Arzi Boaz, Stover Susan M, Garcia Tanya C, Leale Dustin M, Verstraete Frank J M
Am J Vet Res. 2016 May;77(5):445-51. doi: 10.2460/ajvr.77.5.445.
OBJECTIVE To compare the biomechanical behavior of mandibular critical-sized defects stabilized with 2 plating configurations under in vitro conditions resembling clinical situations. SAMPLE 24 mandibles harvested from 12 adult canine cadavers. PROCEDURES 8 mandibles were kept intact as control samples. A critical-sized defect was created in 16 mandibles; these mandibles were stabilized by use of a single locking plate (LP [n = 8]) or an LP combined with an alveolar miniplate (LMP [8]). Mandibles were loaded in cantilever bending in a single-load-to-failure test with simultaneous recording of load and actuator displacement. Stiffness, yield, and failure properties were compared among groups. Mode of failure was recorded. Radiographic evidence of tooth root and mandibular canal damage was quantified and compared between groups. RESULTS Stiffness and yield loads of single LP and LMP constructs were < 30% of values for intact mandibles, and failure loads were < 45% of values for intact mandibles. There were no consistent biomechanical differences at failure between single LP and LMP constructs, but the LMP construct had greater stiffness and strength prior to yield. Frequency of screw penetration of teeth and the mandibular canal was significantly greater for LMP than for single LP constructs. CONCLUSIONS AND CLINICAL RELEVANCE Both fixation methods were mechanically inferior to an intact mandible. The LMP construct was mechanically stronger than the LP construct but may not be clinically justifiable. Addition of an alveolar miniplate provided additional strength to the construct but resulted in more frequent penetration of tooth roots and the mandibular canal.
在类似于临床情况的体外条件下,比较两种接骨板固定方式稳定下颌骨临界尺寸骨缺损的生物力学行为。样本:从12只成年犬尸体上获取的24个下颌骨。方法:8个下颌骨保持完整作为对照样本。在16个下颌骨上制造临界尺寸骨缺损;这些下颌骨通过使用单锁定接骨板(LP[n = 8])或LP联合牙槽微型接骨板(LMP[8])进行固定。在下颌骨进行悬臂弯曲单负荷至破坏试验,同时记录负荷和致动器位移。比较各组的刚度、屈服和破坏特性。记录破坏模式。对牙根和下颌管损伤的影像学证据进行量化并在组间比较。结果:单LP和LMP结构的刚度和屈服负荷均小于完整下颌骨值的30%,破坏负荷小于完整下颌骨值的45%。单LP和LMP结构在破坏时没有一致的生物力学差异,但LMP结构在屈服前具有更大的刚度和强度。LMP结构的螺钉穿入牙齿和下颌管的频率显著高于单LP结构。结论及临床意义:两种固定方法在力学上均劣于完整的下颌骨。LMP结构在力学上比LP结构更强,但在临床上可能不合理。添加牙槽微型接骨板为结构提供了额外的强度,但导致牙根和下颌管穿入更频繁。