Sittitavornwong Somsak, Denson Douglas, Ashley David, Walma David Cruz, Potter Sarah, Freind Jonathan
Associate Professor, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL.
Senior Resident, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL.
J Oral Maxillofac Surg. 2018 Dec;76(12):2611.e1-2611.e8. doi: 10.1016/j.joms.2018.07.029. Epub 2018 Aug 6.
The purpose of this study was to compare the integrity of human mandibular angle fracture after fixation with a single titanium plate along the upper lateral border with that of the native human mandible.
This cross-sectional anatomic study involved the left hemimandibles of 16 human cadavers. They were selected and divided in 2 groups by remaining dental status. Additional predictor variables, such as height of the left mandibular body and gender, were noted. Left hemisected native mandibles were mounted at the condyle and loaded on an Instron 5565 mechanical unit (Instron Corp, Norwood, MA) until fracture. Fractured left hemimandibles were fixated with a titanium miniplate and screws. After plate fixation, each hemimandible was reloaded on an Instron 5565 until fracture. Data pertaining to primary outcomes of load application were recorded in newtons at displacement values of 3.0, 5.0, and 7.0 mm and at displacement at fixation failure. Primary outcomes of maximum load and displacement at maximum load were recorded in newtons and millimeters, respectively. Descriptive statistics were used to summarize sample characteristics. Statistical comparisons were performed using t test, χ (or Fisher exact) test, and linear regression. Pearson correlation was used to examine relations between select biomechanical measurements.
The study sample was composed of 12 female and 4 male cadaveric hemimandibles. Donors' age at time of death ranged from 54 to 95 years (mean age, 78.94 yr). The mean maximum load in native and plated hemimandibles was 943.56 and 292.57 N, respectively (P < .0001).
Key clinical findings of this study include the inability of single plate mandible fixation to restore the mandible to preinjury levels and verification that gender, dental status, and height of the mandible do not alter the stability of a single plate fixated mandible.
本研究旨在比较沿下颌骨上外侧缘使用单块钛板固定后人类下颌角骨折的完整性与正常人类下颌骨的完整性。
本横断面解剖学研究涉及16具人类尸体的左半下颌骨。根据剩余牙齿状况进行选择并分为2组。记录其他预测变量,如左下颌体高度和性别。将左半侧正常下颌骨安装在髁突处,并加载到Instron 5565机械单元(Instron公司,马萨诸塞州诺伍德)上直至骨折。将骨折的左半下颌骨用微型钛板和螺钉固定。钢板固定后,将每个半下颌骨重新加载到Instron 5565上直至骨折。在位移值为3.0、5.0和7.0毫米以及固定失败时的位移处,以牛顿为单位记录与加载主要结果相关的数据。最大载荷和最大载荷时的位移的主要结果分别以牛顿和毫米为单位记录。使用描述性统计来总结样本特征。使用t检验、χ(或Fisher精确)检验和线性回归进行统计比较。使用Pearson相关性来检验选定生物力学测量之间的关系。
研究样本由12具女性和4具男性尸体的半下颌骨组成。供体死亡时的年龄范围为54至95岁(平均年龄,78.94岁)。正常和固定钢板的半下颌骨的平均最大载荷分别为943.56和292.57 N(P <.0001)。
本研究的关键临床发现包括单钢板下颌骨固定无法将下颌骨恢复到损伤前水平,以及证实性别、牙齿状况和下颌骨高度不会改变单钢板固定下颌骨的稳定性。