Assessment of sagittal split ramus osteotomy rigid internal fixation techniques using a finite element method

Albougha, Safieh; Darwich, Khaldoun; Darwich, Ayham; Albogha, Mhd Hassan

doi:10.1016/j.ijom.2015.02.006

Cited by 28 publications

(22 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The present study has shown the comparison of biomechanical properties in 3 fixation techniques when various forces and different mandibular movements are applied. The results of this study support the findings of previous FEA studies by showing that the 2.0 mm bi-cortical screws are more rigid than miniplate fixations [6] [7] [21]. These studies however, have not made biomechanical comparisons of fixation techniques at various mandible movements.…”

Section: Discussionsupporting

confidence: 85%

A Finite Element Analysis Study Comparing 3 Internal Fixation Techniques in Mandibular Sagittal Split Osteotomy

Hassan¹,

Ring²,

Stassen³

2018

IJOHNS

View full text Add to dashboard Cite

Purpose: To analyse, and compare using finite element analysis, the biomechanical properties of the 1.7 mm miniplate fixation against 2 conventional fixation techniques (2.0 mm bi-cortical screws and 2.0 mm miniplate) used in the mandibular sagittal split osteotomy. Methods: A 3-D virtual mandible model was constructed using images from CT scan. Sagittal split osteotomy was carried out virtually, and the fixation techniques were applied onto the model. 9 virtual models consisted of the 3 fixation techniques with mandibular movements of 3 mm setback, 3 mm advancement and 7 mm advancement were developed. Bite forces of 50, 75 and 100 N were applied for incisor bite simulation and 100, 200 and 300 N for molar biting force. Finite element analysis was carried out in Solidworks, and readings of stresses and displacement were recorded. Wilcoxon rank sum test was applied and P-value of 0.05 was set for statistical analysis. Results: In this manuscript the authors have compared 3 internal fixation techniques in mandibular sagittal split osteotomy. There was a statistically significant difference for both stress and displacement readings between the 1.7 mm miniplate, the 2.0 mm bi-cortical screws and the 2.0 mm miniplate for all mandibular movements. For the 1.7 mm miniplate vs 2.0 mm bi-cortical screws, the stress reading was (P = 3.063e−08, W = 314), and for displacement was (P = 5.811e−05, W = 282). For the 1.7 mm miniplate vs 2.0 mm miniplate, the stress reading was (P = 9.862e−4, W = 263) and for displacement was (2.05e−2, W = 235). Conclusion: The 1.7 mm miniplate has adequate strength to be used in mandibular sagittal split osteotomy, although statistically less rigid when compared to the conventional 2.0 mm miniplate and 2.0 mm bi-cortical screws, especially in larger movements.

show abstract

Section: Discussionsupporting

confidence: 85%

A Finite Element Analysis Study Comparing 3 Internal Fixation Techniques in Mandibular Sagittal Split Osteotomy

Hassan¹,

Ring²,

Stassen³

2018

IJOHNS

View full text Add to dashboard Cite

show abstract

“…Previous studies attempted to determine biomechanical effects of osteotomies and hardware placement on the craniofacial skeleton (Albougha et al, 2015;Singh et al, 2016), while others explored the biomechanical effects of MDO in the craniofacial skeleton of animal (Albougha et al, 2015;Boccaccio et al, 2006;Boccaccio et al, 2007) and adult human models (Loboa et al, 2006;Ahan and Kim, 2011;Li et al, 2013). To date, only one published study looks specifically at the biomechanical effects of mandibular distraction on the pediatric mandible (Reina-Romo et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Biomechanical and morphological analysis of Pierre Robin sequence mandible: Finite element and morphometric study

Humphries

Reid

Ross

et al. 2020

The Anatomical Record

View full text Add to dashboard Cite

“…There is no consensus on which permutation or number of screws required and usually is surgeon preference. Although, some in-vitro and FEA studies have shown that the use of 3 bi-cortical screws in an inverted -L pattern is the more stable approach (20)(21)(22)(23)(24)(25)(26).…”

Section: Bi-cortical Screws Fixationmentioning

confidence: 99%

“…In studies that did a comparison among miniplates, it has been shown that locking miniplates are able to spread force more widely in the fixation compared to conventional miniplates, and that miniplates placed in the line of Champy show more stability (20,27,47,48)…”

mentioning

confidence: 99%

Comparison of Three Internal Fixation Techniques in Mandibular Sagittal Split Osteotomy, A Finite Element Analysis

Hassan

Stassen

Ring

2018

British Journal of Oral and Maxillofacial Surgery

View full text Add to dashboard Cite

The sagittal split osteotomy is a versatile technique used in Mandibular orthognathic surgery. There are many types of internal fixation techniques available to provide fixation following the mandible split. The choice of fixation is mainly on surgeon preference, and can range from bi-cortical screws fixation and miniplate fixation. This study used Finite Element Analysis to investigate biomechanical properties of three internal fixation techniques. A pre-operative CT scan of a patient's skull was used to develop a half fully dentate mandible computer model. A sagittal split osteotomy was performed on the computer model and all fixation techniques applied to the model. Finite element analysis was used to study the effect of different fixation techniques on various mandibular movements and force magnitudes. The results of this study have shown consistently that the bi-cortical screws fixation records the least stress and displacement in all simulation models. Stress is mostly concentrated in the inferior-distal screw for the bi-cortical screws fixation whereas the stresses in miniplates are generally dissipated in the connector region of the plate. The 1.7mm miniplate was the least rigid fixation. The stresses in surrounding bone of the fixations were variable for each technique. Miniplate fixations had higher bone stresses in the setback movement but lower with mandibular advancements. Within the limitations of the study, the application of bi-cortical screws has shown to be the most rigid fixation, although with increased stresses in surrounding bone at mandibular advancements. The 1.7mm and 2.0mm miniplates are less rigid than the bi-cortical screws but handled stresses within the ultimate yield strength. Stress The force per unit area applied to an object. Von Mises Stress The equivalent tensile stress used to predict the yielding of materials, when they are placed under loads from different directions.

show abstract

Assessment of sagittal split ramus osteotomy rigid internal fixation techniques using a finite element method

Cited by 28 publications

References 26 publications

A Finite Element Analysis Study Comparing 3 Internal Fixation Techniques in Mandibular Sagittal Split Osteotomy

A Finite Element Analysis Study Comparing 3 Internal Fixation Techniques in Mandibular Sagittal Split Osteotomy

Biomechanical and morphological analysis of Pierre Robin sequence mandible: Finite element and morphometric study

Comparison of Three Internal Fixation Techniques in Mandibular Sagittal Split Osteotomy, A Finite Element Analysis

Contact Info

Product

Resources

About