Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons · 2017
Computed Tomography-Based 3-Dimensional Finite Element Analyses of Various Types of Plates Placed for a Virtually Reduced Unilateral Condylar Fracture of the Mandible of a Patient.
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Murakami Kazuhiro, Yamamoto Kazuhiko, Sugiura Tsutomu, Horita Satoshi, Matsusue Yumiko, Kirita Tadaaki
Аннотация
PURPOSE: This study was performed to evaluate stresses in various types of plates placed for a virtually reduced unilateral condylar fracture of the mandible using computed tomography-based 3-dimensional finite element (FE) models of a patient to select the optimal plate system.
MATERIALS AND METHODS: A computed tomography-based FE model of the mandible of a patient with a unilateral condylar fracture was constructed. The fracture was virtually reduced and fixed with 1 straight titanium plate; 2 straight titanium plates; 2 straight poly-L-lactic acid plates; and 4-hole (box), 5-hole (strut), and 7-hole (lambda) condylar plates. Stresses developing in these plates were analyzed by applying 478.1 N of bite force at the first molar of the contralateral side of the mandible.
RESULTS: The magnitudes of tensile stress were within the tensile strength in all types of plates. However, the magnitudes of compressive stress in 1 straight titanium plate and 2 straight poly-L-lactic acid plates were beyond the compressive strength. The tensile and compressive stresses of the 5-hole (strut) plate were the smallest among the 3 types of condylar plates.
CONCLUSIONS: Fixation by 2 straight titanium plates or any type of condylar plate was biomechanically indicated for the condylar fracture of this patient. Among these plates, the 5-hole (strut) plate was considered optimal. FE analysis is useful in selecting the optimal fixation method in the individual patient.
MATERIALS AND METHODS: A computed tomography-based FE model of the mandible of a patient with a unilateral condylar fracture was constructed. The fracture was virtually reduced and fixed with 1 straight titanium plate; 2 straight titanium plates; 2 straight poly-L-lactic acid plates; and 4-hole (box), 5-hole (strut), and 7-hole (lambda) condylar plates. Stresses developing in these plates were analyzed by applying 478.1 N of bite force at the first molar of the contralateral side of the mandible.
RESULTS: The magnitudes of tensile stress were within the tensile strength in all types of plates. However, the magnitudes of compressive stress in 1 straight titanium plate and 2 straight poly-L-lactic acid plates were beyond the compressive strength. The tensile and compressive stresses of the 5-hole (strut) plate were the smallest among the 3 types of condylar plates.
CONCLUSIONS: Fixation by 2 straight titanium plates or any type of condylar plate was biomechanically indicated for the condylar fracture of this patient. Among these plates, the 5-hole (strut) plate was considered optimal. FE analysis is useful in selecting the optimal fixation method in the individual patient.