterior and lateral areas between the maxillary segments were measured using two-dimensional frontal and lateral views from the three-dimensional images reconstructed over a constant CT value. RESULTS There were no significant differences in the area of bone defect healing between classes II and III at 1 year postoperatively, although there were significant differences between the two groups at 1 week postoperatively (p < 0.05). Furthermore, there were no significant differences in the areas of bone defect between 1 week and 1 year postoperatively, in both groups. CONCLUSION Using measurements based on CT value threshold within 1 year after Le Fort I osteotomy, this study suggests that the areas of bony defect in the region of the anterior and lateral walls of the maxilla do not always decrease in both classes II and III.
Collapse
Affiliation(s)
- Koichiro Ueki
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
| | - Kunio Yoshizawa
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Akinori Moroi
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr K Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| |
Collapse
|
6
|
Pimenta de Melo L, Contessi Negrini N, Farè S, de Mello Roesler CR, de Mello Gindri I, Salmoria GV. Thermomechanical and in vitro biological characterization of injection-molded PLGA craniofacial plates. J Appl Biomater Funct Mater 2019; 17:2280800019831599. [PMID: 30841778 DOI: 10.1177/2280800019831599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE: To evaluate the thermomechanical and in vitro biological response of poly(lactic-co-glycolic acid) (PLGA) plates for craniofacial reconstructive surgery. METHODS: PLGA 85/15 craniofacial plates were produced by injection molding by testing two different temperatures (i.e., 240°C, PLGA_lowT, and 280°C, PLGA_highT). The mechanical properties of the produced plates were characterized by three-point bending tests, dynamic mechanical analysis, and residual stress. Crystallinity and thermal transitions were investigated by differential scanning calorimetry. Finally, in vitro cell interaction was evaluated by using SAOS-2 as cell model. Indirect cytotoxicity tests (ISO 10-993) were performed to prove the absence of cytotoxic release. Cells were then directly seeded on the plates and their viability, morphology, and functionality (ALP) checked up to 21 days of culture. RESULTS: A similar performance of PLGA_lowT and PLGA_highT plates was verified in the three-point bending test and dynamic mechanical analyses. Also, the two processing temperatures did not influence the in vitro cell interaction. Cytotoxicity and ALP activity were similar for the PLGA plates and control. Cell results demonstrated that the PLGA plates supported cell attachment and proliferation. Furthermore, energy-dispersive X-ray spectroscopy revealed the presence of sub-micron particles, which were identified as inorganic mineral deposits resulting from osteoblast activity. CONCLUSION: The present work demonstrated that the selected processing temperatures did not affect the material performance. PLGA plates showed good mechanical properties for application in craniofacial reconstructive surgery and adequate biological properties.
Collapse
Affiliation(s)
- Liliane Pimenta de Melo
- 1 Biomechanics Engineering Laboratory, University Hospital (HU), Federal University of Santa Catarina, Florianópolis, SC, Brazil.,2 NIMMA Laboratory, Department of Mechanical Engineering, Federal University of Santa Catarina, Florianópolis, SC, Brazil.,3 Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Italy
| | - Nicola Contessi Negrini
- 3 Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Italy.,4 INSTM, Consorzio Nazionale di Scienza e Tecnologia dei Materiali, Milan, Italy
| | - Silvia Farè
- 3 Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Italy.,4 INSTM, Consorzio Nazionale di Scienza e Tecnologia dei Materiali, Milan, Italy
| | - Carlos Rodrigo de Mello Roesler
- 1 Biomechanics Engineering Laboratory, University Hospital (HU), Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Izabelle de Mello Gindri
- 1 Biomechanics Engineering Laboratory, University Hospital (HU), Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Gean Vitor Salmoria
