Heidemann W, Gerlach K L, Gröbel K H, Köllner H G
Department of Maxillofacial Surgery, Otto-von-Guericke University, Magdeburg, Germany.
J Craniomaxillofac Surg. 1998 Jun;26(3):163-8. doi: 10.1016/s1010-5182(98)80007-3.
Although the application of self-tapping and non self-tapping screws is virtually universal in cranio-maxillofacial surgery, the inevitable, time consuming procedure of drilling a pilot hole has some potential disadvantages, such as damage to nerves, tooth roots or tooth germs, thermal necrosis of the bone and drill bit breakage. Drill Free Screws (DFS) are a recently developed type of osteosynthesis screws, having a tip like a cork screw and specially formed cutting flutes which enable insertion of the screws without drilling. DFS 1.5 and 2 mm were inserted into discs of wood, polyvinylchloride (PVC) and porcine mandibular bone of varying thicknesses between 2 and 4 mm. The values of insertion torque and maximum torque were recorded using an electric torque tester. Thereafter, the screws were inserted with a fixed torque and uniaxial pull out tests were performed. In comparison with this, the same procedure was performed using 1.5 and 2 mm self-tapping titanium screws. Ten trials for each screw-material-combination were conducted to determine insertion torque, maximum torque and pull out analysis. The results showed that the holding power of DFS lay between 70 and 104% of the holding power of self-tapping titanium screws; only in PVC was the difference more than 15%.
尽管自攻型和非自攻型螺钉在颅颌面外科手术中的应用几乎非常普遍，但不可避免且耗时的钻孔操作存在一些潜在缺点，如损伤神经、牙根或牙胚、骨热坏死以及钻头折断。免钻螺钉（DFS）是最近开发的一种骨固定螺钉，其尖端类似开塞钻，并有特殊形状的切削槽，可在不钻孔的情况下插入螺钉。将1.5毫米和2毫米的DFS插入厚度在2至4毫米之间的木块、聚氯乙烯（PVC）块以及猪下颌骨块中。使用电动扭矩测试仪记录插入扭矩和最大扭矩值。此后，以固定扭矩插入螺钉并进行单轴拔出试验。与此相比，使用1.5毫米和2毫米的自攻钛螺钉进行相同操作。对每种螺钉 - 材料组合进行十次试验以确定插入扭矩、最大扭矩和拔出分析。结果表明，DFS的固持力为自攻钛螺钉固持力的70%至104%；仅在PVC中，差异超过15%。
