Can monocortical miniplates provide bony compression?

Kerawala, Cyrus; Allan, W.; Williams, E. D.

doi:10.1016/s0266-4356(03)00101-3

Cited by 13 publications

(5 citation statements)

References 7 publications

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“…The development of mini implants with the application of monocortical screws has revolutionized human maxillofacial trauma and reconstruction . Areas of safe and sufficient cortical bone thickness have been mapped in humans for drilling and placement of monocortical screws, orthodontic implants, and intermaxillary fixation screws .…”

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confidence: 99%

Caudal Mandibular Bone Height and Buccal Cortical Bone Thickness Measured by Computed Tomography in Healthy Dogs

et al. 2015

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Objective: To characterize the bone height and buccal cortical bone thickness of the caudal mandible of healthy dogs.Study Design: Prospective original study.Sample Population: Client-owned dogs (n=36).Methods: Dogs were distributed by weight into 3 groups (<10, 10-20, >20 kg). Thirteen transverse plane computed tomography images were selected for each dog based on anatomic landmarks from the 4th premolar (PM4) through the 2nd molar. On each image, bone thicknesses were measured along the buccal surface of both mandibles from the alveolar margin to the ventral border in 3 mm increments. The number of 3 mm increments were recorded as an estimation of mandibular height.Results: A total of 14,901 measurements were retained for statistical analysis. Buccal bone was generally thicker ventrally in the area studied with decreasing bone thickness over both roots of PM4 and the mesial root of the 1st molar (M1). Cortical bone thickness of <2.0 mm was measured across all groups at most locations 3 mm ventral from the alveolar margin. Mandibular bone height demonstrated significantly fewer (P<.05) 3 mm increments over the distal root of M1 in dogs > 10 kg compared with the number of observations at the immediately mesial and distal locations. Conclusions:Thin cortical bone overlying the mesial and distal roots of PM4 and mesial root of M1 limits these areas for the potential use of monocortical anchorage devices.Decreased mandibular bone height at mandibular M1 may create a stress riser at this location, which along with thin cortical bone may explain why this is a common area for mandibular fracture. 3Maxillofacial injuries reportedly account for 1.6-2.7% of all fractures in dogs. Implants should be placed beneath the alveolar mucosa to prevent dehiscence and plate exposure and therefore placement below the mucogingival junction is necessary. 16The development of mini implants with the application of monocortical screws has revolutionized human maxillofacial trauma and reconstruction. Patients were anesthetized using a variety of anesthetic protocols and an oral evaluation and periodontal probing of mandibular teeth was performed on all dogs by 1 investigator (CJS or JWS). The imaging study for which the dogs were presented was completed prior to positioning dogs in sternal recumbency for image acquisition for this study (GE HiSpeed LX/i CT, GE Medical Systems, Milawaukee, WI). The head was extended with the lower jaw elevated and oriented with the ventral border of the mandibles parallel to the tabletop (Fig 1). Images were acquired in the transverse plane using 1 mm slice thickness and an interval from the mandibular 1st incisors through the temporomandibular joint using a high (Table 1; Fig 2). Profile images were selected demonstrating greatest cortical bone thickness at locations not overlying tooth root structure (interproximal, furcational, and caudal to the 2nd molar (M2) locations as well as thinnest cortical bone and centered over root structures (mesial and distal roots).The interproximal space was def...

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confidence: 99%

Caudal Mandibular Bone Height and Buccal Cortical Bone Thickness Measured by Computed Tomography in Healthy Dogs

et al. 2015

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“…In the case of monocortical screws, 2 mm of cortical bone present in the buccal sector seems insufficient to ensure segment stability. Additionally, in an experimental model (Kerawala et al, 2003) the possibility of compression with plates and monocortical screws was reported, highlighting the importance to the cortical bone in the area. Using the available bone, the ideal sector to install the screws is related to the central incisors, which present greater symphysis height compared to the canine zone.…”

