Evaluation of the Rigidity of Sagittal Split Ramus Osteotomy Fixation Using Four Designs of Biodegradable and Titanium Plates--a Numerical Study

Overview

Journal Oral Maxillofac Surg

Specialties Dentistry
General Surgery

Date 2015 Mar 19

PMID 25784154

Citations 1

Authors

Safieh Albougha

Mhd Hassan Albogha

Mhd Ayham Darwich

Khaldoun Darwich

Affiliations

Soon will be listed here.

Abstract

Purpose: This study was conducted to determine the best design of biodegradable plates for providing rigidity when used for fixation of sagittal split ramus osteotomy.

Methods: A computerized tomography image of a patient was used to generate a 3D model of a hemi-mandible. Four plate designs were merged with the hemi-mandible. They were (1) straight plate, (2) double straight plate, (3) T-shaped plate, and (4) double Y-shaped plate. Four finite element models were analyzed using the properties of biodegradable materials for the plates, and four additional models were analyzed using titanium alloy properties.

Results: The models predicted that rigidity of fixation would be noticeably less among biodegradable plates than titanium plates. They also predicted that the most rigid design among the titanium plates would be the straight plate, but among the biodegradable plates, it would be the double Y-shaped plate.

Conclusion: The double Y-shaped design is recommended when using biodegradable plates in fixation of sagittal split ramus osteotomy.

Citing Articles

Comperative evaluation of the current and new design miniplate fixation techniques of the advanced sagittal split ramus osteotomy using three-dimensional finite element analysis.

Altuncu F, Kazan D, Ozden B Med Oral Patol Oral Cir Bucal. 2023; 28(6):e553-e561.

PMID: 37823299 PMC: 10635628. DOI: 10.4317/medoral.25964.

References

Throckmorton G, Buschang P, Ellis 3rd E . Improvement of maximum occlusal forces after orthognathic surgery. J Oral Maxillofac Surg. 1996; 54(9):1080-6. DOI: 10.1016/s0278-2391(96)90165-2. View

Aymach Z, Nei H, Kawamura H, Bell W . Biomechanical evaluation of a T-shaped miniplate fixation of a modified sagittal split ramus osteotomy with buccal step, a new technique for mandibular orthognathic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 111(1):58-63. DOI: 10.1016/j.tripleo.2010.03.028. View

Ueki K, Okabe K, Miyazaki M, Mukozawa A, Moroi A, Marukawa K . Skeletal stability after mandibular setback surgery: comparisons among unsintered hydroxyapatite/poly-L-lactic acid plate, poly-L-lactic acid plate, and titanium plate. J Oral Maxillofac Surg. 2011; 69(5):1464-8. DOI: 10.1016/j.joms.2010.06.187. View

Ueki K, Moroi A, Sotobori M, Ishihara Y, Marukawa K, Iguchi R . Evaluation of recovery in lip closing pressure and occlusal force and contact area after orthognathic surgery. J Craniomaxillofac Surg. 2014; 42(7):1148-53. DOI: 10.1016/j.jcms.2014.01.047. View

Nieminen T, Rantala I, Hiidenheimo I, Keranen J, Kainulainen H, Wuolijoki E . Degradative and mechanical properties of a novel resorbable plating system during a 3-year follow-up in vivo and in vitro. J Mater Sci Mater Med. 2007; 19(3):1155-63. DOI: 10.1007/s10856-007-3082-x. View

Dolanmaz D, Uckan S, Isik K, Saglam H . Comparison of stability of absorbable and titanium plate and screw fixation for sagittal split ramus osteotomy. Br J Oral Maxillofac Surg. 2004; 42(2):127-32. DOI: 10.1016/S0266-4356(03)00234-1. View

Iwase M, Ohashi M, Tachibana H, Toyoshima T, Nagumo M . Bite force, occlusal contact area and masticatory efficiency before and after orthognathic surgical correction of mandibular prognathism. Int J Oral Maxillofac Surg. 2006; 35(12):1102-7. DOI: 10.1016/j.ijom.2006.08.014. View

Ko E, Huang C, Lo L, Chen Y . Alteration of masticatory electromyographic activity and stability of orthognathic surgery in patients with skeletal class III malocclusion. J Oral Maxillofac Surg. 2013; 71(7):1249-60. DOI: 10.1016/j.joms.2013.01.002. View

Yang L, Xu M, Jin X, Xu J, Lu J, Zhang C . Skeletal stability of bioresorbable fixation in orthognathic surgery: a systemic review. J Craniomaxillofac Surg. 2013; 42(5):e176-81. DOI: 10.1016/j.jcms.2013.08.003. View

10.

