Biomechanical Analysis of the Forces Exerted during Different Occlusion Conditions following Bilateral Sagittal Split Osteotomy Treatment for Mandibular Deficiency

Abstract

The bilateral sagittal split osteotomy (BSSO) technique is commonly used to correct mandibular deficiency. If the patient is exposed to excessive external forces after the procedure, occlusal changes or nonunion may occur. However, previous studies only focused on single external forces on the mandible and did not conduct relevant research on the forces exerted by different occlusion conditions. The main purpose of this study was to use finite element analysis methods to determine the biomechanics of four common occlusion conditions after BSSO surgical treatment. This study constructed a finite element analysis computer model of a miniplate implanted in the lower jaw. The structure of the model consisted of the mandible, miniplate, and screws. In addition, external forces were applied to the superficial masseter, deep masseter, medial pterygoid, anterior temporalis, middle temporalis, and posterior temporalis muscles to simulate the incisal clench, intercuspal position (ICP), right unilateral molar clench (RMOL), and right group function occlusion conditions. Subsequently, this study observed the effects of these conditions on the miniplate, screws, and mandible, including the von Mises stress values. The results showed that all of the different occlusion conditions that this study evaluated placed high stress on the miniplate. In the ICP and RMOL occlusion conditions, the overall mandibular structure experienced very high stress. The screw on the proximal segment near the bone gap experienced high stress, as did the screw on the buccal side. According to the present analysis, although the data were not directly obtained from clinical practice, the finite element analysis could evaluate the trend of results under different external forces. The result of this study recommended that patients without intermaxillary fixation avoid the ICP and RMOL occlusion conditions. It can be used as a pilot study in the future for providing clinicians more information on the biomechanics of implantation.

Biomechanics of Non-Carious Cervical Lesions in Finite Element Models: An Integrative Review

“…However, an oblique force of 105 N can induce tension in the cervical zone (SRIREKHA; BASHETTY, 2013;GUIMARÃES et al, 2014;CHANG et al, 2019).…”

“…INTRODUCTIONNon-carious cervical lesions, especially the abfraction type lesions, are loss of dental structure close to the cemento-enamel junction, without bacterial involvement, presenting a wedge shape. The etiology of these structural losses is often multifactorial and the evidence supports that inappropriate occlusal forces are related to the emergence of the abfraction (SRIREKHA;BASHETTY, 2013;CHANG et al, 2019;HARALUR et al, 2019). flexion, the occlusal forces are dissipated from the axial axis towards the cervical zones and the chemical bonds of the enamel hydroxyapatites can be damaged, initiating the loss of structure in this region (SADAF; AHMAD, 2014; MARINESCU et al,…”

Finite element analysis between Hunsuck/Epker and novel modification of Low Z plasty technique of mandibular sagittal split osteotomy

“…These FE results agreed with those of previous studies on the BSSO surgery. 11,17,35 Takahashi et al 11 found that the highest concentration of the mechanical stress occurred at the screw site and upper border of the miniplate near the fracture site. Erkmen et al 17 investigated the stress distributions for four different fixation methods, and also found that the maximum stress accumulated at the center of the miniplate near the fracture site.…”

“…Erkmen et al 17 investigated the stress distributions for four different fixation methods, and also found that the maximum stress accumulated at the center of the miniplate near the fracture site. In addition, Chang et al 35 evaluated the stress on the miniplate and screws, under four occlusal conditions, and found the highest stress at the screw close to the fracture gap.…”

Biomechanics of Non-Carious Cervical Lesions in Finite Element Models: An Integrative Review

“…, an oblique force of 105 N can induce tension in the cervical zone (SRIREKHA;BASHETTY, 2013; GUIMARÃES et al, 2014;CHANG et al, 2019).In the cervical zone of the dental elements, there is a transition in the orientation of the hydroxyapatite prisms that comprise them. When approaching the cementitious junction, there is a tendency to flatten and reduce the thickness of the enamel, in addition to having a lower mineral density.…”