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Published on: October 9, 2014
Strength analysis of Le Fort I osteotomy fixation: titanium versus resorbable plates
M M Araujo1, P D Waite, J E Lemons
1Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham Medical Center, Birmingham, AL, USA.
Summary
This study compared metallic and polymeric fixation systems for maxillary advancement. Titanium and resorbable systems demonstrated adequate fixation strength, with resorbable systems showing less elastic stiffness but sufficient capacity for mastication forces.
Area of Science:
- Biomechanical Engineering
- Craniofacial Surgery
- Materials Science
Background:
- Maxillary advancement surgery requires robust fixation systems.
- Metallic and polymeric fixation options exist, each with unique biomechanical properties.
- Understanding these properties is crucial for optimizing surgical outcomes.
Purpose of the Study:
- To compare the biomechanical performance of metallic (titanium) and polymeric (resorbable) fixation systems.
- To simulate clinical conditions of maxillary advancement and loading using a 3D skull model.
- To evaluate load displacement, load to failure, and deformation characteristics.
Main Methods:
- Polyurethane skulls were surgically altered and fitted with standard titanium, prebent titanium, or resorbable plates and mesh.
- Constructs were subjected to anterior-posterior (AP) and inferior-superior (IS) loading using an Instron machine.
- Load displacement, failure load, and deformation modes were analyzed using ANOVA (P <.05).
Main Results:
- Elastic stiffness differed significantly between groups in the AP direction, but not the IS direction.
- The IS loading direction exhibited significantly greater load displacement (stiffness) than the AP direction.
- Maximum loads for permanent deformation were higher in the AP direction, while maximum loads for breaking were higher in the IS direction.
Conclusions:
- The in vitro model and testing procedure provided valuable biomechanical insights.
- All tested fixation systems exceeded 285 N (64 lbs) in load capacity and offered greater elastic resistance in the IS direction.
- Resorbable systems, while having lower elastic stiffness than titanium, demonstrated adequate fixation strength for clinical application and resisting masticatory forces.
