The influence of stress distribution in four different fixation systems used in treatment of mandibular angle fractures – a three‐dimensional finite element analysis

Aim To study and compare the stress distribution fields in four fixative materials used commonly in the treatment of angle of the mandible fractures using finite element analysis (FEA). Materials and methods Using commercially available FEA software, four three-dimensional models of the mandibular angle region were created by graphical representation, and an oblique unfavourable fracture was simulated. A conventional titanium miniplate, a three-dimensional titanium miniplates, a locking titanium miniplates and a bioresorbable plate were modelled three-dimensionally and applied to the mandibular angle region of the model, and stress distribution fields of each were analysed under similar loading conditions. Results The locking titanium plate and the three-dimensional titanium plate had favourable stress distribution when compared with the conventional titanium miniplating system and the bioresorbable plating system, showing that they were superior to the latter in terms of post-fixation stability. Conclusion The locking titanium miniplate and the three-dimensional titanium miniplate would offer better fixation stability in the post-fixation period when compared with the conventional titanium miniplate and the bioresorbable plating system.

[1]  Koutaro Maki,et al.  Anthropometric analysis of the human mandibular cortical bone as assessed by cone-beam computed tomography. , 2009, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[2]  G. Kearns,et al.  Superior border plating technique in the management of isolated mandibular angle fractures: a retrospective study of 50 consecutive patients. , 2007, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[3]  H. Korkmaz Evaluation of different miniplates in fixation of fractured human mandible with the finite element method. , 2007, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[4]  Jan Marciniak,et al.  The use of miniplates in mandibular fractures—biomechanical analysis , 2006 .

[5]  Tatsuo Nakajima,et al.  A comparative study of most suitable miniplate fixation for mandibular symphysis fracture using a finite element model. , 2006, The Keio journal of medicine.

[6]  Y. Ide,et al.  Three-dimensional bone microstructures of the mandibular angle using micro-CT and finite element analysis: relationship between partially impacted mandibular third molars and angle fractures. , 2006, Dental traumatology : official publication of International Association for Dental Traumatology.

[7]  G. D. Wood Inion biodegradable plates: the first century. , 2006, The British journal of oral & maxillofacial surgery.

[8]  N. Clelland,et al.  Comparison of strains produced by titanium and poly D, L-lactide Acid plating systems to in vitro forces. , 2005, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[9]  E. Erkmen,et al.  Three-dimensional finite element analysis used to compare methods of fixation after sagittal split ramus osteotomy: setback surgery-posterior loading. , 2005, The British journal of oral & maxillofacial surgery.

[10]  David S Strait,et al.  Modeling elastic properties in finite-element analysis: how much precision is needed to produce an accurate model? , 2005, The anatomical record. Part A, Discoveries in molecular, cellular, and evolutionary biology.

[11]  José R. Fernández,et al.  A three-dimensional computer model of the human mandible in two simulated standard trauma situations. , 2004, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[12]  R. Kellman,et al.  Mandibular angle fractures: two-miniplate fixation and complications. , 2003, Archives of facial plastic surgery.

[13]  Uwe Eckelt,et al.  Analysis of complications in fractures of the mandibular angle--a study with finite element computation and evaluation of data of 277 patients. , 2003, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[14]  Tyler Cox,et al.  Computerized analysis of resorbable polymer plates and screws for the rigid fixation of mandibular angle fractures. , 2003, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[15]  Rolf Ewers,et al.  A 3-dimensional finite-element analysis investigating the biomechanical behavior of the mandible and plate osteosynthesis in cases of fractures of the condylar process. , 2002, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[16]  P. Maurer,et al.  Study by finite element method of the mechanical stress of selected biodegradable osteosynthesis screws in sagittal ramus osteotomy. , 2002, The British journal of oral & maxillofacial surgery.

[17]  R. Haug,et al.  A biomechanical evaluation of mandibular angle fracture plating techniques. , 2001, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[18]  U. Joos,et al.  Experimental and finite element study of a human mandible. , 2000, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[19]  J. Ma'aita,et al.  Is the mandibular third molar a risk factor for mandibular angle fracture? , 2000, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[20]  T.M.G.J. van Eijden,et al.  Biomechanics of the Mandible , 2000 .

[21]  E. Ellis Treatment methods for fractures of the mandibular angle. , 1999, International journal of oral and maxillofacial surgery.

[22]  R. Schmelzeisen,et al.  One- or two-plate fixation of mandibular angle fractures? , 1997, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[23]  R. N. Kruse,et al.  Biomechanical evaluation of new fixation devices for mandibular angle fractures , 1997 .

[24]  E. Otten,et al.  A three-dimensional study of loads across the fracture for different fracture sites of the mandible. , 1996, The British journal of oral & maxillofacial surgery.

[25]  J. Meechan,et al.  Relationship between fractures of the mandibular angle and the presence and state of eruption of the lower third molar. , 1995, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[26]  Byung-Ho Choi,et al.  Stability testing of a two miniplate fixation technique for mandibular angle fractures. An in vitro study. , 1995, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[27]  E. Ellis,et al.  Treatment of mandibular angle fractures using two noncompression miniplates. , 1994, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[28]  L. Assael Treatment of mandibular angle fractures: plate and screw fixation. , 1994, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[29]  D. Klotch,et al.  Testing biomechanical strength of repairs for the mandibular angle fracture , 1994, The Laryngoscope.

[30]  D. Sinn,et al.  Complications of nonrigid fixation of mandibular angle fractures. , 1993, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[31]  C. Lindqvist,et al.  Rigid Internal Fixation of Fractures in the Angular Region of the Mandible: An Analysis of Factors Contributing to Different Complications , 1993, Plastic and reconstructive surgery.

[32]  J. Cordey,et al.  The use of miniplates in mandibular fractures. An in vitro study. , 1991, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[33]  R. Haug,et al.  An epidemiologic survey of facial fractures and concomitant injuries , 1990 .

[34]  W C Van Buskirk,et al.  The Elastic Properties of a Human Mandible , 1987, Advances in dental research.

[35]  A. Caputo,et al.  Distribution of stresses in the human skull. , 1985, Journal of oral rehabilitation.

[36]  Lamberg Ma Site, type and causes of mandibular fractures in 704 inpatients. , 1978 .