Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing.
Department of Oral and Maxillofacial Surgery, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin.
J Craniofac Surg. 2021 Oct 1;32(7):2557-2561. doi: 10.1097/SCS.0000000000007601.
The aim of this study was to compare through finite element analysis two- and three-dimensional (2D and 3D) fixation in the treatment of mandibular symphyseal fracture combined with bilateral condylar intracapsular fractures. The authors created 2 fixation models for the above fracture, and analyzed the stress and displacement in the mandible and fixation materials under 3 loading conditions. The von Mises stress of the mandible and plates peaked during lateral occlusion, and was lowest during central occlusion. In all conditions, stresses in the fixation materials did not exceed the yield stress of titanium. The inferior border of the symphyseal fracture segments showed opposing displacements, and the mandible tended to widen in the 2D fixation model. However, the fracture displacement did not exceed 150 μm for either fixation method. The results suggested that after well reduction and fixation of condylar intracapsular fractures, either 2D or 3D fixation for symphyseal fracture can provide adequately strong fixation. Compared with 2D fixation, 3D fixation has more advantages in controlling the mandibular width and preventing the fixation materials from enduring excessive stress.
本研究旨在通过有限元分析比较两种和三种(2D 和 3D)固定治疗下颌骨联合双侧髁突囊内骨折。作者为上述骨折创建了 2 种固定模型,并在 3 种加载条件下分析了下颌骨和固定材料的应力和位移。下颌骨和钢板的 von Mises 应力在侧方咬合时达到峰值,在正中咬合时最低。在所有条件下,固定材料的应力均未超过钛的屈服应力。联合骨折段的下缘显示出相反的位移,在 2D 固定模型中,下颌骨倾向于变宽。然而,对于两种固定方法,骨折位移均未超过 150μm。结果表明,在良好地复位和固定髁突囊内骨折后,对于联合骨折,2D 或 3D 固定均可提供足够强的固定。与 2D 固定相比,3D 固定在控制下颌骨宽度和防止固定材料承受过大的应力方面具有更多优势。