A Biomechanical Evaluation of Plating Techniques Used for Reconstructing Mandibular Symphysis/Parasymphysis Fractures

Madsen, Matthew J.; McDaniel, Christopher A.; Haug, Richard H.

doi:10.1016/j.joms.2008.06.013

Cited by 69 publications

(57 citation statements)

References 14 publications

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“…5 It is well known that the mandible is normally subjected to tensioning forces on its superior border and compression forces on its inferior border. [5][6][7][8] However, that is only true for fractures in the body and angle of the mandible; in the case of fractures in the symphyseal and parasymphyseal regions, the opposite situation prevails and a single form of biomechanical behaviour can be expected for this latter region as a whole. 6 Irrespective of the fixation method used, stability is a key factor for the successful treatment of the symphyseal fracture.…”

mentioning

confidence: 99%

“…[5][6][7][8] However, that is only true for fractures in the body and angle of the mandible; in the case of fractures in the symphyseal and parasymphyseal regions, the opposite situation prevails and a single form of biomechanical behaviour can be expected for this latter region as a whole. 6 Irrespective of the fixation method used, stability is a key factor for the successful treatment of the symphyseal fracture. 9,10 This can be evaluated by mechanical tests that simulate the forces that the mandibular fractures will be subjected to, making it possible to determine the resistance of the fixation material and the behaviour of the fractured region.…”

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confidence: 99%

“…4 The symphysis is one of the most common mandibular fracture sites, with reports of prevalence varying from 9% to 57%; it is only surpassed by fractures of the condyle or of the angle. [5][6][7][8][9] Each mandibular region has its own peculiarities, including variations in the forces exerted by the chewing muscles, zones of fragility, and the possible presence of mechanical forces acting in different directions. These factors determine the extent of a region's susceptibility to trauma and its propensity for a favourable response to treatment.…”

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confidence: 99%

“…These factors determine the extent of a region's susceptibility to trauma and its propensity for a favourable response to treatment. 5,11 Recent work done by Madsen et al 6 and by Oliveira and Passeri 4 has involved the comparative biomechanical assessment of different fixation techniques applied to symphyseal and parasymphyseal mandibular fractures, but they did not make use of three-dimensional (3D) fixations.…”

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confidence: 99%

“…12,13 While there have been some investigations using 3D plates as the fixation method, there is no scientific evidence concerning their use in the symphysis/ parasymphysis region. 4,6,[14][15][16][17] Thus the present work was undertaken to perform a laboratory evaluation of the resistance and performance of square and rectangular 2.0-mm system 3D miniplates used to stabilize fractures in the anterior region of the mandible, as compared to the performance of standard pattern plates, namely two straight plates also of the 2.0-mm (screw diameter) system.…”

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confidence: 99%

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In vitro mechanical assessment of 2.0-mm system three-dimensional miniplates in anterior mandibular fractures

Oliveira

Moraes

Silva

et al. 2014

International Journal of Oral and Maxillofacial Surgery

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Abstract. This study constituted a comparative assessment of the mechanical resistance of square and rectangular 2.0-mm system three-dimensional miniplates as compared to the standard configuration using two straight miniplates. 90 polyurethane replica mandibles were used for the mechanical trials. Groups 1, 2, and 3 simulated complete symphyseal fractures characterized by linear separation of the central incisors; groups 4, 5, and 6 simulated parasymphyseal fractures with an oblique configuration. Groups 1 and 4 represented the standard method with two straight miniplates set parallel to one another. Square miniplates were used in groups 2 and 5, and rectangular miniplates in groups 3 and 6. A universal testing machine set to a velocity of 10 mm/min and delivering a vertical linear load to the first left molar was used to test each group. Maximum load values and load values with pre-established dislocation of 5 mm were obtained and submitted to statistical analysis using a calculated reliability interval of 95%. The mechanical performances of the devices were similar, except in the case of rectangular plates used in the parasymphyseal fractures. The innovative fixation methods used showed significantly better results in the case of symphyseal fractures.

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confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

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In vitro mechanical assessment of 2.0-mm system three-dimensional miniplates in anterior mandibular fractures

Oliveira

Moraes

Silva

et al. 2014

International Journal of Oral and Maxillofacial Surgery

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Miniplate Fixation of Fractures of the Symphyseal and Parasymphyseal Regions of the Mandible

Lee

Sawhney

Ducic

2013

JAMA Facial Plast Surg

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To review our experience with miniplate fixation of fractures of the symphyseal and parasymphyseal regions of the mandible. Methods: A retrospective review of all mandible fractures treated from July 1, 1999, through July 31, 2011, by one of us (Y.D.) was performed. Intraoral, open rigid fixation of noncomminuted symphyseal and parasymphyseal fractures was performed using a combination of 2 miniplates that were either a 4-hole or a 6-hole miniplate using monocortical screws. The miniplates were 1-mm thick with a 2-mm screw diameter. Results: A total of 218 patients with noncomminuted symphyseal and parasymphyseal mandible fractures were included in this study. Eighteen patients (8.3%) with concurrent panfacial fractures and other indications were left in postoperative maxillomandibular fixation (MMF), whereas 200 patients (91.7%) did not require postoperative MMF. All patients in this series achieved bony union. The following complications were noted: plate exposure, 2.3%; malocclusion, 1.4%; wound infection, 1.4%; and tooth root injury, 0.9%. The use of postoperative antibiotics and either a nonlocking or locking system was not associated with significant differences in the rates of complications. Conclusions: For noncomminuted symphyseal and parasymphyseal mandible fractures, the application of 2 miniplates with monocortical screws offers good surgical outcomes in most patients with minimal complications. The advantages of using miniplates include easy plate adaptability, no need for MMF unless indicated, small screw diameter, and provision of adequate load-sharing rigid fixation for simple, noncomminuted symphyseal and parasymphyseal mandible fractures.

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Interventions for the management of mandibular fractures

Nasser

Pandis

Fleming

et al. 2013

Cochrane Database of Systematic Reviews

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A Biomechanical Evaluation of Plating Techniques Used for Reconstructing Mandibular Symphysis/Parasymphysis Fractures

Cited by 69 publications

References 14 publications

In vitro mechanical assessment of 2.0-mm system three-dimensional miniplates in anterior mandibular fractures

In vitro mechanical assessment of 2.0-mm system three-dimensional miniplates in anterior mandibular fractures

Miniplate Fixation of Fractures of the Symphyseal and Parasymphyseal Regions of the Mandible

Interventions for the management of mandibular fractures

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