Plate osteosynthesis of the mandibular condyle

Area of Science:

• Oral and Maxillofacial Surgery
• Biomedical Engineering
• Orthopedic Biomechanics

Background:

• Mandible condylar-process fractures pose significant challenges in treatment.
• Evaluating biomechanical stability of osteosynthesis materials is crucial for effective fracture repair.
• Existing literature shows varied stability data for different plating techniques.

Purpose of the Study:

• To compare the biomechanical stability of four different monocortical plating techniques for mandible condylar-process fractures.
• To identify the most stable osteosynthesis material for treating these specific fractures.
• To provide data-driven insights for surgical decision-making in mandibular fracture management.

Main Methods:

• 160 porcine mandibles were used to test four plating techniques: delta plate, trapezoid plate, dynamic compression plate, and double mini-plates.
• Fractures were created and anatomically reduced, followed by monocortical plating.
• A universal mechanical testing machine (TIRAtest 2720) applied linear loading in four directions (lateral-medial, medial-lateral, anterior-posterior, posterior-anterior).
• Yield load and yield displacement were measured to assess stability.

Main Results:

• Statistically significant differences in biomechanical stability were observed among the four fixation groups across all loading directions.
• Double mini-plates demonstrated the highest stability in lateral-medial, medial-lateral, and anterior-posterior directions.
• The delta plate exhibited the highest load resistance in the posterior-anterior direction and was the second-best performer in the other three directions.
• All tested plating techniques showed varying degrees of stability, highlighting the importance of material and technique selection.

Conclusions:

• Rigid internal fixation using double mini-plates provides superior biomechanical stability for mandible condylar-process fractures in most loading directions.
• The delta plate is a strong alternative, particularly in the posterior-anterior loading scenario.
• These findings offer valuable guidance for surgeons selecting osteosynthesis materials to optimize outcomes in treating mandible condylar-process fractures.