Finite element analysis of newly introduced plates for mandibular
condyle neck fracture treatment by open reduction and rigid fixation

Kozakiewicz, Marcin; Świniarski, Jacek

doi:10.17219/dmp/78913

Cited by 7 publications

(6 citation statements)

References 22 publications

(30 reference statements)

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“…Some studies [4,13] show that the same osteosynthesis plates has been screwed in different positions and surprisingly the biomechanical effect was not worse than those of the positions suggested by the manufacturer.…”

Section: Discussionmentioning

confidence: 99%

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Forces Causing One-Millimeter Displacement of Bone Fragments of Condylar Base Fractures of the Mandible after Fixation by All Available Plate Designs

et al. 2019

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Background: There has been no direct comparison of all existing plates dedicated for fracture osteosynthesis of mandibular condyle base until now. The aim of the study was to test mechanically all available designs of titanium plates on the market on polyurethane mandibles using an individually designed clamping system. Methods: Forces required for a 1 mm displacement of fixed fracture and incidents of screw loosening were recorded. Results indicated the best mechanical plates among all existing designs available. Results: It has occured that some of osseofixation plates should not be used any more, whereas some shape of the single plates are similar shape to two single plates shape are regarded as the best osseofixation method for condyle base fracture. Conclusion: General observation is the bigger plate and more screws, the better rigid stable osteosynthesis of mandibular condyle base. 4 plates of current designs of total 30 tested series can be recommended for open rigid internal fixation of fractures of the base of the mandibular condyle. The rest of 26 existing plates should not be used in condylar base fractures.

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Section: Discussionmentioning

confidence: 99%

“…A little help in information is literature selection of the most proper plate for clinical situations. There are only fragmentary studies concerning one or few plates [4,5,6,7,8,9,10,11,12,13,14]. Open rigid internal fixation is the standard surgical procedure when the fracture is dislocated or significantly displaced.…”

Section: Introductionmentioning

confidence: 99%

Forces Causing One-Millimeter Displacement of Bone Fragments of Condylar Base Fractures of the Mandible after Fixation by All Available Plate Designs

et al. 2019

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“…Another factor that modifies stability is the shape of the plates. Small plates do not perform well mechanically [26]. However, among the many plate shapes available, it is possible to choose the most durable plate as a base for the condyle fracture [27] (which is a relatively easy fracture to treat) and for ORIF of the condylar neck [20,28].…”

Section: Resultsmentioning

confidence: 99%

Choice of Screws for Fixation of Mandibular Condyle Fractures Guided by Anthropometric Data

Bielecki-Kowalski

Kozakiewicz

2021

Applied Sciences

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Open reduction and internal fixation (ORIF) is becoming increasingly common in treatment of the condylar process, including mandible head fractures. This approach significantly improves the results in terms of anatomical reduction of bone fragments, and shortens the treatment time, allowing for early functional recovery. The success of ORIF is largely determined by the stability of the osteosynthesis. The stabilization effect depends on the screw type and length of the plate used, in addition to the diameter and length of the screws used. The aim of this study was to determine the largest possible screw length that can be used in ORIF of the mandibular condyle considering the variable bone thickness. A total of 500 condyles were examined using computer tomography (CT)-based 3D models in Caucasians. For all models, three measurements were made in the frontal projection in places typical for the stabilization of osteosynthesis plates in the fractures of the condylar process: the base, the top, and the sigmoid notch. In addition, one measurement of the mandible head was made in the place of the greatest width. The results showed that 8 mm screws should be used in the region of the condylar base as the longest anatomically justified screw, whereas in the area of a sigmoid notch only 1.5–2 mm screws should be used. Measurements in the area of the neck top revealed statistically significant differences in the measurements between the sex of patients, with average differences below 1 mm (p < 0.05). In this area, the maximal length of the screw was found to be 10 mm. In mandibular head fractures, the use of long screws is extremely important due to the desired effect of fragment compression. Statistically significant differences were found in the measurement results between women and men. The maximal screw length for bicortical fixation was found to be 22 mm in men and 20 mm in women. In post-traumatic patients, the ability to obtain a clear measurement is often limited by a deformed anatomy. Taking into account the fact that the fracture stability is influenced by both the plate length and the length of the fixation screws, an assessment of the standard measurement values in a cohort group will improve the quality of the surgical fixations of the fractures.

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“…Moreover, stable fixation is easy because the screw is inserted perpendicular to the fracture line. Oblique insertion, which may be necessary in type C fractures, may require deeper screw immersion if the osteosynthesis material is added below the bone level or in the case of conversion to plate fixation [19].…”

Section: Discussionmentioning

confidence: 99%

Comparison of compression screws used for mandible head fracture treatment—experimental study

Kozakiewicz

2019

Clin Oral Invest

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Objectives Compression screws that can fix a fracture of the condylar head of the mandible are available. Although typical titanium lag screws are generally used, a series of headless screws have been designed for this purpose. The Bheadless^advantage derived from the complete submergence of the screw in the bone after fixation is the lack of irritation of the lateral ligament of the temporo-mandibular joint by the screw head. The aim of this study is to compare the compression force of typically used lag screws with that of newly developed headless compression screws. Materials and methods This study tested five types of screws with a 14-mm length: 10 2.0-mm lag screws and 40 headless screws (four groups of equal size: 1.5-mm H screws, 1.8-mm H screws, 2.0-mm H screws, and 1.8-mm W screws). Two cuboid blocks of standardized polyurethane foam were fixed by one screw. The maximal compression force (F in N) and torque at maximal compression force (T in Ncm) were tested according to the guidelines of the American Society for Testing and Materials (ASTM F1839-08). Results The test results were as follows: 2.0-mm lag screw:

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Finite element analysis of newly introduced plates for mandibular condyle neck fracture treatment by open reduction and rigid fixation

Cited by 7 publications

References 22 publications

Forces Causing One-Millimeter Displacement of Bone Fragments of Condylar Base Fractures of the Mandible after Fixation by All Available Plate Designs

Forces Causing One-Millimeter Displacement of Bone Fragments of Condylar Base Fractures of the Mandible after Fixation by All Available Plate Designs

Choice of Screws for Fixation of Mandibular Condyle Fractures Guided by Anthropometric Data

Comparison of compression screws used for mandible head fracture treatment—experimental study

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