Three-dimensional finite element analysis of the stress distribution and displacement in different fixation methods of bilateral sagittal split ramus osteotomy
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives: This study evaluated a range of fixation methods to determine which is best for the postoperative stabilization of a mandibular osteotomy using three-dimensional finite element analysis of the stress distribution on the plate, screw and surrounding bone and displacement of the lower incisors. Materials and Methods: The model was generated using the synthetic skull scan data, and the surface model was changed to a solid model using software. Bilateral sagittal split ramus osteotomy was performed using the program, and 8 different types of fixation methods were evaluated. A vertical load of 10 N was applied to the occlusal surface of the first molar. Results: In the case of bicortical screws, von-Mises stress on the screws and screw hole and deflection of the lower central incisor were minimal in type 2 (inverted L pattern with 3 bicortical repositioning screws). In the case of plates, von-Mises stress was minimal in type 8 (fixation 5 mm above the inferior border of the mandible with 1 metal plate and 4 monocortical screws), and deflection of the lower central incisor was minimal in types 6(fixation 5 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws) and 7 (fixation 12 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws). Conclusion: Types 2 and 6 fixation methods provide better stability than the others.
Abstract
Objectives: This study evaluated a range of fixation methods to determine which is best for the postoperative stabilization of a mandibular osteotomy using three-dimensional finite element analysis of the stress distribution on the plate, screw and surrounding bone and displacement of the lower incisors. Materials and Methods: The model was generated using the synthetic skull scan data, and the surface model was changed to a solid model using software. Bilateral sagittal split ramus osteotomy was performed using the program, and 8 different types of fixation methods were evaluated. A vertical load of 10 N was applied to the occlusal surface of the first molar. Results: In the case of bicortical screws, von-Mises stress on the screws and screw hole and deflection of the lower central incisor were minimal in type 2 (inverted L pattern with 3 bicortical repositioning screws). In the case of plates, von-Mises stress was minimal in type 8 (fixation 5 mm above the inferior border of the mandible with 1 metal plate and 4 monocortical screws), and deflection of the lower central incisor was minimal in types 6(fixation 5 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws) and 7 (fixation 12 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws). Conclusion: Types 2 and 6 fixation methods provide better stability than the others.
참고문헌 (17)
- Park JU, "Orthognathic surgery", pp.267~316 (2003), Koonja Publishing
- Wolford LM, "The sagittal split ramus osteotomy as the preferred treatment for mandibular prognathism", Oral Maxillofac Surg, 58, pp.310~312 (2000)
- Oguz Y, "Stability of locking and conventional 2.0-mm miniplate", screw systems after sagittal split ramus osteotomy: finite element analysis, 2009, pp.108, 174~177
- Ueki K, "Skeletal stability after mandibular setback surgery: bicortical fixation using a 2.0-mm locking plate system versus monocortical fixation using a nonlocking plate system", J Oral Maxillofac Surg, 66, pp.900~904 (2008)
- Brasileiro BF, "An in vitro evaluation of rigid internal fixation techniques for sagittal split ramus osteotomies: advancement surgery", J Oral Maxillofac Surg, 67, pp.809~817 (2009)
- Jafari A, "Study of stress distribution and displacement of various craniofacial structures following application of transverse orthopedic forces--a three-dimensional FEM study", Angle Orthod, 73, pp.12~20 (2003)
- Holberg C, "Effects of rapid maxillary expansion on the cranial base--an FEM-analysis", J Orofac Orthop, 66, pp.54~66 (2005)
- Proffit WR, "Adaptations in lip posture and pressure following orthognathic surgery", Am J Orthod Dentofacial Orthop, 93, pp.294~302 (1988)
- Nagai I, "Changes in occlusal state of patients with mandibular prognathism after orthognathic surgery: a pilot study", Br J Oral Maxillofac Surg, 39, pp.429~433 (2001)
- Jang HS, "A clinical study on the relapse after bssro for the correction of mandibular prognathism", J Kor Oral Maxillofac Surg, 22, pp.4~9 (1996)
- Erkmen E, "Comparison of different fixation methods following sagittal split ramus osteotomies using three-dimensional finite elements analysis. Part 1: advancement surgery-posterior loading", Int J Oral Maxillofac Surg, 34, pp.551~558 (2005)
- 윤옥병, "하악지시상분할골절단술 시행 후 von-Miese 항복강도에 대한 유한요소법적 연구", 대한구강악안면외과학회지, 28(3), pp.5~204 (2002), 대한구강악안면외과학회
- Lindorf HH, "Sagittal ramus osteotomy with tandem screw fixation. Technique and results", J Maxillofac Surg, 14, pp.311~316 (1986)
- Haug RH, "An in vitro comparison of the effect of number and pattern of positional screws on load resistance", J Oral Maxillofac Surg, 57, pp.300~308 (1999)
- Swift JQ, "Mandibular advancement", Atlas Oral Maxillofac Surg Clin North Am, 1, pp.17~27 (1993)
- Anucul B, "In vitro strength analysis of sagittal split osteotomy fixation: noncompression monocortical plates versus bicortical position screws", J Oral Maxillofac Surg, 50, pp.1295~1299 (1992)
- Chuong CJ, "Mechanical characteristics of the mandible after bilateral sagittal split ramus osteotomy: comparing 2 different fixation techniques", J Oral Maxillofac Surg, 63, pp.68~76 (2005)