Section: Discussionmentioning

confidence: 97%

Cortical and Cancellous Bone in Mandibular Symphysis: Implications in Osteosynthesis and Osteotomy

et al. 2017

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SUMMARY:The aim of this study was to quantify the presence of cortical and cancellous bone in the mandibular symphysis. A descriptive study was conducted using cone beam computed tomography where skeletal class I and class III subjects were included, defined according to characteristics detected on dental, clinical and dental occlusion x-rays. From the 3D reconstruction, sections were used in relation to the axial axis of the teeth of the anterior sector; the amount of buccal cortical, cortical, lingual, inferior cortical and cancellous bone as well as symphysis height were determined. The measurements were taken using routine methods and analyzed with ANOVA and Tukey's HSD test with p <0.05 for statistical significance. 20 skeletal class I subjects aged 23 years (± 4.5) and 20 class III subjects aged 22 years (± 5.2) were included. Symphysis height was significantly greater in skeletal class III subjects, exceeding by 0.8 mm the height of class I subjects; the buccal cortical bone presented on average 2 mm less at different dental levels, whereas the lingual cortical and inferior basal bones were significantly larger than the buccal cortical bone. The cancellous and cortical bones did not present any significant differences between the two groups (p=0.093). The buccal and basilar cortical bone is smaller than lingual cortical bone.

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“…11 Biomechanical principles state that fixation should not only be able resist tensile, torsional, and shear stresses (which are detrimental to bone healing), but also provide adequate compressive stress. 12 As open reduction and internal fixation is widely performed clinically, determining a predicable protocol for fixation is important. Previous comparisons of various fixation techniques mainly relied on clinical observation of complications and radiography, such as CT measurements of fracture displacement.…”

Section: Discussionmentioning

confidence: 99%

“…Fracture healing is a process of redistributing and recombining stress 11 . Biomechanical principles state that fixation should not only be able resist tensile, torsional, and shear stresses (which are detrimental to bone healing), but also provide adequate compressive stress 12 . As open reduction and internal fixation is widely performed clinically, determining a predicable protocol for fixation is important.…”

Section: Discussionmentioning

confidence: 99%

Finite Element Analysis of Two- and Three-Dimensional Fixation in Treating Mandibular Symphyseal Fracture Combined With Bilateral Condylar Intracapsular Fractures

Zhou

Rong

et al. 2021

Journal of Craniofacial Surgery

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The aim of this study was to compare through finite element analysis two-and three-dimensional (2D and 3D) fixation in the treatment of mandibular symphyseal fracture combined with bilateral condylar intracapsular fractures. The authors created 2 fixation models for the above fracture, and analyzed the stress and displacement in the mandible and fixation materials under 3 loading conditions. The von Mises stress of the mandible and plates peaked during lateral occlusion, and was lowest during central occlusion. In all conditions, stresses in the fixation materials did not exceed the yield stress of titanium. The inferior border of the symphyseal fracture segments showed opposing displacements, and the mandible tended to widen in the 2D fixation model. However, the fracture displacement did not exceed 150 mm for either fixation method. The results suggested that after well reduction and fixation of condylar intracapsular fractures, either 2D or 3D fixation for symphyseal fracture can provide adequately strong fixation. Compared with 2D fixation, 3D fixation has more advantages in controlling the mandibular width and preventing the fixation materials from enduring excessive stress.

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Can monocortical miniplates provide bony compression?

Cited by 13 publications

References 7 publications

Caudal Mandibular Bone Height and Buccal Cortical Bone Thickness Measured by Computed Tomography in Healthy Dogs

Caudal Mandibular Bone Height and Buccal Cortical Bone Thickness Measured by Computed Tomography in Healthy Dogs

Cortical and Cancellous Bone in Mandibular Symphysis: Implications in Osteosynthesis and Osteotomy

Finite Element Analysis of Two- and Three-Dimensional Fixation in Treating Mandibular Symphyseal Fracture Combined With Bilateral Condylar Intracapsular Fractures

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