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下颌髁突骨折接骨板固定技术的比较生物力学评估

A comparative biomechanical evaluation of mandibular condyle fracture plating techniques.

作者信息

Asprino Luciana, Consani Simonides, de Moraes Márcio

机构信息

Oral Maxillofacial Surgery, State University of Campinas, Piracicaba Dental School, São Paulo, Brazil.

出版信息

J Oral Maxillofac Surg. 2006 Mar;64(3):452-6. doi: 10.1016/j.joms.2005.11.017.

Abstract

OBJECTIVES

The aim of this study was to comparatively evaluate the resistance of 3 plating rigid internal fixation techniques for mandibular condylar process fractures.

MATERIALS AND METHODS

Synthetic hemi-mandible replicas made in polyurethane were used to evaluate a control, and 3 mandibular condyle plating techniques using 2-mm system plates and screws. The plating techniques were fixation with a 4-hole plate and 4 6-mm screws, fixation with a 4-hole plate and 4 8-mm screws and fixation with 2 4-hole plates with 4 6-mm screws each. Each group was subjected to linear loading in medial to lateral and anterior to posterior directions by an Instron 4411 servohydraulic mechanical testing unit (Instron Corp, Norwood, MA). Load peak value and peak displacement were measured. Means and standard derivations were derived and compared for statistical significance using an analyses variance (P < .05) and compared by Tukey test.

RESULTS

Statistically significant differences were noted between fixation groups for the different mechanical measures evaluated under the different directions of linear loading. The 2-plate fixation system presented better behavior, followed by 1 plate with 4 8-mm screws and 1 plate with 4 6-mm screws. The fixation systems used were more resistant to antero-posterior load and the use of 8-mm screws improved the resistance of the fixation when compared with 6-mm screws only in the antero-posterior test.

CONCLUSION

Under the conditions tested the 2-plate fixation system provided the most favorable mechanical behavior. We can suggest that lengthy screws, with bicortical engagement, can increase the stability at fixation of mandibular condylar process fractures.

摘要

目的

本研究旨在比较评估下颌髁突骨折的三种接骨板坚固内固定技术的抗力。

材料与方法

使用聚氨酯制作的合成半下颌骨复制体作为对照,并采用三种下颌髁突接骨板技术,使用2毫米系统接骨板和螺钉。接骨板技术分别为:用一块4孔接骨板和4枚6毫米螺钉固定;用一块4孔接骨板和4枚8毫米螺钉固定;用两块4孔接骨板,每块接骨板各有4枚6毫米螺钉固定。每组通过一台Instron 4411伺服液压机械测试装置(Instron公司,马萨诸塞州诺伍德)在从内侧到外侧以及从前向后的方向上进行线性加载。测量载荷峰值和峰值位移。计算均值和标准差,并使用方差分析进行统计学显著性比较(P <.05),并通过Tukey检验进行比较。

结果

在不同线性加载方向下评估的不同力学指标方面,各固定组之间存在统计学显著差异。双接骨板固定系统表现更佳,其次是一块接骨板加4枚8毫米螺钉固定和一块接骨板加4枚6毫米螺钉固定。所使用的固定系统对前后向载荷的抵抗力更强,并且仅在前后向测试中,与6毫米螺钉相比,使用8毫米螺钉可提高固定的抗力。

结论

在测试条件下,双接骨板固定系统提供了最有利的力学性能。我们可以认为,具有双皮质骨锚固的长螺钉可增加下颌髁突骨折固定时的稳定性。

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