Biomechanical Evaluation of Bite Force after Reduction and Fixation of Different Mandibular Angle Fracture Patterns with Different Miniplate Osteosynthesis Using the Finite Element Analysis

Document Type : Original Article

Authors

1 Department of Oral and Maxillofacial surgery., Faculty of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

2 Department of Oral and Maxillofacial surgery., Faculty of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

3 Department of Oral and Maxillofacial surgery., Faculty of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 3-Dentist.

Abstract

Background and Objective: The aim of this study was to compare bite force in different mandibular angle fracture patterns after reduction and fixation with miniplate osteosynthesis with intact mandibles using finite element analysis (FEA).
Subject and Methods: Three-dimensional finite element models of human mandible was prepared using CBCT. Simulated intact mandible and 4 different types of angle fractures were fixed with 5 different fixation methods of titanium miniplates. The finite element analysis was performed to determine bite force during clenching in the intercuspal position under loading with full masticatory forces.
Results: Bite force in the mandible reduced with 2 miniplates were closer that in the intact mandible. The use of double miniplates on the inferior border of the lateral cortex and external oblique ridge showed the best bite force and the single plate on superior border of the lateral cortex pattern was the worst.
Conclusion: This study presented a FEA based indirect method to estimate bite force. Finite element method can be effective tool in maxillofacial researches. Double miniplate fixation method for patients with mandibular angle fracture have a biomechanical advantage over 1 miniplate on the restoration of bite force.
 

