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使用颊侧台阶改良矢状劈开下颌支截骨术后不同固定技术的生物力学评估:一项研究。

Biomechanical evaluation of different fixation techniques following modified sagittal split ramus osteotomy using buccal step: An study.

作者信息

Warade Pratik Dhananjay, Kshirsagar Rajesh, Mishra Prasamita, Prasad Pranave, Sardeshmukh Amruta

机构信息

Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth Dental College and Hospital, Pune, Maharashtra, India.

出版信息

Natl J Maxillofac Surg. 2022 Sep-Dec;13(3):443-448. doi: 10.4103/njms.njms_321_21. Epub 2022 Dec 10.

Abstract

OBJECTIVE

This study was to evaluate the efficacy of three different designs of rigid fixation using polyurethane hemimandible replicas following modified sagittal split ramus osteotomy with buccal step.

MATERIALS AND METHODS

Forty-eight polyurethane hemimandible replicas have been used. Following the osteotomy and fixation, each specimen has been mounted on a Universal Testing unit using a prefabricated customized jig and has been tested to a range of vertical forces starting from 0 on the incisal edge of lateral incisor and lateral forces of on lateral surface of mandibular first molar. Progressive load has been applied until a deflection of 10 mm was observed. SPSS version 20 has been used for analyzing the data. The biomechanical stability of different osteosynthesis has been compared using a one-way ANOVA with post hoc Bonferroni test. ≤ 0.05 will be considered statistically significant.

RESULTS

After advancement of 7 mm, comparison of vertical load and lateral load among different miniplate systems showed that load was maximum in bicortical screws in inverted L pattern followed by T-shaped miniplate system and was least in single six-hole straight plate (0.001) at ≤ 0.05.

CONCLUSION

Our study concludes that bicortical screws in inverted "L" pattern are more resistant to lateral load as well as on the application of vertical load when compared to other fixation techniques and statistical difference was evident.

摘要

目的

本研究旨在评估在改良矢状劈开下颌支截骨术并伴有颊侧台阶后,使用三种不同设计的刚性固定方式固定聚氨酯半下颌骨复制体的疗效。

材料与方法

使用了48个聚氨酯半下颌骨复制体。截骨和固定后,每个标本通过预制的定制夹具安装在万能测试装置上,并从侧切牙切缘的0开始施加一系列垂直力,在下颌第一磨牙侧面施加侧向力进行测试。持续施加渐进式载荷,直至观察到10毫米的挠度。使用SPSS 20版分析数据。采用单因素方差分析和事后邦费罗尼检验比较不同骨内固定术的生物力学稳定性。P≤0.05将被视为具有统计学意义。

结果

在推进7毫米后,不同微型钢板系统之间垂直载荷和侧向载荷的比较表明,倒L形双皮质螺钉的载荷最大,其次是T形微型钢板系统,单六孔直板的载荷最小(P = 0.001),P≤0.05。

结论

我们的研究得出结论,与其他固定技术相比,倒“L”形双皮质螺钉在承受侧向载荷以及垂直载荷时更具抵抗力,且统计学差异明显。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8ac/9851348/71eb0d8f7359/NJMS-13-443-g001.jpg

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本文引用的文献

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In Vitro Mechanical Analysis of Different Techniques of Internal Fixation of Combined Mandibular Angle and Body Fractures.
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Mechanical evaluation of different techniques for symphysis fracture fixation--an in vitro polyurethane mandible study.
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In vitro biomechanical evaluation of the use of conventional and locking miniplate/screw systems for sagittal split ramus osteotomy.
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Malocclusions resulting from loss of fixation after sagittal split ramus osteotomies.
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In vitro comparison of biomechanical characteristics of sagittal split osteotomy fixation techniques.
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