Biomechanical grounding of the transalveolar osteosynthesis of еdentulous мandible fractures
DOI:
https://doi.org/10.26641/2307-0404.2021.1.228016Keywords:
mandibular fracture, transalveolar osteosynthesis, 3D computer modelingAbstract
The purpose of the work is improvement of the effectiveness of the mandibular fractures treatment in patients with partial or complete adentia by developing and experimentally testing transalveolar osteosynthesis technique. An experimental study was carried out by 3D computer simulation modeling by the final element analysis to assess the efficiency of mandibular fractures fixation at partial or complete adentia using the Ш-shaped plate, which we developed for the transalveolar osteosynthesis method. Calculations of the immobilized fractures for static (own weight) and dynamic (functional) loads were performed according to the author's method, taking into account pronounced resorptive processes in the bone from the beginning of the reparative reaction to assess the rigidity of fragments fixation during the entire period of the fractures healing. Under the conditions of the same three-dimensional model of the mandible, calculations were performed when the fracture was fixed with ordinary linear titanium osseous plates. It is proved that at functional load the new plate provides a compression effect in the fractures region, as evidenced by the negative displacements in the final elements of the mental region according to the results of design load combination 2- 3. The maximum efforts in the screws of the calculation model with a conventional bone plate were 136.955 N, which is almost ten times more than on the model with a Ш-shaped titanium retainer (12.656 N).
References
Artiushkevych AS. [Injuries and reconstructive surgery of the maxillofacial region]. Minsk: Vysheishaya shkola. 2016. р. 255. Russian.
Komok OA, Idashkina NG, Tereshkov DYu. [Usage of new wire splints in the treatment of bilateral fractures of the mandibule in combination with osteosynthesis]. Medicni perspektivi. 2012;17(1):122-127. Ukrainian. Available from: https://medpers.dsma.dp.ua/2012-summary/2012-n1/#Komok
Kopchak AV, Krishuk MG. [Stress distribution in the "fixer-bone" system during osteosynthesis of the mandible by ankinal mini-plates]. Ukrayinskyi zhurnal hirurgii. 2014;(1):44-49. Ukrainian. Available from: http://www.mif-ua.com/archive/article/37980
Palchikova IO, et al. Interventions for the management of mandibular fractures in patients with acquired partial or complete adentia (Review). Сlinical and experimental pathology. 2019;18(1):132-7. Ukrainian. doi: https://doi.org/10.24061/17274338.XVІII.1.67.2019.219
[Bone plate for mandibular fracture osteosynthesis]. Pat. 39746 Ukraine: A61B 17/064, A61B 17/58. N 2001010705; st. 31.01.01; publ. 15.06.01. Bul. N 5. Ukrainian. Available from: http://uapatents.com/4-39746-nakistkova-plastina-dlya-osteosintezu-zlamu-nizhno-shhelepi.html
Pohranychna KhR. [Principles of treatment of mandibular fractures]. Medicina transportu Ukrayini. 2013;(3):86-90. Ukrainian. Available from: http://nbuv.gov.ua/UJRN/MTU_2013_3_24
[Method of surgical treatment of mandibular fractures and bone plate for its implementation]: pat. 120811 Ukraine: A61B 17/58, A61B 17/80. N а201810385; st. 22.10.18; publ. 10.02.20. Bul. N 3. Ukrainian. Available from: https://base.uipv.org/searchINV/search.php?action=viewdetails&IdClaim=265628
Chujko AN, Dragomireckaya MS, Mirza RA. [Primary (elastic) and secondary (residual) deformation of the mandible and its effect on the dental occlusion]. Ukrayinskyi stomatologichnyi almanah. 2011;(5):39-51. Ukrainian. Available from: http://nbuv.gov.ua/UJRN/Usa_2011_5_10
Carlson AR, et al. A Technique for Reduction of Edentulous Fractures Using Dentures and SMARTLock Hybrid Fixation System. Plastic Reconstr Surg. 2017;5(9):1473-7. doi: https://doi.org/10.1097/GOX.0000000000001473
Emam HA, Ferguson HW, Jatana CA. Manage¬ment of atrophic mandible fractures: an updated comprehensive review. Oral Surg. 2018;(1):79-87. doi: https://doi.org/10.1111/ors.12300
Krishnan S, et al. Fracture management of an edentulous mandible in a geriatric osteoporotic patient. Ind J Dent Research. 2015;(5):542-4. doi: https://doi.org/10.1097/GOX.0000000000001473
Idashkina NG. Computer modeling and biological processes: new opportunities for experimental estimation of stable mandibular osteosynthesis. Modern Scientific Researches. 2018;(5):47-60. doi: https://doi.org/10.30889/2523-4692.2018-05-03-039
Balasubramanian SP, et al. Lingual Splint for Sagittal Fractures of Mandible; An Effective Adjunct to Contemporary Osteosynthesis: A Case Series with Re¬view of Literature. Craniomaxillofacial Trauma & Reconstruction Open. 2017;(1):9-14. doi: https://doi.org/10.1055/s-0037-1603578
Zaky MM, et al. The use of microplates for fixation of mandibular fractures: a systematic review. J Med Sci Res. 2019;(2):1-7. doi: https://doi.org/10.4103/JMISR.JMISR_9_19
Van der Kolk – Bender CA, Koudstaal MJ, Wolvius EB. Treatment of Severely Atrophic Edentulous Mandible Fractures: Load-Bearing or Load-Sharing? Craniomaxillofac Trauma Reconstruction Open. 2018;(2):55-60.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Medicni perspektivi (Medical perspectives)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submitting manuscript to the journal "Medicni perspektivi" the author(s) agree with transferring copyright from the author(s) to publisher (including photos, figures, tables, etc.) editor, reproducing materials of the manuscript in the journal, Internet, translation into other languages, export and import of the issue with the author’s article, spreading without limitation of their period of validity both on the territory of Ukraine and other countries. This and other mutual duties of the author and all co-authors separately and editorial board are secured by written agreement by special form to use the article, the sample of which is presented on the site.
Author signs a written agreement and sends it to Editorial Board simultaneously with submission of the manuscript.
