Changes in the inferior alveolar nerve following sagittal split ramus osteotomy in monkeys: A comparison of monocortical and bicortical fixation

Hu, Jing; Zhao, Qiang; Tang, Jie; Zheng, Zongsheng; Qi, Mengchun

doi:10.1016/j.bjoms.2006.08.008

Cited by 11 publications

(5 citation statements)

References 16 publications

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“…The advantages of traditional 4HMCPf are as follows: a lower degree of inferior alveolar nerve damage [29], faster recovery of inferior alveolar nerve function [30], no scars on the face from transbuccal drilling, the prevention of mandible condylar rotation [4,31], and possible latent positional adjustability of the mandible segment at the fixation site [32]. Despite the popularity and advantages of the 4HMCP [4,5,21,29,30,32], the disadvantages of 4HMCP fixation are as follows. First, the plate should be molded according to the shape of the mandible curve and it is not easy to fit all the holes of the plate perfectly on the mandible surface without distorting the orientation of the bone segments.…”

Section: Advantages and Disadvantages Of Monocortical Platementioning

confidence: 99%

Investigation of a Modified Novel Technique in Bilateral Sagittal Splitting Osteotomy Fixation: Finite Element Analysis and In Vitro Biomechanical Test

Chang

Chen

Jeng

et al. 2020

BioMed Research International

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Purpose. To evaluate the biomechanical properties of the modified novel 2-hole monocortical plate fixation (2HMCPf) and traditional 4-hole monocortical plate fixation (4HMCPf) techniques in bilateral sagittal splitting osteotomy (BSSO) synthesis using a finite element analysis (FEA) and an in vitro biomechanical test with the application of a shearing loading force on a sawbone mandible model. Materials and Methods. A three-dimensional mandible models were generated using the geometry obtained from the computerized tomography image of a sawbone mandible. Plates and screws were generated and combined with the mandible in a CAD environment. The 2HMCPf and traditional 4HMCPf techniques for BSSO osteosynthesis were then analyzed under the occlusal load using the FEA. An in vitro biomechanical test was executed to verify the result of FEA. The force on fixation failure and pattern of failure were recorded. Results. The results revealed that the von Mises Stress on the mandible cortical bone (75.98 MPa) and the screw/plate (457.19 MPa) of the 2HMCPf group was lower than that of the 4HMCPf group (987.68 MPa, 1781.59 MPa). The stress concentrated on the central region of the 4HMCPf group and the distal set of the 2HMCPf group. In vitro study using the sawbone mandible model showed mechanical failure at the region of the proximal segment near the osteotomy site with the 4HMCPf group (average 32.198 N) but no failure on the fixation sites with the 2HMCPf group. Instead, the mandible sawbone fractured on the condyle neck region (average 44.953 N). Conclusion. From the biomechanical perspective, we proved that the 2HMCPf method was able to withstand a higher shearing loading force than the 4HMCPf fixation method in BSSO osteosynthesis.

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Section: Advantages and Disadvantages Of Monocortical Platementioning

confidence: 99%

Investigation of a Modified Novel Technique in Bilateral Sagittal Splitting Osteotomy Fixation: Finite Element Analysis and In Vitro Biomechanical Test

Chang

Chen

Jeng

et al. 2020

BioMed Research International

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“…1). In a study on monkeys comparing bicortical and monocortical osteosynthesis, signs of Wallerian degeneration, including demyelination, axonal swelling, and axoplasmic darkening after mandibular setback by BSSO were observed with both types of fixation (11). In a clinical study, electrical signals from nerves recorded intraoperatively decreased, indicative of blocked conduction, when the first fixation screw was tightened and the compression between the fragments increased (12).…”

Section: Inferior Alveolar Nerve Injury During Mandibular Osteotomymentioning

confidence: 99%

Inferior alveolar nerve injury following orthognathic surgery: a review of assessment issues

Phillips¹,

Essick

2010

Journal of Oral Rehabilitation

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SUMMARYThe sensory branches of the trigeminal nerve encode information about facial expressions, speaking and chewing movements, and stimuli that come into contact with the orofacial tissues. Whatever the cause, damage to the inferior alveolar nerve negatively affects the quality of facial sensibility as well as the patient's ability to translate patterns of altered nerve activity into functionally meaningful motor behaviours. There is no generally accepted, standard method of estimating sensory disturbances in the distribution of the inferior alveolar nerve following injury. Assessment of sensory alterations can be conducted using three types of measures: (i) objective electrophysiological measures of nerve conduction, (ii) sensory testing (stimulus) measures and (iii) patient report. Each type of measure with advantages and disadvantages for use are reviewed.

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“…Ochs 22 concluded that using 3 bicortical screws was the most cost‐effective and rigid method, providing a favourable prognosis. However, a number of recent reports have shown that the stability of miniplate fixation is equal to that provided by bicortical screw fixation 23 . Choi et al 24 suggested that stability at more than 24 months after surgery did not differ significantly between the bicortical screw fixation and the miniplate with monocortical screw fixation.…”

Section: Discussionmentioning

confidence: 97%

Comparison of Maximum Mouth Opening Following Mandibular Bilateral Sagittal Splitting Ramus osteotomies in Class III Females Using Two Different Osteosynthesis Methods

Ooi

Inoue

Matsushita

et al. 2020

J of Oral Rehabilitation

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Background Limitation of mouth opening is a common complaint following orthognathic surgery. Objectives This investigation reports on the progress of maximum incisal opening following orthognathic surgery and compares the impact of two different osteosynthesis methods on mouth opening in female patients with Class III dentofacial deformities. Methods Forty cases of skeletal class III malocclusion were divided into twenty cases treated using the conventional single miniplate osteosynthesis method (P1) and twenty cases using the additional L‐shaped miniplate osteosynthesis method (P2). No significant differences in pre‐operative clinical status were detected between the P1 and P2 group, and all patients were managed with elastics in the post‐operative period. Independent mouth opening exercises were initiated seven days after surgery, and inter‐incisal distance was measured as maximum mouth opening (MMO) at 1 week, 2 weeks, and 1, 2, 3, 6 months. Statistical analysis was performed in order to analyse differences in MMO between the P1 and P2 groups (Prism 7 GraphPad software, San Diego, CA). Values of P < .05 were considered to be significant. Results MMO significantly increased from 2 weeks after surgery in both groups. The MMO of P2 was significantly larger than that of P1 in all experimental periods after surgery. MMO was statistically improved in P2 at 2 months after surgery, while MMO in P1 was significantly smaller than the pre‐operative MMO, even at 6 months post‐operative. A minimum MMO of 40 mm was achieved by all patients. Conclusion L‐shaped miniplate osteosynthesis was more useful for early limitation of mandibular opening improvement than conventional single miniplate osteosynthesis.

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Changes in the inferior alveolar nerve following sagittal split ramus osteotomy in monkeys: A comparison of monocortical and bicortical fixation

Cited by 11 publications

References 16 publications

Investigation of a Modified Novel Technique in Bilateral Sagittal Splitting Osteotomy Fixation: Finite Element Analysis and In Vitro Biomechanical Test

Investigation of a Modified Novel Technique in Bilateral Sagittal Splitting Osteotomy Fixation: Finite Element Analysis and In Vitro Biomechanical Test

Inferior alveolar nerve injury following orthognathic surgery: a review of assessment issues

Comparison of Maximum Mouth Opening Following Mandibular Bilateral Sagittal Splitting Ramus osteotomies in Class III Females Using Two Different Osteosynthesis Methods

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