Assessment of the Biomechanical Performance of 5 Plating Techniques in Fixation of Mandibular Subcondylar Fracture Using Finite Element Analysis

Darwich, Ayham; Albogha, Mhd Hassan; Abdelmajeed, Adnan; Darwich, Khaldoun

doi:10.1016/j.joms.2015.11.021

Cited by 46 publications

(28 citation statements)

References 26 publications

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“…Those considerations have been the object of numerous FEA studies [ 28 , 29 , 30 ]. Some research has investigated how the optimal stabilization of the condylar fracture fragments can be obtained [ 31 , 32 ], whereas another study, after a thorough evaluation by FEA, introduced a completely new type of osteosynthesis plate [ 33 ]. A tendency to introduce new, more optimized, more durable and more lightweight fixation elements leads to the assumption that there is still a vast field for FEA application in trauma surgery, in particular, when a movement towards materials which can undergo biodegradation can be seen [ 26 ].…”

Section: Trauma Surgerymentioning

confidence: 99%

Application of Finite Element Analysis in Oral and Maxillofacial Surgery—A Literature Review

Lisiak-Myszke¹,

Marciniak

Bieliński

et al. 2020

Materials

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In recent years in the field of biomechanics, the intensive development of various experimental methods has been observed. The implementation of virtual studies that for a long time have been successfully used in technical sciences also represents a new trend in dental engineering. Among these methods, finite element analysis (FEA) deserves special attention. FEA is a method used to analyze stresses and strains in complex mechanical systems. It enables the mathematical conversion and analysis of mechanical properties of a geometric object. Since the mechanical properties of the human skeleton cannot be examined in vivo, a discipline in which FEA has found particular application is oral and maxillofacial surgery. In this review we summarize the application of FEA in particular oral and maxillofacial fields such as traumatology, orthognathic surgery, reconstructive surgery and implantology presented in the current literature. Based on the available literature, we discuss the methodology and results of research where FEA has been used to understand the pathomechanism of fractures, identify optimal osteosynthesis methods, plan reconstructive operations and design intraosseous implants or osteosynthesis elements. As well as indicating the benefits of FEA in mechanical parameter analysis, we also point out the assumptions and simplifications that are commonly used. The understanding of FEA’s opportunities and advantages as well as its limitations and main flaws is crucial to fully exploit its potential.

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Section: Trauma Surgerymentioning

confidence: 99%

Application of Finite Element Analysis in Oral and Maxillofacial Surgery—A Literature Review

Lisiak-Myszke¹,

Marciniak

Bieliński

et al. 2020

Materials

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“…Implants were finally implanted into the grafted fibula and were modeled using SolidWorks (SolidWorks Corp., Dassault Systemes Concord, MA, USA). The finite element (FE) models were meshed using 10-node solid tetrahedral elements in ANSYS Workbench (Swanson Analysis Systems Co., Houston, TX, USA) [29]. The stress, strain, and displacement of each node of each connection section of each model were collected using ANSYS software.…”

Section: Finite Element Modelingmentioning

confidence: 99%

Biomechanical Analysis of Various Reconstructive Methods for the Mandibular Body and Ramus Defect Using a Free Vascularized Fibula Flap

Jiang

Gao

et al. 2020

BioMed Research International

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Several different methods exist for reconstructing the mandibular body and ramus defect with the use of a free vascularized fibula flap, but none have adequately addressed the long-term mechanical stability and osseointegration. The aim of this study is to compare the biomechanics of different surgical methods and to investigate the best approach for reconstructing the mandibular body and ramus defect. Five finite element models based on different reconstructive methods were simulated. Stress, strain, and displacement of connective bone sections were calculated for five models and compared. The models were printed using a 3D printer, and stiffness was measured using an electromechanical universal testing machine. The postoperative follow-up cone beam computed tomography (CBCT) was taken at different time points to analyze bone mineral density of connective bone sections. The results showed that the "double up" (DU) model was the most efficient for reconstructing a mandibular body and ramus defect by comparing the mechanical distribution of three sections under vertical and inclined loading conditions of 100 N. The stiffness detection showed that stiffness in the DU and "double down" (DD) models was higher compared with the "single up" (SU), "single down" (SD), and "distraction osteogenesis" (DO) models. We used the DU model for the surgery, and postoperative follow-up CBCT showed that bone mineral density of each fibular connective section increased gradually with time, plateauing at 12 weeks. We conclude that a free vascularized fibula flap of the DU type was the best approach for the reconstruction of the mandibular body and ramus defect. Preoperative finite element analysis and stiffness testing were shown to be very useful for maxillofacial reconstruction.

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“…53 Recently, an in vitro study demonstrated TCPs induced the least amount of strain on cortical bone and were best at resisting displacement. 54 A variety of 3D plates, shapes have been designed, with narrower plates purposed for use in the condylar neck and larger, wider plates used for condylar base or comminuted fractures where additional holes for screw placement are needed. A recent position article drafted by an international consortium of surgeons reported that a more stable condylar neck fracture repair can be achieved using either 3D miniplates or two straight miniplates compared with a single miniplate.…”

Section: Achievement Of Stable Osteosynthesismentioning

confidence: 99%

Contemporary Issues in the Open Management of Subcondylar Fractures of the Mandible

et al. 2016

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Subcondylar fractures encompass a large portion of mandible fractures. Owing to their proximity to the temporomandibular joint and difficulty achieving surgical exposure, treatment of these fractures has been challenging and highly debated throughout the literature. While no one modality is the accepted gold standard, there are multiple options for addressing these fractures that can yield satisfying results for both patient and surgeon alike. A thorough literature review was conducted using PubMed, analyzing articles in the past 15 years for relevance to the subject matter. Various search terms were used to glean information regarding closed treatment, open treatment, and the risks and benefits of the different surgical approaches involved. The articles were reviewed by all of the authors for applicability and quality of data provided. A total of 50 articles were selected for inclusion in the current study. The open management of subcondylar fractures encompasses a vast array of techniques. While some surgeons advocate closed treatment in some circumstances, open treatment affords numerous advantages with the advent of multiple access modalities. There is no single superior method, and as such, the craniofacial surgeon should have a comprehensive understanding of options so as to select the appropriate option that is individualized to the patient. A clear understanding of fracture biomechanics balanced with patient expectations and operative safety allows for the surgeon to make a sound decision for treatment.

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Assessment of the Biomechanical Performance of 5 Plating Techniques in Fixation of Mandibular Subcondylar Fracture Using Finite Element Analysis

Cited by 46 publications

References 26 publications

Application of Finite Element Analysis in Oral and Maxillofacial Surgery—A Literature Review

Application of Finite Element Analysis in Oral and Maxillofacial Surgery—A Literature Review

Biomechanical Analysis of Various Reconstructive Methods for the Mandibular Body and Ramus Defect Using a Free Vascularized Fibula Flap

Contemporary Issues in the Open Management of Subcondylar Fractures of the Mandible

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