Biomechanical analysis of titanium plate systems in mandibular condyle fractures: a systematized literature review

Abstract

PURPOSE:To conduct a systematized review of the literature about the main methodologies used to evaluate the biomechanical fixation systems with titanium plates in fractures of the mandibular condyle. METHODS: A systematized review of literature was performed in the electronic databases PubMed, EMBASE, LILACS and MEDLINE without restriction of the publication date. The eligibility criteria were laboratory studies involving mandibular condyle fractures, studies using titanium plates, biomechanical studies, in vitro and computational studies involving the finite element method (FEM). RESULTS: Eleven articles that met the eligibility criteria were selected, including seven articles involving in vitro studies and four studies with biomechanical analysis by using FEM. CONCLUSION: Although few articles have used the finite element method, the results of in vitro studies were similar to those found in computational studies, regarding to the stable use of two titanium miniplates. Key words: Mandibular Condyle. Fracture Fixation. Titanium. Biomechanics. Review. RESUMO OBJETIVO:Realizar uma revisão sistematizada da literatura sobre as principais metodologias empregadas na avaliação biomecânica de sistemas de fixação com placas de titânio em fraturas de côndilo mandibular. MÉTODOS: Foi realizada uma revisão sistematizada da literatura nas bases de dados eletrônicas PubMed, EMBASE, LILACS e MEDLINE sem restrição quanto à data de publicação. Os critérios de elegibilidade foram estudos laboratoriais envolvendo fraturas de côndilo mandibular, estudos utilizando placas de titânio, estudos biomecânicos, estudos in vitro e estudos computacionais envolvendo o método de elementos finitos (MEF). RESULTADOS: Foram selecionados 11 artigos que se enquadraram nos critérios de elegibilidade, incluindo sete artigos envolvendo estudos in vitro e quatro utilizando análise biomecânica através do MEF. CONCLUSÃO: Embora poucos artigos tenham utilizado o método de elementos finitos, os resultados das pesquisas in vitro assemelhamse aos encontrados nos estudos computacionais, com relação ao uso estável de duas miniplacas de titânio. Descritores: Côndilo Mandibular. Fixação de Fratura. Titânio. Biomecânica. Revisão. Biomechanical analysis of titanium plate systems in mandibular condyle fractures. A systematized literature review

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

“…In addition, future clinical trials, applying the methodology with finite elements or not, are postulated to better indicate the most appropriate techniques for osteosynthesis in cases of mandibular condyle fractures. 24 Moreover, the intense discussion of the best surgical management of condylar is still ongoing, including assortment of the fixing material. Application of positioning lag screws, 25 which is the predicted method of treatment in high condylar fractures, can have a better prognosis than using a titanium plate and obviously much better than the removal of the condylar fragment.…”

Comparative Evaluation of the Mechanical Properties of Resorbable and Titanium Miniplates Used for Fixation of Mandibular Condyle Fractures

“…8 The conventional method, i.e., the intermaxillary fixation and functional treatment combination, is still used. 14 On the other hand, rigid fixation by open reduction has become popular thanks to the developments in the field of osteosynthesis technologies.…”

“…Titanium miniplates and screws have been widely used for rigid fixation of the mandibular condyle fractures. 7,8 The main drawback of these metallic fixations is to require a second surgery to be removed from the body. The development of resorbable materials has proposed an effective remedy for this problem.…”

Failure location prediction by finite element analysis for an additive manufactured mandible implant

“…However, to the best of our knowledge, the design of such implants nowadays is much dependent only on the essential experience of surgeons [4]. One way to prevent such failures is to employ preoperative finite element (FE) analysis to predict structural strength and assist the design of implants [5][6][7].…”

“…(a) Postoperative image of the mandible, and (b) 3D reconstruction of the mandible assembly(1), osseointegrated dental titanium implants (2), load-bearing plate (3), homogenised scaffold (4) and screws(5).…”