Comparison of five different fixation techniques of sagittal split ramus osteotomy using three-dimensional finite elements analysis

Sato, Fábio Ricardo Loureiro; Asprino, Luciana; Noritomi, Pedro Yoshito; Silva, J.V.L. da; Moraes, Márcio de

doi:10.1016/j.ijom.2012.03.018

Cited by 33 publications

(31 citation statements)

References 30 publications

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“…4,5 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 577 578 579 580 581 582 583 584 585 586 587 588 589 590 591 592 593 594 595 596 597 598 599 600 601 602 603 604 605 606 607 608 609 610 611 612 613 614 615 616 617 However, because of the esthetic disadvantage, some patients undergoing orthognathic surgery reject a transcutaneous approach. 15,21 To avoid skin incision, the authors performed intraoral bicortical screw fixation. Becker et al 15 reported that advantages of the intraoral approach include avoiding external skin scars and damage to the mandibular branch of the facial nerve, especially in patients requiring a high level of esthetic satisfaction.…”

Section: Discussionmentioning

confidence: 99%

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Does Intraoral Miniplate Fixation Have Good Postoperative Stability After Sagittal Splitting Ramus Osteotomy? Comparison With Intraoral Bicortical Screw Fixation

Nakakuki

Kosugi

Kurohara

et al. 2016

Journal of Oral and Maxillofacial Surgery

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Section: Discussionmentioning

confidence: 99%

“…[22][23][24] These reports have indicated that bicortical screw fixation have stronger resistance against force than miniplate fixation. Sato et al 20,21 Q5 studied resistance and tension areas created after loading in different fixation systems. They indicated that bicortical screw fixation was more rigid than miniplate fixation.…”

Section: Discussionmentioning

confidence: 99%

Does Intraoral Miniplate Fixation Have Good Postoperative Stability After Sagittal Splitting Ramus Osteotomy? Comparison With Intraoral Bicortical Screw Fixation

Nakakuki

Kosugi

Kurohara

et al. 2016

Journal of Oral and Maxillofacial Surgery

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“…This study was conducted according to previously described methods that used mechanical and photoelastic test and finite element analysis. In the mechanical test, one polyurethane hemimandible was sectioned according to sagittal split ramus osteotomy proposed by Epker in 1977.…”

Section: Methodsmentioning

confidence: 99%

“…When great movement is present or needed, with segments of thin bone structures and bad split cases, the use of miniplates represents a better clinical option. Furthermore, in some situations, such as in cases of great movement and asymmetry, miniplates are a better choice than positional screws.…”

Section: Introductionmentioning

confidence: 99%

Fixation of sagittal split ramus osteotomy of the mandible: a comparative assessment of three techniques based on mechanical, photoelastic and finite element analysis

et al. 2017

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Aim:The purpose of the present study was to compare the mechanical characteristics and stress distribution when using two plates, or two plates joined by bridge, in the fixation of sagittal split ramus osteotomy (SSRO). Material and methods: A 3D finite element model of a hemimandible was created and a 5 mm advancement SSRO was simulated on a computer model. The model was fixed using three different techniques: two plates; two plates joined by one bridge; and two plates joined by two bridges. Load was applied until 3 mm displacement was attained and the results were compared with previous mechanical and photoelastic tests, thus analysing the mechanical stress developed in the proximity of miniplates and screws, as well as within the fixation system itself. Results: Fixation with two separate plates produced better mechanical resistance in the mechanical test for peak displacement, peak and ending load. In the photoelastic test, the same group exhibited better stress distribution, far from the osteotomy line. In the finite element analysis, the best technique involved two plates joined by one bridge, with the results showing a more uniform stress distribution. Conclusions: This article may provide knowledge about the rational advantages of using two plates, which produced more mechanical resistance and better stress distribution. Clinical relevanceScientific rationale for study Several companies offer osteosynthesis products to use in orthognathic surgery. When the surgeon decided to use two 2.0 mm plates in the fixation of sagittal split ramus osteotomy, is the addition of one or two bridges between the plates improves mechanical stability? Principal findingsTwo plates without bridge showed highest mechanical resistance and better stress distribution for areas of thicker bone. Practical implicationsThis article provides knowledge about the advantages of choosing separated plates in the fixation of mandibular sagittal split osteotomies.Oral Surgery 10 (2017) e48--e54.

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“…RIF methods contribute to postoperative bone healing and masticatory function. Furthermore, using RIF method, instead of intermaxillary rigid fixation, can initiate the early improvement of oral hygiene [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Fixation Methods for Mandibular Advancement and Their Effects on Temporomandibular Joint: A Finite Element Analysis Study

Demircan

Ureturk

Apaydin

et al. 2020

BioMed Research International

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Objectives. Bilateral sagittal split osteotomy (BSSO) is a common surgical procedure to correct dentofacial deformities that involve the mandible. Usually bicortical bone fixation screw or miniplates with monocortical bone fixation screw were used to gain stability after BSSO. On the other hand, the use of resorbable screw materials had been reported. In this study, our aim is to determine first stress distribution values at the temporomandibular joint (TMJ) and second displacement amounts of each mandibular bone segment. Methods. A three-dimensional virtual mesh model of the mandible was constructed. Then, BSSO with 9 mm advancement was simulated using the finite element model (FEM). Fixation between each mandibular segment was also virtually performed using seven different combinations of fixation materials, as follows: miniplate only (M), miniplate and a titanium bicortical bone fixation screw (H), miniplate and a resorbable bicortical bone fixation screw (HR), 3 L-shaped titanium bicortical bone fixation screws (L), 3 L-shaped resorbable bicortical bone fixation screws (LR), 3 inverted L-shaped titanium bicortical bone fixation screws (IL), and 3 inverted L-shaped resorbable bicortical bone fixation screws (ILR). Results. At 9 mm advancement, the biggest stress values at the anterior area TMJ was seen at M fixation and LR fixation at posterior TMJ. The minimum stress values on anterior TMJ were seen at L fixation and M fixation at posterior TMJ. Minimum displacement was seen in IL method. It was followed by L, H, HR, M, ILR, and LR, respectively. Conclusion. According to our results, bicortical screw fixation was associated with more stress on the condyle. In terms of total stress value, especially LR and ILR lead to higher amounts.

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Comparison of five different fixation techniques of sagittal split ramus osteotomy using three-dimensional finite elements analysis

Cited by 33 publications

References 30 publications

Does Intraoral Miniplate Fixation Have Good Postoperative Stability After Sagittal Splitting Ramus Osteotomy? Comparison With Intraoral Bicortical Screw Fixation

Does Intraoral Miniplate Fixation Have Good Postoperative Stability After Sagittal Splitting Ramus Osteotomy? Comparison With Intraoral Bicortical Screw Fixation

Fixation of sagittal split ramus osteotomy of the mandible: a comparative assessment of three techniques based on mechanical, photoelastic and finite element analysis

Fixation Methods for Mandibular Advancement and Their Effects on Temporomandibular Joint: A Finite Element Analysis Study

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