Comparison of Neck Screw and Conventional Fixation Techniques in Mandibular Condyle Fractures Using 3-Dimensional Finite Element Analysis

Conci, Ricardo Augusto; Tomazi, Flávio Henrique Silveira; Noritomi, Pedro Yoshito; Silva, Jorge Vicente Lopes da; Fritscher, Guilherme Genehr; Heitz, Corey

doi:10.1016/j.joms.2015.01.037

Cited by 15 publications

(6 citation statements)

References 12 publications

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“…Moreover, resorption of the condylar head may occur when excessive dissection of the intracapsular area is performed for perfect reduction [19]. Therefore, many surgical approaches based on assistance with endoscopes or zigs have been proposed for precise rigid fixation [3,4,[20][21][22]. However, successful fixation of condylar process fractures is still a dilemma for surgeons.…”

Section: Discussionmentioning

confidence: 99%

Semi-Rigid Fixation Using a Sliding Plate for Treating Fractures of the Mandibular Condylar Process

Kim

et al. 2021

JCM

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Occlusal displacement often occurs after surgery for condylar process fractures because it is difficult to reduce these fractures precisely. However, performing semi-rigid fixation using a sliding plate may overcome this limitation. A retrospective clinical comparison between semi-rigid and rigid fixations was performed. Among 34 patients who had unilateral condylar process fractures, 17 were treated with rigid fixation and the remaining with semi-rigid fixation using a sliding plate. For all patients, panoramic radiographs were collected 1 day and 6 months after surgery. In these radiographs, ramus height and condylar process inclination were measured, and the differences between the fractured and normal sides were assessed. Additionally, the radiographic density of the fracture area was measured. Differences in surgical outcomes and operative times between the two groups and changes in postoperative deviations within each group were analyzed. There was no statistically significant difference in ramus height and condylar process inclination between the two groups at postoperative day 1 and 6 months. Radio-density was observed to be higher in the rigid fixation group, and it increased with time in both groups. The semi-rigid fixation group had a significantly shorter operative time than the other group did. Semi-rigid and rigid fixations showed no differences in terms of effectiveness and outcomes of surgery. In terms of operative time, semi-rigid fixation was superior to rigid fixation.

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Section: Discussionmentioning

confidence: 99%

Semi-Rigid Fixation Using a Sliding Plate for Treating Fractures of the Mandibular Condylar Process

Kim

et al. 2021

JCM

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“…The three types of plates had the same pattern of juxtaposition contact with the bone tissue. The fixation screws and plates were made of commercially pure titanium and were fabricated in the model with sliding contact to more closely resemble clinical reality [13]. The plates were modeled virtually to allow perfect adaptation and reduction of the bone-plate interface.…”

Section: Elaboration Of the Modelmentioning

confidence: 99%

Biomechanical Behavior of Different Miniplate Designs for Skeletal Anchorage in the Anterior Open Bite Treatment

et al. 2022

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This study aimed to evaluate the stress distribution and mechanical behavior of miniplate designs to skeletal anchorage for the treatment of anterior open bite in adult patients. A complete hemimaxilla, teeth, brackets, transpalatal bar, and three miniplates were virtually modeled. I-, Y-, and T-shaped miniplates were installed in the area of the alveolar zygomatic crest. The assembly was constricted and three intrusive forces (2, 4, and 6 N) were applied to the maxillary molars and anchorage according to the miniplates. All materials were considered homogeneous, elastic, and linear; the mesh was 1,800,000 hexahedrons with 2,800,000 nodes on average. Displacement, maximum principal stress, and von Mises stress were evaluated according to the shape of the anchorage device and intrusive force. The miniplate configurations resulted in different stress and displacement intensities in the bone tissue and plate; these stresses were always located in the same regions and were within physiological limits. The Y-plate showed the best performance since its application generated less stress in bone tissue with less displacement.

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“…Several researchers have previously aimed to evaluate the effect of bone plate implantation and biomechanical analysis, to develop more effective strategies for bone plate fixation [ 9 – 12 ]. A clinical study by Marwan et al [ 9 ] showed that using two bone plates for subcondylar fracture fixation resulted in a better prognosis and fewer complications than using a single bone plate.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical analysis of subcondylar fracture fixation using miniplates at different positions and of different lengths

et al. 2021

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Background Many types of titanium plates were used to treat subcondylar fracture clinically. However, the efficacy of fixation in different implant positions and lengths of the bone plate has not been thoroughly investigated. Therefore, the primary purpose of this study was to use finite element analysis (FEA) to analyze the biomechanical effects of subcondylar fracture fixation with miniplates at different positions and lengths so that clinicians were able to find a better strategy of fixation to improve the efficacy and outcome of treatment. Methods The CAD software was used to combine the mandible, miniplate, and screw to create seven different FEA computer models. These models with subcondylar fracture were fixed with miniplates at different positions and of different lengths. The right unilateral molar clench occlusal mode was applied. The observational indicators were the reaction force at the temporomandibular joint, von Mises stress of the mandibular bone, miniplate and screw, and the sliding distance on the oblique surface of the fracture site at the mandibular condyle. Results The results showed the efficacy of fixation was better when two miniplates were used comparing to only one miniplates. Moreover, using longer miniplates for fixation had better results than the short one. Furthermore, fixing miniplates at the posterior portion of subcondylar region would have a better fixation efficacy and less sliding distance (5.46–5.76 μm) than fixing at the anterolateral surface of subcondylar region (6.10–7.00 μm). Conclusion Miniplate fixation, which was placed closer to the posterior margin, could effectively reduce the amount of sliding distance in the fracture site, thereby achieving greater stability. Furthermore, fixation efficiency was improved when an additional miniplate was placed at the anterior margin. Our study suggested that the placement of miniplates at the posterior surface and the additional plate could effectively improve stability.

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Comparison of Neck Screw and Conventional Fixation Techniques in Mandibular Condyle Fractures Using 3-Dimensional Finite Element Analysis

Cited by 15 publications

References 12 publications

Semi-Rigid Fixation Using a Sliding Plate for Treating Fractures of the Mandibular Condylar Process

Semi-Rigid Fixation Using a Sliding Plate for Treating Fractures of the Mandibular Condylar Process

Biomechanical Behavior of Different Miniplate Designs for Skeletal Anchorage in the Anterior Open Bite Treatment

Biomechanical analysis of subcondylar fracture fixation using miniplates at different positions and of different lengths

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