Evaluation of prebent miniplates in fixation of Le Fort I advancement osteotomy with the finite element method

Coşkunses, Fatih Mehmet; Kan, Bahadır; Mutlu, İbrahim; Cilasun, Ulkem; Çelik, Talip

doi:10.1016/j.jcms.2015.07.004

Cited by 19 publications

(35 citation statements)

References 31 publications

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“…Titanium has been the gold standard for decades and still remains the material of choice for rigid fixation of freed maxillary segments (Coskunses et al, 2015;Philippe, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…The surgical treatment includes the separation of the maxilla into free segments to enable its repositioning in the desired, pre-surgically planned position. Regarding the fixation of the adjusted segments, the use of titanium mini-plates and screws is referred as the gold standard (Coskunses et al, 2015;He et al, 2015;Pan and Patil, 2014;Ueki et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical testing of zirconium dioxide osteosynthesis system for Le Fort I advancement osteotomy fixation

Hingsammer

Grillenberger

Schagerl

et al. 2018

Journal of the Mechanical Behavior of Biomedical Materials

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The following work is the first evaluating the applicability of 3D printed zirconium dioxide ceramic miniplates and screws to stabilize maxillary segments following a Le-Fort I advancement surgery. Conventionally used titanium and individual fabricated zirconium dioxide miniplates were biomechanically tested and compared under an occlusal load of 120N and 500N using 3D finite element analysis. The overall model consisted of 295,477 elements. Under an occlusal load of 500N a safety factor before plastic deformation respectively crack of 2.13 for zirconium dioxide and 4.51 for titanium miniplates has been calculated. From a biomechanical point of view 3D printed ZrO mini-plates and screws are suggested to constitute an appropriate patient specific and metal-free solution for maxillary stabilization after Le Fort I osteotomy.

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“…Titanium has been the gold standard for decades and still remains the material of choice for rigid fixation of freed maxillary segments (Coskunses et al, 2015;Philippe, 2013).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biomechanical testing of zirconium dioxide osteosynthesis system for Le Fort I advancement osteotomy fixation

Hingsammer

Grillenberger

Schagerl

et al. 2018

Journal of the Mechanical Behavior of Biomedical Materials

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“…The mandibular muscles were modeled as springs to simulate real environment of human mandible, which can effectively analyze the mechanical performance of the fractured mandible with different fixation modalities. In addition, the material properties of mandible in this paper were assigned by the HU values of CT images, which will be more appropriate than the method that just takes use of two material (cortical and cancellous bone) of mandible [ 28 ], because the human mandible is an inhomogeneous material components. In addition, our FEA results were studied under incisor and second molar loading positions that are considered as the most common occlusal situations.…”

Section: Discussionmentioning

confidence: 99%

“…Three occlusal situations simulated at different dental positions were applied to the angle fractured mandible model: loading I, incisor loading with 125 N, loading II, left second molar loading with 250 N, and loading III, right second molar loading with 250 N, and the directions of loads were all vertical (Fig. 4 ) [ 28 ]. Both condyles were fixed at 3 degrees of freedom, simulating the moment of biting.…”

Section: Methodsmentioning

confidence: 99%

A customized fixation plate with novel structure designed by topological optimization for mandibular angle fracture based on finite element analysis

et al. 2017

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BackgroundThe purpose of this study was to design a customized fixation plate for mandibular angle fracture using topological optimization based on the biomechanical properties of the two conventional fixation systems, and compare the results of stress, strain and displacement distributions calculated by finite element analysis (FEA).MethodsA three-dimensional (3D) virtual mandible was reconstructed from CT images with a mimic angle fracture and a 1 mm gap between two bone segments, and then a FEA model, including volume mesh with inhomogeneous bone material properties, three loading conditions and constraints (muscles and condyles), was created to design a customized plate using topological optimization method, then the shape of the plate was referenced from the stress concentrated area on an initial part created from thickened bone surface for optimal calculation, and then the plate was formulated as “V” pattern according to dimensions of standard mini-plate finally. To compare the biomechanical behavior of the “V” plate and other conventional mini-plates for angle fracture fixation, two conventional fixation systems were used: type A, one standard mini-plate, and type B, two standard mini-plates, and the stress, strain and displacement distributions within the three fixation systems were compared and discussed.ResultsThe stress, strain and displacement distributions to the angle fractured mandible with three different fixation modalities were collected, respectively, and the maximum stress for each model emerged at the mandibular ramus or screw holes. Under the same loading conditions, the maximum stress on the customized fixation system decreased 74.3, 75.6 and 70.6% compared to type A, and 34.9, 34.1, and 39.6% compared to type B. All maximum von Mises stresses of mandible were well below the allowable stress of human bone, as well as maximum principal strain. And the displacement diagram of bony segments indicated the effect of treatment with different fixation systems.ConclusionsThe customized fixation system with topological optimized structure has good biomechanical behavior for mandibular angle fracture because the stress, strain and displacement within the plate could be reduced significantly comparing to conventional “one mini-plate” or “two mini-plates” systems. The design methodology for customized fixation system could be used for other fractures in mandible or other bones to acquire better mechanical behavior of the system and improve stable environment for bone healing. And together with SLM, the customized plate with optimal structure could be designed and fabricated rapidly to satisfy the urgent time requirements for treatment.

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“…Modifications in these fixation appliances have been evolving for the past three decades since rigid fixation became the routine practice. Prebent plates are one of the most recent modifications in the plate technology designed specifically for maxillary advancements 56. They have a larger and thicker design than traditional plates and appear to give more stability 6.…”

mentioning

confidence: 99%

A Modified Technique for Placing Prebent Plates during a Le Fort I Osteotomy: A Technical Note

Ragaey

Sickels

2016

Craniomaxillofacial Trauma & Reconstruction

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Prebent plates have gained popularity in recent years as a fixation appliance for large maxillary advancements. They are larger than standard plates used for maxillary procedures and appear to give greater stability. Due to their size and configuration, they have the potential to be more palpable than standard plates, possibly causing discomfort following placement. With a simple “box” osteotomy of the maxilla at the site of placement and a minor modification of the plate, the plate is less palpable and better tolerated by the patient.

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Evaluation of prebent miniplates in fixation of Le Fort I advancement osteotomy with the finite element method

Cited by 19 publications

References 31 publications

Biomechanical testing of zirconium dioxide osteosynthesis system for Le Fort I advancement osteotomy fixation

Biomechanical testing of zirconium dioxide osteosynthesis system for Le Fort I advancement osteotomy fixation

A customized fixation plate with novel structure designed by topological optimization for mandibular angle fracture based on finite element analysis

A Modified Technique for Placing Prebent Plates during a Le Fort I Osteotomy: A Technical Note

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