Van Bakelen N, Boermans B, Buijs G, Jansma J, Pruim G, Hoppenreijs T . Comparison of the long-term skeletal stability between a biodegradable and a titanium fixation system following BSSO advancement - a cohort study based on a multicenter randomised controlled trial. Br J Oral Maxillofac Surg. 2014; 52(8):721-8. DOI: 10.1016/j.bjoms.2014.06.014. View

11.

Stoelinga P, Borstlap W . The fixation of sagittal split osteotomies with miniplates: the versatility of a technique. J Oral Maxillofac Surg. 2003; 61(12):1471-6. DOI: 10.1016/j.joms.2003.07.002. View

12.

Yoshioka I, Igawa K, Nagata J, Yoshida M, Baba T, Ichiki T . Risk factors for breakage of biodegradable plate systems after bilateral sagittal split mandibular setback surgery. Br J Oral Maxillofac Surg. 2012; 51(4):307-11. DOI: 10.1016/j.bjoms.2012.06.007. View

13.

SHIKINAMI Y, Okuno M . Bioresorbable devices made of forged composites of hydroxyapatite (HA) particles and poly-L-lactide (PLLA): Part I. Basic characteristics. Biomaterials. 1999; 20(9):859-77. DOI: 10.1016/s0142-9612(98)00241-5. View

14.

Borstlap W, Stoelinga P, Hoppenreijs T, vant Hof M . Stabilisation of sagittal split advancement osteotomies with miniplates: a prospective, multicentre study with two-year follow-up. Part II. Radiographic parameters. Int J Oral Maxillofac Surg. 2004; 33(6):535-42. DOI: 10.1016/j.ijom.2004.01.015. View

15.

Ahn Y, Kim S, Baik S, Kim B, Kim H, Moon S . Comparative study between resorbable and nonresorbable plates in orthognathic surgery. J Oral Maxillofac Surg. 2010; 68(2):287-92. DOI: 10.1016/j.joms.2009.07.020. View

16.

Ueki K, Marukawa K, Shimada M, Nakagawa K, Yamamoto E . Change in condylar long axis and skeletal stability following sagittal split ramus osteotomy and intraoral vertical ramus osteotomy for mandibular prognathia. J Oral Maxillofac Surg. 2005; 63(10):1494-9. DOI: 10.1016/j.joms.2005.06.013. View

17.

Ribeiro-Junior P, Magro-Filho O, Shastri K, Papageorge M . Which kind of miniplate to use in mandibular sagittal split osteotomy? An in vitro study. Int J Oral Maxillofac Surg. 2012; 41(11):1369-73. DOI: 10.1016/j.ijom.2012.05.003. View

18.

Buijs G, Van Bakelen N, Jansma J, de Visscher J, Hoppenreijs T, Bergsma J . A randomized clinical trial of biodegradable and titanium fixation systems in maxillofacial surgery. J Dent Res. 2012; 91(3):299-304. DOI: 10.1177/0022034511434353. View

19.

Pereira Filho V, Iamashita H, Monnazzi M, Gabrielli M, Vaz L, Passeri L . In vitro biomechanical evaluation of sagittal split osteotomy fixation with a specifically designed miniplate. Int J Oral Maxillofac Surg. 2012; 42(3):316-20. DOI: 10.1016/j.ijom.2012.07.008. View

20.

Ueki K, Marukawa K, Shimada M, Nakagawa K, Alam S, Yamamoto E . Maxillary stability following Le Fort I osteotomy in combination with sagittal split ramus osteotomy and intraoral vertical ramus osteotomy: a comparative study between titanium miniplate and poly-L-lactic acid plate. J Oral Maxillofac Surg. 2005; 64(1):74-80. DOI: 10.1016/j.joms.2005.09.015. View