Gulsever Serap, Munevveroglu Sumer, Hartomacioglu Selim, Guldiken Ipek Necla, Uckan Sina
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul Medipol University, IstanbulTürkiye.
Department of Mechanical Engineering, Faculty of Technology, Marmara University, IstanbulTürkiye.
Eur Oral Res. 2025 Jan 5;59(1):40-45. doi: 10.26650/eor.20241371296.
The purpose of this study was to evaluate the distribution of stresses in screw and plate fixation systems during simulated advancement genioplasty using finite element analysis.
A cone-beam computed tomography image of a patient was used to create three-dimensional virtual models of mandibular bone. Chin advancement of 8 mm was simulated following a horizontal osteotomy of the chin in a computer-aided design program. The distal segment was stabilized with two titanium mini-screws placed bilaterally in the first model and a single 4-hole titanium pre-bent chin plate placed centrally in the second model. The plate was fixed with four mini-screws, two in the proximal and two in the distal segment. All fixative appliances were submitted to 15 N force applied backwards to the lingual surface of the chin parallel to the occlusal plane and 7 N force applied upwards to the buccal surface of the chin perpendicular to the occlusal plane. The distributions of von Mises stresses and deformations in bone and titanium materials were evaluated.
In the screw fixation system (22.52 MPa) higher stress values were observed compared to the plate fixation system (13.71 MPa). The deformation value was higher for the screw fixation system (0.021 mm) than the plate fixation system (0.0007 mm).
In advancement genioplasty, fixation with a single pre-bent centrally placed chin plate showed slightly better stabilization than fixation with two bilaterally placed bicortical screws. The stress values were within the physical strength limits of bone and titanium for both systems.
本研究的目的是使用有限元分析评估模拟前移颏成形术过程中螺钉和钢板固定系统中的应力分布。
使用一名患者的锥形束计算机断层扫描图像创建下颌骨的三维虚拟模型。在计算机辅助设计程序中，在颏部水平截骨后模拟8mm的颏部前移。在第一个模型中，通过双侧放置两个钛质微型螺钉稳定远心段，在第二个模型中，在中央放置一个单孔4孔钛质预弯颏板。该钢板用四个微型螺钉固定，近端两个，远端两个。所有固定装置均承受向后平行于咬合平面施加于颏部舌面的15N力和向上垂直于咬合平面施加于颏部颊面的7N力。评估骨和钛材料中冯·米塞斯应力和变形的分布。
与钢板固定系统（13.71MPa）相比，螺钉固定系统（22.52MPa）观察到更高的应力值。螺钉固定系统的变形值（0.021mm）高于钢板固定系统（0.0007mm）。
在前移颏成形术中，使用单个中央放置的预弯颏板固定比使用两个双侧放置的双皮质螺钉固定显示出略好的稳定性。两个系统的应力值均在骨和钛的物理强度极限范围内。