- 1 Biomechanics Engineering Laboratory, University Hospital (HU), Federal University of Santa Catarina, Florianópolis, SC, Brazil.,2 NIMMA Laboratory, Department of Mechanical Engineering, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| |
Collapse
|
7
|
Ramos V, Pinto L, Basting R. Force and deformation stresses in customized and non-customized plates during simulation of advancement genioplasty. J Craniomaxillofac Surg 2017; 45:1820-1827. [DOI: 10.1016/j.jcms.2017.08.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 07/16/2017] [Accepted: 08/21/2017] [Indexed: 11/16/2022] Open
|
8
|
Finite-Element Analysis of a New Designed Miniplate which is Used via Intraoral Approach to the Mandible Angle Fracture: Comparison of the Different Fixation Techniques. J Craniofac Surg 2016; 26:e445-8. [PMID: 26091053 DOI: 10.1097/scs.0000000000001890] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The mandible is the largest facial bone as well as the most commonly fractured bone in the maxillofacial region. Despite numerous studies conducted to identify optimal treatment modalities and plates configurations for intraoral and transoral approaches, no definitive conclusion has been reached. This study used finite element analysis (FEA) to assess 4 scenarios for treatment of an angle fracture (6-hole noncompression miniplate; 6-hole single plate/Champy's technique, 3D strut plate; 2 parallel 4-hole noncompression miniplates). Analysis included segmental displacement and Von Mises Stress evaluations of a 3D reconstruction of a human mandible. Von Mises Stress values for plates did not vary significantly among treatment groups. Moreover, no significant differences were observed in cumulative displacement of segments subjected to vertical and horizontal loads, with all treatment configurations demonstrating clinical acceptability.
Collapse
|
9
|
Evaluation of prebent miniplates in fixation of Le Fort I advancement osteotomy with the finite element method. J Craniomaxillofac Surg 2015; 43:1505-10. [DOI: 10.1016/j.jcms.2015.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 06/23/2015] [Accepted: 07/07/2015] [Indexed: 11/19/2022] Open
|
10
|
Faller G, dos Santos LA, Marques D, Collares MV. Development and testing of an absorbable spring for cranial expansion in rabbits. J Craniomaxillofac Surg 2015; 43:1269-76. [DOI: 10.1016/j.jcms.2015.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 05/06/2015] [Accepted: 06/08/2015] [Indexed: 11/29/2022] Open
|
11
|
Wu W, Zhou J, Xu CT, Zhang J, Jin YJ, Sun GL. Biomechanical evaluation of maxillary Lefort Ι fracture with bioabsorbable osteosynthesis internal fixation. Dent Traumatol 2014; 30:447-54. [PMID: 25146129 DOI: 10.1111/edt.12120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Wei Wu
- Department of stomatology; Tianjin medical university general hospital; Tianjin China
| | - Jiang Zhou
- Department of stomatology; Tianjin medical university general hospital; Tianjin China
| | - Chong-Tao Xu
- Department of stomatology; Tianjin medical university general hospital; Tianjin China
| | - Jie Zhang
- Department of stomatology; Tianjin medical university general hospital; Tianjin China
| | - Yan-Jiao Jin
- Department of stomatology; Tianjin medical university general hospital; Tianjin China
| | - Geng-Lin Sun
- Department of stomatology; Tianjin medical university general hospital; Tianjin China
| |
Collapse
|
12
|
Dreher ML, Nagaraja S, Bui H, Hong D. Characterization of load dependent creep behavior in medically relevant absorbable polymers. J Mech Behav Biomed Mater 2014; 29:470-9. [DOI: 10.1016/j.jmbbm.2013.10.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 09/30/2013] [Accepted: 10/07/2013] [Indexed: 10/26/2022]
|
13
|
Analysis of Stress Distribution on Fixation of Bilateral Sagittal Split Ramus Osteotomy With Resorbable Plates and Screws Using the Finite-Element Method. J Oral Maxillofac Surg 2012; 70:1434-8. [DOI: 10.1016/j.joms.2011.05.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 05/23/2011] [Accepted: 05/23/2011] [Indexed: 11/18/2022]
|
14
|
Tatum SA. Retrospective Review of Resorbable Plate Fixation in Pediatric
Craniofacial Surgery. ACTA ACUST UNITED AC 2012. [DOI: 10.1001/archfaci.2011.1280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|