Abstract
Among the osteotomies performed in orthognathic surgery, the sagittal osteotomy of the mandibular ramus (SOMR) is the most common, allowing a great range of movements and stable internal fixation (SIF), therefore eliminating the need of maxillomandibular block in the postoperative period. Objectives: The purpose of this study was to evaluate the biomechanical resistance of three national systems used for SIF in SOMR in sheep mandibles. Material and methods: The study was performed in 30 sheep hemi-mandibles randomly divided into 3 experimental groups, each containing 10 hemi-mandibles. The samples were measured to avoid discrepancies and then subjected to SOMR with 5-mm advancement. In group I, 2.0x12 mm screws were used for fixation, inserted in an inverted "L" pattern (inverted "L" group). In group II, fixation was performed with two 2.0x12 mm screws, positioned in a linear pattern and a 4-hole straight miniplate and four 2.0x6.0 mm monocortical screws (hybrid group). In group III, fixation was performed with two 4-hole straight miniplates and eight 2.0x6.0 mm monocortical screws (mini plate group). All materials used for SIF were supplied by Osteosin - SIN. The hemimandibles were subjected to vertical linear load test by Kratos K2000MP mechanical testing unit for loading registration and displacement. Results: All groups showed similar resistance during mechanical test for loading and displacement, with no statistically significant differences between groups according to analysis of variance. Conclusion: These results indicate that the three techniques of fixation are equally effective for clinical fixation of SOMR.
Highlights
Sagittal osteotomy of the mandibular ramus (SOMR) is certainly one of the most performed surgical procedures in orthognathic surgery
The versatility provided by its outlining offers a wide contact between the osteotomized segments, promoting better repair and stability, as well as allowing a precise and adequate application of the FRQFHSW RI VWDEOH LQWHUQDO ¿[DWLRQ
Several studies have shown that the SOMR can EH ¿[HG E\ PHDQV RI SODWHV DQGRU LQWHU IUDJPHQWDU\ screws, with good results both in vitro[12,23] and in patients19,31 6WDEOH LQWHUQDO ¿[DWLRQ 6,) LV a method that enables the stabilization of the osteotomized segments through screws or metallic SODWHV 7KLV W\SH RI ¿[DWLRQ LV SXW GLUHFWO\ LQ FRQWDFW with the bone structure, allowing its function during the bone repair[8]
Summary
Sagittal osteotomy of the mandibular ramus (SOMR) is certainly one of the most performed surgical procedures in orthognathic surgery. Several studies have shown that the SOMR can EH ¿[HG E\ PHDQV RI SODWHV DQGRU LQWHU IUDJPHQWDU\ screws, with good results both in vitro[12,23] and in patients19,31 6WDEOH LQWHUQDO ¿[DWLRQ 6,) LV a method that enables the stabilization of the osteotomized segments through screws or metallic SODWHV 7KLV W\SH RI ¿[DWLRQ LV SXW GLUHFWO\ LQ FRQWDFW with the bone structure, allowing its function during the bone repair[8]. It eliminates or reduces the application of the maxillomandibular block,. All of them tend to explain which techniques present better SIF, providing greater stabilization between the bone segments and lower morbidity[28]
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