Advertisement
Research Article| Volume 58, ISSUE 7, P848-853, September 2020

Assessment of biomechanical properties of specially-designed miniplate patterns in a mandibular subcondylar fracture model with finite element analysis and a servohydraulic testing unit

  • N. Kolsuz
    Affiliations
    Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Istanbul, Turkey
    Search for articles by this author
  • O. Atali
    Correspondence
    Corresponding author at: Marmara University Dentistry Faculty, Department of Oral and Maxillofacial Surgery, Marmara Universitesi Saglik Bilimleri Yerleskesi, Basibuyuk, Maltepe, Istanbul, Turkey. Tel.: +90 216 421 16 21, +90 532 304 36 69.
    Affiliations
    Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Istanbul, Turkey
    Search for articles by this author
  • A. Varol
    Affiliations
    Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Istanbul, Turkey
    Search for articles by this author

      Abstract

      The aim of our study was to compare the biomechanical stability of three different systems used to fix mandibular condylar fractures on synthetic polyurethane mandibles using a servohydraulic testing unit and finite element analysis (FEA). We measured the resistance to displacement loads causing 1.75 and 3.5 mm displacements of the fragments, and the maximum resistance values before failure of the fixation system in 30 condylar necks of 15 polyurethane mandible models. The three subgroups investigated were arranged as a triangular plate (n = 10), a quadrangular plate (n = 10), and a straight miniplate (n = 10). The most successful fixation pattern was achieved with two straight four-hole miniplates. However, the triangular plate can easily be applied as a second option by an endoscopic approach. The rectangular plates showed no success in mandibular condylar fractures.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to British Journal of Oral and Maxillofacial Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Rozeboom A.V.J.
        • Dubois L.
        • Bos R.R.M.
        • et al.
        Closed treatment of unilateral mandibular condyle fractures in adults: a systematic review.
        Int J Oral Maxillofac Surg. 2017; 46: 456-464
        • Sehgal S.
        • Ramanujam L.
        • Prasad K.
        • et al.
        Three-dimensional v/s standard titanium miniplate fixation in the management of mandibular fractures — a randomized clinical study.
        J Craniomaxillofac Surg. 2014; 42: 1292-1299
        • De Jesus G.P.
        • Vaz L.G.
        • Gabrielli M.F.
        • et al.
        Finite element evaluation of three methods of stable fixation of condyle base fractures.
        Int J Oral Maxillofac Surg. 2014; 43: 1251-1256
        • Atali O.
        • Varol A.
        • Basa S.
        • et al.
        Comparison and validation of finite element analysis with a servo-hydraulic testing unit for a biodegradable fixation system in a rabbit model.
        Int J Oral Maxillofac Surg. 2014; 43: 32-39
        • Korkmaz H.H.
        Evaluation of different miniplates in fixation of fractured human mandible with the finite element method.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 103: e1-13
        • Kolk A.
        • Neff A.
        Long-term results of ORIF of condylar head fractures of the mandible: a prospective 5-year follow-up study of small-fragment positional-screw osteosynthesis (SFPSO).
        J Craniomaxillofac Surg. 2015; 43: 452-461
        • Zhang B.
        • Yang M.
        • Zhou Q.
        • et al.
        Delayed open reduction and single screw internal fixation as a treatment option in cases of failed non-surgical treatment of bilateral condylar head fractures with fragmentation.
        J Craniomaxillofac Surg. 2016; 44: 1655-1661
        • Abdel-Galil K.
        • Loukota R.
        Fractures of the mandibular condyle: evidence base and current concepts of management.
        Br J Oral Maxillofac Surg. 2010; 48: 520-526
        • Wusiman P.
        • Yarbag A.
        • Wurouzi G.
        • et al.
        Three dimensional versus standard miniplate fixation in management of mandibular fractures: a systematic review and meta-analysis.
        J Craniomaxillofac Surg. 2016; 44: 1646-1654
        • Al-Moraissi E.A.
        • El-Sharkawy T.M.
        • El-Ghareeb T.I.
        • et al.
        Three-dimensional versus standard miniplate fixation in the management of mandibular angle fractures: a systematic review and meta-analysis.
