Biomechanical evaluation of type p condylar head osteosynthesis using conventional small-fragment screws reinforced by a patient specific two-component plate

Pavlychuk, Tetiana; Chepurnyi, Yurii; Neff, Andreas; Копчак, Андрій

doi:10.1186/s13005-020-00236-0

Cited by 17 publications

(15 citation statements)

References 36 publications

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“…However, it is not the only option, especially in multifracture fractures. A new approach from the Kiev team [5,6] with custom-made plates for proximal fragment reduction is a very interesting solution to a serious clinical issue. Consideration could be given to manufacturing these customized plates with magnesium alloy.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Evaluation of Magnesium Alloy Osteosynthesis in the Mandibular Head

2022

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Titanium alloys are used in skeletal surgery. However, once bone union is complete, such fixation material becomes unnecessary or even harmful. Resorbable magnesium materials have been available for several years (WE43 alloy). The aim of this study was to clinically compare magnesium versus titanium open reduction and rigid fixations in mandible condylar heads. Ten patients were treated for fractures of the mandibular head with magnesium headless compression screws (2.3 mm in diameter), and 11 patients were included as a reference group with titanium screws (1.8 mm in diameter) with similar construction. The fixation characteristics (delay, time, and number of screws), distant anatomical results (mandibular ramus height loss, monthly loss rate, and relative loss of reconstructed ramus height), basic functional data (mandibular movements, facial nerve function, and cutaneous perception) and the influence of the effects of the injury (fracture type, fragmentation, occlusion, additional fractures, and associated diseases) on the outcome were evaluated. The long-term results of treatment were evaluated after 18 months. Treatment results similar to those of traditional titanium fixation were found with magnesium screws. Conclusions: Resorbable metal screws can be a favored option for osteosynthesis because surgical reentry can be avoided. These materials provide proper and stable treatment results.

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Section: Discussionmentioning

confidence: 99%

“…Titanium alloys are used in skeletal surgery, in both children [1][2][3] and adults [4][5][6][7]. Long screw fixation through the lateral fragment end of the ascending ramus (i.e., distal fragment) has been a well-known procedure for osteosynthesis of the condylar head for approximately the last 30 years [8].…”

Section: Introductionmentioning

confidence: 99%

Clinical Evaluation of Magnesium Alloy Osteosynthesis in the Mandibular Head

2022

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“…This results in excellent final results. In the condylar head region, custom repositioning plates/mesh according to the Ukrainian concept is a highly promising prospect [ 76 , 77 ]. Full adaptation to the details of the mandibular head anatomy can be cited as specific applications [ 78 ] to induce faster cell growth, more cell divisions, and eventually better quality bone consolidation.…”

Section: Discussionmentioning

confidence: 99%

Bone Union Quality after Fracture Fixation of Mandibular Head with Compression Magnesium Screws

Kozakiewicz

Gabryelczak

2022

Materials

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For some years now, fixation devices created with resorbable magnesium alloys for the mandibular head have been clinically available and are beginning to be used. It is thus valuable to evaluate the quality of unions in these cases. The aim of this study was radiological comparison of magnesium versus titanium open reduction and rigid fixations in the mandible condylar head. Thirty-one patients were treated for fractures of the mandibular head with magnesium WE43 alloy headless compression screws (diameter 2.3 mm) and, as a reference group, 29 patients were included with similar construction titanium screws (diameter 1.8 mm). The 12-month results of the treatment were evaluated by the texture analysis of CT. Near similar treatment results were found with magnesium screws in traditional titanium fixation. Magnesium screws result in a higher density of the bone structure in the mandibular head. Conclusions: The quantitative evaluation of bone union after surgical treatment of mandibular head fracture with magnesium compression headless screws indicates that stable consolidation was achieved. Undoubtedly, the resorption process of the screws was found to be incomplete after 12 months, evidenced by a marked densification of the bone structure at the fracture site.

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“…[ 21 31 ] Relatively high survival rate of PSI in our study with a long-term follow-up compared to the results reported for the mandible with PSI failure from 12.5% to 27% could be explained by the influence of predominantly static bio-mechanical loading of the implants with low stress and strains values. [ 32 33 ] However, excessive tension of skin above the implant can be considered as risk factor of its exposure and should be prevented during at CAD stage of the treatment planning. [ 1 7 25 ]…”

Section: Onclusionmentioning

confidence: 99%

Application of patient-specific implants as alternative approach to zygoma defect management - A retrospective study

Kustro

Chepurnyi

Zhukovtseva

et al. 2021

Ann Maxillofac Surg

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Introduction: Zygoma defects are a challenging clinical problem and are frequently connected with the alteration of facial harmony, horizontal asymmetry of the face, and significant functional deficit. The application of patient-specific implants (PSIs) has the potential to improve the effectiveness of zygoma defect management. The aim of this study was to evaluate the anatomic, esthetic, and functional outcomes of PSI application for zygoma reconstruction. Materials and Methods: A retrospective study was conducted on data from 11 patients with zygoma defects who underwent a reconstruction procedure in which a PSI was applied and was followed for >1 year after surgery with the evaluation of esthetic and functional outcomes. Precision of PSI position and anatomy reconstruction was estimated by superimposition of the models with automatic point-to-point measurement and determination of the existing deviations between models. Results: The mean follow-up period in our study was 21.6 ± 6.2 months (range 14–39 months). No major complications occurred in the postoperative period: There were no clinical or computed tomography symptoms of maxillary sinusitis, implant-related infection, or implant exposure. The mean deviation between the planned and real positions of PSIs in our series was 0.72 ± 0.41 mm. The mean deviation between the reconstructed zygomatic complex and the mirrored intact side in our series was 1.45 ± 0.7 mm. The mean volume difference between the intact and damaged orbits was 1.7 ± 0.8 mm 3 . Discussion: The results of the present study support the wider clinical application of PSIs in orbital and zygoma reconstructions, as it is an effective option to achieve precise reconstruction of the complex zygoma anatomy.

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Biomechanical evaluation of type p condylar head osteosynthesis using conventional small-fragment screws reinforced by a patient specific two-component plate

Cited by 17 publications

References 36 publications

Clinical Evaluation of Magnesium Alloy Osteosynthesis in the Mandibular Head

Clinical Evaluation of Magnesium Alloy Osteosynthesis in the Mandibular Head

Bone Union Quality after Fracture Fixation of Mandibular Head with Compression Magnesium Screws

Application of patient-specific implants as alternative approach to zygoma defect management - A retrospective study

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