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Comparative evaluation of two osteosynthesis methods on stability following sagittal split ramus osteotomy
Peter Maurer1, Wolf-Dietrich Knoll, Johannes Schubert
1Department for Oral and Plastic Maxillofacial Surgery, Klinik und Poliklinik für Mund, Kiefer- und plastische Gesichtschirurgie, Martin Luther-University, Halle-Wittenberg, Halle, Germany. peter.maurer@medizin.uni-halle.de
Summary
The finite element method (FEM) shows bicortical triangular screw configurations offer superior stability over miniplates for bilateral sagittal split osteotomies. This FEM analysis provides valuable insights for developing new osteosynthesis materials and techniques.
Area of Science:
- Biomaterials Engineering
- Biomechanics
- Oral and Maxillofacial Surgery
Background:
- Bilateral sagittal split osteotomy (BSSO) is a common surgical procedure.
- Assessing the stability of osteosynthesis materials is crucial for successful outcomes.
- Titanium screws and miniplates are frequently used for mandibular reconstruction.
Purpose of the Study:
- To compare the biomechanical stability of bicortical triangular screw configurations versus titanium miniplates in a simulated BSSO.
- To evaluate the efficacy of the finite element method (FEM) in analyzing maxillofacial mechanical stresses.
Main Methods:
- A 3D finite element model of the mandible was created with 19,854 elements and 4285 nodes.
- Mechanical properties of titanium osteosynthesis materials were obtained from literature and manufacturer data.
- Simulated masticatory forces were applied to assess material stability under ultimate tensile stress.
Main Results:
- The bicortical triangular screw configuration neutralized a higher masticatory force (1675 N) compared to the miniplate (1246 N).
- The peri-implant bone, not the osteosynthesis material, reached its strain limit.
- FEM analysis results aligned with existing literature and clinical observations.
Conclusions:
- FEM is a suitable tool for simulating mechanical stresses in maxillofacial surgery.
- Bicortical triangular screw configurations demonstrate greater stability than miniplates for BSSO.
- FEM can reduce the time, material, and animal testing required for developing new osteosynthesis solutions.