        Int J Oral Maxillofac Surg. 2014; 43: 708-716
        • Barde D.H.
        • Mudhol A.
        • Ali F.M.
        • et al.
        Efficacy of 3-dimensional plates over Champys miniplates in mandibular anterior fractures.
        J Int Oral Health. 2014; 6: 20-26
        • Al-Tairi N.H.
        • Shoushan M.M.
        • Saad Khedr M.M.
        • et al.
        Comparison of three-dimensional plate versus double miniplate osteosynthesis for treatment of unfavorable mandibular angle fractures.
        Tanta Dent J. 2015; 12: 89-98
        • Kalfarentzos E.F.
        • Deligianni D.
        • Mitros G.
        • et al.
        Biomechanical evaluation of plating techniques for fixing mandibular angle fractures: the introduction of a new 3D plate approach.
        Oral Maxillofac Surg. 2009; 13: 139-144
        • Agarwal M.
        • Meena B.
        • Gupta D.K.
        • et al.
        A prospective randomized clinical Trial comparing 3D and standard miniplates in treatment of mandibular symphysis and parasymphysis fractures.
        J Maxillofac Oral Surg. 2014; 13: 79-83
        • Sadhwani B.S.
        • Anchlia S.
        Conventional 2.0 mm miniplates versus 3-D plates in mandibular fractures.
        Ann Maxillofac Surg. 2013; 3: 154-159
        • Alkan A.
        • Metin M.
        • Muğlali M.
        • et al.
        Biomechanical comparison of plating techniques for fractures of the mandibular condyle.
        Br J Oral Maxillofac Surg. 2007; 45: 145-149
        • Pilling E.
        • Eckelt U.
        • Loukota R.
        • et al.
        Comparative evaluation of ten different condylar base fracture osteosynthesis techniques.
        Br J Oral Maxillofac Surg. 2010; 48: 527-531
        • Meyer C.
        • Serhir L.
        • Boutemi P.
        Experimental evaluation of three osteosynthesis devices used for stabilizing condylar fractures of the mandible.
        J Craniomaxillofac Surg. 2006; 34: 173-181
        • Celegatti Filho T.S.
        • Rodrigues D.C.
        • Lauria A.
        • et al.
        Development plates for stable internal fixation: study of mechanical resistance in simulated fractures of the mandibular condyle.
        J Craniomaxillofac Surg. 2015; 43: 158-161
        • Hakim S.G.
        • Wolf M.
        • Wendlandt R.
        • et al.
        Comparative biomechanical study on three miniplates osteosynthesis systems for stabilisation of low condylar fractures of the mandible.
        Br J Oral Maxillofac Surg. 2014; 52: 317-322
        • Chuong C.J.
        • Borotikar B.
        • Schwartz-Dabney C.
        • et al.
        Mechanical characteristics of the mandible after bilateral sagittal split ramus osteotomy: comparing 2 different fixation techniques.
        J Oral Maxillofac Surg. 2005; 63: 68-76
        • Shyam Sundar S.
        • Nandlal B.
        • Saikrishna D.
        • et al.
        Finite element analysis: a maxillofacial surgeon’s perspective.
        J Maxillofac Oral Surg. 2012; 11: 206-211
        • Murphy M.T.
        • Haug R.H.
        • Barber J.E.
        An in vitro comparison of the mechanical characteristics of three sagittal ramus osteotomy fixation techniques.
        J Oral Maxillofac Surg. 1997; 55: 489-495
        • Oguz Y.
        • Uckan S.
        • Ozden A.U.
        • et al.
        Stability of locking and conventional 2.0-mm miniplate/screw systems after sagittal split ramus osteotomy: finite element analysis.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108: 174-177
        • Wagner A.
        • Krach W.
        • Schicho K.
        • et al.
        A 3-dimensional finite-element analysis investigating the biomechanical behavior of the mandible and plate osteosynthesis in cases of fractures of the condylar process.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 94: 678-686
        • dos Santos Jr, J.D.
        • de Rijk W.G.
        Vectorial analysis of the equilibrium of forces transmitted to TMJ and occlusal biteplane splints.
        J Oral Rehabil. 1995; 22: 301-310
        • Basciftci F.A.
        • Korkmaz H.H.
        • Işeri H.
        • et al.
        Biomechanical evaluation of mandibular midline distraction osteogenesis by using the finite element method.
        Am J Orthod Dentofacial Orthop. 2004; 125: 706-715
        • Aquilina P.
        • Chamoli U.
        • Parr W.C.
        • et al.
        Finite element analysis of three patterns of internal fixation of fractures of the mandibular condyle.
        Br J Oral Maxillofac Surg. 2013; 51: 326-331