Keywords

References

-Fernandez R،Gallas M,Viano Jm.A three dimensional numerical simulation of mandibular fracture reduction with screwed miniplates.J biomechanics.2003;36:329-37.
2-Vetter JD,Topazian RG,Goldberg MH,Smith DG.Facial fractures occuring in a medium sized metropolitian area:recend trends.Int J Oral Maxillofac Surg.1991;20:214-16.
3-Haug RH,Prather J,Indersano AT.An epidemiologic survey of facial fractures and concomitant injueris.J Oral Maxillofac Surger.1990;48:926-32.
4-Libersa P,Roze D,Dumousseau T.Spontaneous mandibular fracture in a partially edentulous patient :case report.J Can Dent Assoc.2003;69:428-30.
5-A. Shalleve, C, V. Huempfner. Transient finite element analysis of traumatic fracture of the Zygomatic bone coused by a head collision. Int J oralmaxillofacial surg: 2012; 41: 66-73.
6-S. Tharani, Kumar. Evaluation of bite force after open reduction and internal fixation using microplates J of dentistry Tehran uni. 2013; vol. 10, No. 5. 475-485.
7-Korkmaz H. Evaluation of different miniplates in fixation of fractured human mandible with FEA. Oral surg oral med oral path oral Rad Endad. 2007 Jun; 103(6): 11-13.
8-Gear AJ, APasovaE, Treatment modalities for mandibular angle fractures. Journal Maxillofa surg. 2005; 63(5); 655-630.
9-Wagnar WF,Neal DC ,Alpert B.Morbidity associated with extraoral open reduction of mandibular fractures .J Oral Surg.1979;37:97-100.
10-James RB,Fredrickson C,Kent JN .Prospective study of mandibular fractures.J Oral surg.1981;39:275-81.
11-Chuong R,Donoff RB ,Guralnick WC.A retrospective analysis of 327 mandibular fracturs.J Oral Maxillofac Surg.1983;41:305-9.
12-Lizuka T,Lindqvist c,Hallikainen D.Infection after rigid internal fixation of mandibular angle fractures:a clinical and radiologic study.J Oral Maxillofac Surg.1991;49:585-93.
13-Dichard A,Klotch DW.Testing biomechanical strength of repairs for the mandibular angle fracture .Laryngoscope1994;104:201-8.
14-Dana Ak.Comparsion of a single non compression miniplate versus 2 noncompression miniplates in the treatment of mandibular angle fractures.J Oral Maxillofac Surg.2010;68:1565-7.
15-Ellis III E . Treatment methods for fractures of the mandibular angle. J Craniomaxillofac Trauma 1996; 2: 28- 36.
16-Amstrong JEA, Lapointe HJ, Hogg NJV, Kwok AD. Preliminary investigation of the biomechanics of internal fixation of sagittal split osteotomies with miniplates using a newly designed in vitro testing model. J Oral Maxillofac Surg. 2001; 59: 191-5.
17-Crofts CE, trowbridge A, Aung TM. A comparative in vitro study of fixation of mandibular fractures with parskeletal clamps or screw plates. J Oral Maxillofac Surg. 1990 ; 48: 461.
18-Haug RH. The effects of screw number and length on two methods of tension band plating J Oral Maxillofac surg. 1993; 51: 159.
19-Korioth TW, Hannam AG. Deformation of the human mandible during simulated tooth clenching . J Dent Res. 1994; 73(1): 56-66.
20-Hegtcedth AK, Michaels GC, Beals DW. Comparison of the resistance of miniplates and microplates to various in vitro forces. J Oral Maxillofac Surg. 1994; 52: 251-7.
21-Dolanmaz D, Uckan S, Isik K, Saglam H. Comparison of stability of obsorbable and titanium plate and screw fixation for sagital split ramus osteotomy. Br J Oral Maxillofac Surg. 2004; 42: 127-32.
22-Hammer B, Schier P, Prein J. Osteosynthesis of condyla neck fractures: a reviw of 30 patients. Br J Oral Maxillofac Surg. 1997; 35: 288-91.
23-ChoiBH,Yoo JH.Clinical evaluation of 3 type of plate osteosynthesis for fixation of condylar neck fractures.J Oral maxillofac Surg.2001;59:734-7.
24-Sugiura T, Yamamoto K, Murakami K, Sugimura M. A comparative evaluation of osteosynthesis with lag screws , miniplates, or Kirschner wires for mandibular condylar process fractures. J Oral Maxillofac Surg. 2001; 59: 1161-8.
25-Undt G, Kermer C, Rasse M, Sinko K, Evers R. Transoral miniplate osteosynthesis of condylar neck fractures . Oral Surg Oral Med Oral Pathol Oral Radiol endod. 1999; 88: 534-43.
26-Ellis E, Dean J. Rigid fixation of mandibular condyle fractures. Oral surg Oral Med Oral Pathol Oral Radiol Endod. 1993; 76: 6 – 15.
27. Wagner A, Krach W, Schicho k, Undt G, Ploder O, Ewers R. A 3- dimensional finite – element analysis investigating the biomechainical behavior of the mandible and plate osteosynthesis in cases of fractures of the condylar process. Oral Surg Oral Pathol Oral Radiol Endod 2002; 94: 678-86.
28-Champy M, Loddé JP, Schmitt R, Jaeger JH, Muster D. mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg. 1978 Feb; 6(1): 14-21.
29-Ellis E 3rd, Walker LR. Treatment of mandibular angle fractures using one noncompression miniplate. J Oral Maxillofac Surg. 1996; 54(7): 864-71.
30-Choi BH, Kim Kn, Kang HS: Clinical and in vitro evaluation of mandibular angle fracture fixation with two – miniplate system . Oral Surg Oral Med Oral Pathol oral Radiol Endod. 79: 692, 1995.
31-Shetty V, McBreaty D, Fourney M, et al: Fracture line stability as a function of the internal fixation system: An in vitro comparison using a mandibular angle fracture model. J Oral Maxillofac Surg. 53: 791, 1995.
33-Bayram B , Araz K, Uckan S, Balcik C. Comparison of fixation stability of resorbable versus titanium plate and screws in mandibular angle fractures . J Oral Maxillofac Surg 2009; 67: 1644 – 8.
34-Wang H, Ji B, Jiang w, Liu L, Zhang P, Tang W, Tian W, Fan Y. Three – dimensional finite element analysis of mechanical stress in symphyseal fractured human mandible reduced with miniplates during mastication. J Oral Maxillofac Surg. 2010; 67(7): 1585-92.
35-Arbag H, Korkmaz HH, Ozturk K, Uyar Y. Comparative evaluation of different miniplates for internal fixation of mandible fractures using finite element analysis. J Oral Maxillofac Surg. 2008; 66(6): 1225 – 32.
36-Auto CAD 2013-3D CAD Design Software. 2012. Autodesk. Available at : URL: http://usa . autodesk. Com/ autocad. Accessed nov. 10, 2012.
37-Dicom Homepage. 2012 . Nema. Available at: URL: http: // dicom. Nema. Org. Accessed nov. 15, 2012.
38-Marentette L. miniplate osteosynthesis of mandible fractures. Open Tech Otolaryngol Head Neck Surg. 1995; 6(2): 86-88.
39-Kumar S, Prabhakar V, Rao K, Brar r. A comparative review of treatment of 80 mandibular angle fracture fixation with miniplates using three different thechniques . Indian J Otolaryngol Head Neck Surg. 2011; 63(2): 190-2.   
 
 
 
 
 
Jundishapur Scientific Medical Journal
Volume 14, Issue 3 - Serial Number 96
May and June 2015
Pages 323-332

Files

History

  • Receive Date: 01 February 2015
  • Revise Date: 12 February 2015
  • Accept Date: 16 March 2015

Share

How to cite

Statistics