Andrade Valdir Cabral, Luthi Leonardo Flores, Sato Fabio Loureiro, Pozzer Leandro, Olate Sergio, Albergaria-Barbosa Jose Ricardo
Department of Oral and Maxillofacial Surgery, State University of Campinas, São Paulo, Brazil.
Department of Oral Rehabilitation and Periodontics, State University of Campinas, São Paulo, Brazil.
J Korean Assoc Oral Maxillofac Surg. 2015 Jun;41(3):133-8. doi: 10.5125/jkaoms.2015.41.3.133. Epub 2015 Jun 23.
To evaluate the influence of the type of osteotomy in the inferior aspect of the mandible on the mechanical performance.
The study was performed on 20 polyurethane hemimandibles. A sagittal split ramus osteotomy (SSRO) was designed in 10 hemimandibles (group 1) with a vertical osteotomy in the buccal side (second molar level) and final osteotomy was performed horizontally on the lingual aspect, while the mandible body osteotomy was finalized as a straight osteotomy in the basilar area, perpendicular to the body. For group 2, the same osteotomy technique was used, but an oblique osteotomy was done in the basilar aspect of the mandibular body, forming continuity with the sagittal cut in the basilar area. Using a surgical guide, osteosynthesis was performed with bicortical screws using an inverted L scheme. In both groups vertical compression tests were performed with a linear load of 1 mm/min on the central fossa of the first molar and tests were done with models made from photoelastic resin. Data were analyzed using Student's t-test, establishing a statistical significance when P <0.05.
A statistical difference was not observed in the maximum displacements obtained in the two osteotomies (P <0.05). In the extensiometric analysis, statistically significant differences were identified only in the middle screw of the fixation. The photoelastic resin models showed force dissipation towards the inferior aspect of the mandible in both SSRO models.
We found that osteotomy of the inferior aspect did not influence the mechanical performance for osteosynthesis with an inverted L system.
评估下颌骨下缘截骨类型对力学性能的影响。
对20个聚氨酯半下颌骨进行研究。在10个半下颌骨(第1组)中设计矢状劈开下颌支截骨术(SSRO),在颊侧(第二磨牙水平)进行垂直截骨,最终在舌侧进行水平截骨,而下颌骨体截骨在基底区域最终确定为垂直于骨体的直线截骨。对于第2组,采用相同的截骨技术,但在下颌骨体的基底部分进行斜行截骨,与基底区域的矢状切口形成连续。使用手术导板,采用倒L形方案用双皮质螺钉进行骨内固定。在两组中,对第一磨牙中央窝以1 mm/min的线性载荷进行垂直压缩试验,并对由光弹性树脂制成的模型进行测试。使用学生t检验分析数据,当P<0.05时确定具有统计学意义。
两种截骨术获得的最大位移未观察到统计学差异(P<0.05)。在伸长测量分析中,仅在固定的中间螺钉处发现统计学上的显著差异。光弹性树脂模型在两个SSRO模型中均显示力向下颌骨下缘消散。
我们发现下颌骨下缘截骨术对倒L形系统骨内固定的力学性能没有影响。