矢状分叉支截骨下颌后退手术后三种不同的固定方式:三维有限元分析的比较研究。

IF 0.9 Q3 SURGERY
Majid Eshghpour, Sahand Samieirad, Zahra Shooshtari, Abdolrahim Shams, Nafiseh Ghadirimoghaddam
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引用次数: 0

摘要

背景:颌面部手术后提供足够的稳定性对于减少并发症和疾病复发至关重要。截骨片的稳定导致正常咀嚼功能的快速恢复,骨骼复发的减少,以及截骨部位的平稳愈合。我们的目的是比较三种不同的口内固定技术在双侧矢状劈开截骨(BSSO)桥接后的虚拟下颌骨模型上的应力分布模式。方法:本研究于2021年3月至2022年3月在伊朗马什哈德牙科学院口腔颌面外科进行。使用健康成人下颌骨计算机断层扫描生成三维模型;之后,模拟了3毫米后移的BSSO。模型采用以下三种固定技术:1)两枚双皮质螺钉,2)三枚双皮质螺钉,3)一枚微型钢板。将双侧第二前磨牙和第一磨牙分别置于75,135和600N的机械载荷下模拟对称咬合力。在Ansys软件中进行有限元分析(FEA),记录机械应变、应力和位移计算。结果:有限元分析结果显示应力主要集中在固定单元内。虽然双皮质螺钉比微型钢板具有更好的刚性,但它们具有更高的应力和位移读数。结论:微型钢板内固定表现出最好的生物力学性能,其次分别为2枚和3枚双皮质螺钉内固定。小型钢板联合单皮质螺钉的口腔内固定可以作为BSSO复位手术后骨骼稳定的适当固定安排和治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Three Different Fixation Modalities following Mandibular Setback Surgery with Sagittal Split Ramus Osteotomy: A Comparative Study using Three-dimensional Finite Elements Analysis.

Three Different Fixation Modalities following Mandibular Setback Surgery with Sagittal Split Ramus Osteotomy: A Comparative Study using Three-dimensional Finite Elements Analysis.

Three Different Fixation Modalities following Mandibular Setback Surgery with Sagittal Split Ramus Osteotomy: A Comparative Study using Three-dimensional Finite Elements Analysis.

Three Different Fixation Modalities following Mandibular Setback Surgery with Sagittal Split Ramus Osteotomy: A Comparative Study using Three-dimensional Finite Elements Analysis.

Background: The provision of sufficient stability after maxillofacial surgery is essential for the reduction of complications and disease recurrence. The stabilization of osteotomized pieces results in rapid restoration of normal masticatory function, reduction of skeletal relapse, and uneventful healing at the osteotomy site. We aimed to compare qualitatively stress distribution patterns over a virtual mandible model after bilateral sagittal split osteotomy (BSSO) bridged with three different intraoral fixation techniques.

Methods: This study was conducted in the Oral and Maxillofacial Surgery Department of Mashhad School of Dentistry, Mashhad, Iran, from March 2021-March 2022. The mandible computed tomography scan of a healthy adult was used to generate a 3D model; thereafter, BSSO with a 3mm setback was simulated. The three following fixation techniques were applied to the model: 1) two bicortical screws, 2) three bicortical screws, and 3) a miniplate. The bilateral second premolars and first molars were placed under mechanical loads of 75, 135, and 600N in order to simulate symmetric occlusal forces. Finite element analysis (FEA) was carried out in Ansys software, and the mechanical strain, stress, and displacement calculations were recorded.

Results: The FEA contours revealed that stress was mainly concentrated in the fixation units. Although bicortical screws presented better rigidity than miniplates, they were associated with higher stress and displacement readings.

Conclusion: Miniplate fixation demonstrated the most favorable biomechanical performance, followed by fixation with two and three bicortical screws, respectively. Intraoral fixation with miniplates in combination with monocortical screws can serve as an appropriate fixation arrangement and treatment option for skeletal stabilization after BSSO setback surgery.

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