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Fixation Methods for Mandibular Advancement and Their Effects on Temporomandibular Joint: A Finite Element Analysis
Sabit Demircan1, Erdoğan Utku Uretürk2, Ayşegül Apaydın2
1Beykent University Vocational School Dental Services, Oral Health Program, Istanbul, Turkey.
Biomed Research International
|March 19, 2020
Summary
This study compared fixation methods after mandibular surgery, finding that bicortical screw fixation increased temporomandibular joint stress. Resorbable fixation options, particularly LR and ILR, resulted in higher overall stress values.
Area of Science:
- Oral and Maxillofacial Surgery
- Biomaterials Science
- Biomechanics
Background:
- Bilateral sagittal split osteotomy (BSSO) corrects dentofacial deformities.
- Traditional fixation uses bicortical or monocortical screws and miniplates.
- Resorbable screw materials offer an alternative fixation method.
Purpose of the Study:
- To evaluate stress distribution at the temporomandibular joint (TMJ) after BSSO.
- To quantify mandibular bone segment displacement with various fixation techniques.
Main Methods:
- A 3D finite element model (FEM) simulated BSSO with 9mm mandibular advancement.
- Seven fixation combinations were tested: miniplate only, miniplate with titanium or resorbable bicortical screws, and L-shaped or inverted L-shaped titanium or resorbable bicortical screws.
Main Results:
- Maximum TMJ stress occurred with miniplate-only (M) and resorbable L-shaped bicortical screw (LR) fixation.
- Minimum TMJ stress was observed with titanium L-shaped bicortical screw (L) and miniplate-only (M) fixation.
- The inverted L-shaped titanium bicortical screw (IL) fixation resulted in the least mandibular displacement.
Conclusions:
- Bicortical screw fixation correlates with increased condylar stress.
- Resorbable fixation methods, specifically LR and ILR, generate higher total stress values.
- Fixation choice significantly impacts TMJ stress and mandibular segment stability post-BSSO.
