Can Serhat, Basa Selcuk, Varol Altan
Specialist, Bahcesehir University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul, Turkey.
Professor & Dean, Bahcesehir University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul, Turkey.
J Stomatol Oral Maxillofac Surg. 2021 Sep;122(4):e7-e14. doi: 10.1016/j.jormas.2021.04.004. Epub 2021 Apr 10.
This study aims to evaluate biomechanical stability and stress distribution of five different fixation types with finite element analysis using 10-mm advancement with or without counterclockwise rotation of the mandible.
After sagittal split osteotomy, 10-mm advancement was performed in the first group and 10-mm advancement and 10-degree counterclockwise rotation were performed in the second group. One miniplate (M-1), two-miniplate (M-2), one miniplate and a bicortical screw (H), l-shaped bicortical screw (B-1), and inverted l-shaped bicortical screw (B-2) systems were placed. Totally, 120 N force was applied to the models at a 45-degree angle from the lower edge of the symphysis.
The highest values on fixation were seen with miniplate, while the mean values were obtained with bicortical screw system. The highest values on bone were achieved using bicortical screws. One miniplate (M-1) showed both the highest and mean displacement. The highest values in counterclockwise-rotated models increased in all parameters, compared to non-rotated models.
In cases in which passive alignment between segments and adequate bone contact are ensured, inverted l-shaped bicortical screw, two-miniplate, or hybrid systems are recommended.
本研究旨在通过有限元分析评估五种不同固定类型在下颌骨进行10毫米前移（有或无逆时针旋转）时的生物力学稳定性和应力分布。
矢状劈开截骨术后，第一组进行10毫米前移，第二组进行10毫米前移和10度逆时针旋转。分别植入一种微型钢板（M-1）、两种微型钢板（M-2）、一种微型钢板和一枚双皮质螺钉（H）、L形双皮质螺钉（B-1）以及倒L形双皮质螺钉（B-2）系统。在模型的耻骨联合下缘处以45度角施加120牛的力。
微型钢板的固定值最高，而双皮质螺钉系统获得平均值。双皮质螺钉在骨上的值最高。一种微型钢板（M-1）的位移最高值和平均值均最大。与未旋转模型相比，逆时针旋转模型的所有参数值均增加。
在确保节段间被动对齐和充分骨接触的情况下，推荐使用倒L形双皮质螺钉、两种微型钢板或混合系统。
