Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Giresun University, Giresun, Turkey.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ordu University, Ordu, Turkey.
J Stomatol Oral Maxillofac Surg. 2023 Feb;124(1S):101276. doi: 10.1016/j.jormas.2022.08.019. Epub 2022 Sep 1.
The aim of this study is to evaluate different plate systems and contribute to revealing the most appropriate treatment option for severe atrophic edentulous mandible fractures. A total of 8 different types of rigid internal fixation methods, which were a 4-hole miniplate on the crest, a 4-hole miniplate on the basis, a 6-hole miniplate on the crest, a 6-hole miniplate on the basis, two 4-hole mini plates on both the crest and basis, two 6-hole mini plates on both crest and basis, a 6-hole reconstruction plate on the crest and a 6-hole reconstruction plate on the basis, were simulated. Stress analysis on plates and screws and the displacement between fragments were evaluated using finite element analysis. The lowest von Mises stress was observed on the basis plate in Group 6. The highest von Mises stresses were measured on the screws closes to the fracture line. Values exceeding the boundary conditions were observed only in Groups 3 and 4 under molar loading. The highest compressive stresses were measured in Group 1, and the lowest compressive stresses were measured in Group 6. Under molar loading, the highest displacement was observed in Group 3, and the lowest displacement was observed in Group 6. When all groups are evaluated in terms of stress distributions and stability, a 1.5 mm thick six-hole reconstruction plate can be a reliable method in the treatment of severe atrophic edentulous mandible fractures.
本研究旨在评估不同的接骨板系统，并为严重萎缩性无牙下颌骨骨折的最佳治疗选择提供依据。共模拟了 8 种不同的刚性内固定方法，包括牙槽嵴 4 孔微型钢板、牙槽嵴基底部 4 孔微型钢板、牙槽嵴 6 孔微型钢板、牙槽嵴基底部 6 孔微型钢板、牙槽嵴和基底部各 2 个 4 孔微型钢板、牙槽嵴和基底部各 2 个 6 孔微型钢板、牙槽嵴 6 孔重建钢板和牙槽嵴基底部 6 孔重建钢板。采用有限元分析评估了接骨板和螺钉的应力分布以及骨折块之间的位移。在第 6 组中，基底部接骨板的 von Mises 应力最低。靠近骨折线的螺钉的 von Mises 应力最高。只有在磨牙加载时，第 3 组和第 4 组才会出现超过边界条件的数值。第 1 组的压缩应力最高，第 6 组的压缩应力最低。在磨牙加载下，第 3 组的位移最大，第 6 组的位移最小。从应力分布和稳定性的角度评价所有组时，1.5mm 厚的六孔重建钢板可作为治疗严重萎缩性无牙下颌骨骨折的可靠方法。
