Lee Jin-Yong, Lee Jung-Woo, Pang Kang-Mi, Kim Hyoun-Ee, Kim Soung-Min, Lee Jong-Ho
Clinical Assistant Professor, Department of Dentistry, Korea University Guro Hospital, Seoul, Korea.
Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Kyunghee University School of Dentistry, Seoul, Korea.
J Oral Maxillofac Surg. 2014 Feb;72(2):402.e1-13. doi: 10.1016/j.joms.2013.10.003. Epub 2013 Oct 17.
The aim of this study was to evaluate the stress distribution of a magnesium (Mg)-based resorbable screw system in a bilateral sagittal split ramus osteotomy (BSSO) and to compare its biomechanical stability with those of titanium (Ti)-based and polymer (IN)-based systems.
A 3-dimensional BSSO model (10-mm advancement and setback) was constructed with Mimics. Bicortical screw fixation using Ti, IN, and Mg screws was performed with 4 different geometries of fixation. With an occlusal load of 132 N on the lower first molar, the von Mises stress (VMS) distribution was calculated using ANSYS.
The VMS distribution of Mg was more similar to that of Ti than to that of IN. In all cases, the highest VMS was concentrated on the screw at the most posterior and superior area. Stress was distributed mainly around the screw holes (cancellous bone) and the retromolar area (cortical bone). In the advancement surgery, fixation with 5 Mg screws (5A-Mg, 99.810 MPa at cortical bone) showed biomechanical stability, whereas fixation with the same number of IN screws did not (5A-IN, 109.021 MPa at cortical bone). In the setback surgery, although the maximum VMSs at cortical bone for Mg, IN, and Ti were lower than 108 MPa (yield strength of cortical bone), Mg screws showed more favorable results than IN screws because the maximum VMSs of Mg at cancellous bone were lower than those of IN.
The Mg-based resorbable screw system is a promising alternative to the IN-based system.
本研究旨在评估镁(Mg)基可吸收螺钉系统在双侧矢状劈开下颌支截骨术(BSSO)中的应力分布,并将其生物力学稳定性与钛(Ti)基和聚合物(IN)基系统进行比较。
使用Mimics构建三维BSSO模型(前移和后退10毫米)。采用4种不同的固定几何形状,分别用Ti、IN和Mg螺钉进行双皮质螺钉固定。在下颌第一磨牙施加132 N的咬合负荷,使用ANSYS计算冯·米塞斯应力(VMS)分布。
Mg的VMS分布与Ti的更相似,而与IN的不同。在所有情况下,最高的VMS集中在最后方和上方区域的螺钉上。应力主要分布在螺钉孔(松质骨)和磨牙后区(皮质骨)周围。在前移手术中,用5枚Mg螺钉固定(5A-Mg,皮质骨处为99.810 MPa)显示出生物力学稳定性,而用相同数量的IN螺钉固定则没有(5A-IN,皮质骨处为109.021 MPa)。在后退手术中,尽管Mg、IN和Ti在皮质骨处的最大VMS均低于108 MPa(皮质骨的屈服强度),但Mg螺钉显示出比IN螺钉更有利的结果,因为Mg在松质骨处的最大VMS低于IN。
Mg基可吸收螺钉系统是IN基系统的一个有前景的替代方案。