Abstract
Osteosynthesis absorbable materials made of uncalcined and unsintered hydroxyapatite (u-HA) particles, poly-l-lactide (PLLA), and u-HA/PLLA are bioresorbable, and these plate systems have feasible bioactive osteoconductive capacities. However, their strength and stability for fixation in mandibular subcondylar fractures remain unclear. This in vitro study aimed to assess the biomechanical strength of u-HA/PLLA bioresorbable plate systems after internal fixation of mandibular subcondylar fractures. Tensile and shear strength were measured for each u-HA/PLLA and titanium plate system. To evaluate biomechanical behavior, 20 hemimandible replicas were divided into 10 groups, each comprising a titanium plate and a bioresorbable plate. A linear load was applied anteroposteriorly and lateromedially to each group to simulate the muscular forces in mandibular condylar fractures. All samples were analyzed for each displacement load and the displacement obtained by the maximum load. Tensile and shear strength of the u-HA/PLLA plate were each approximately 45% of those of the titanium plates. Mechanical resistance was worst in the u-HA/PLLA plate initially loaded anteroposteriorly. Titanium plates showed the best mechanical resistance during lateromedial loading. Notably, both plates showed similar resistance when a lateromedially load was applied. In the biomechanical evaluation of mandibular condylar fracture treatment, the u-HA/PLLA plates had sufficiently high resistance in the two-plate fixation method.
Highlights
Mandibular condylar fractures constitute 25%–35% of all mandibular fractures [1] and are the most common form of mandible fracture.The selection between closed and open techniques are linked to the type of fracture, the patient’s age, and the degree of functional impairment caused by Materials 2019, 12, 1557; doi:10.3390/ma12091557 www.mdpi.com/journal/materialsMaterials 2019, 12, 1557 the fracture
Our results were similar to those of previous research [20]. These were very important previous research on the strength of titanium plates when the same material of the bioresorbable findings. These results suggest that the unsintered hydroxyapatite (u-HA)/PLLA bioresorbable plate system plate was used
In the biomechanical evaluation of mandibular condylar fracture treatment, our results showed that the u-HA/PLLA bioresorbable plate had sufficiently high resistance in the two-plate fixation method
Summary
Mandibular condylar fractures constitute 25%–35% of all mandibular fractures [1] and are the most common form of mandible fracture.The selection between closed (conservative treatment) and open (surgical treatment) techniques are linked to the type of fracture, the patient’s age, and the degree of functional impairment caused by Materials 2019, 12, 1557; doi:10.3390/ma12091557 www.mdpi.com/journal/materialsMaterials 2019, 12, 1557 the fracture. Growing patients with certain undisplaced mandibular condylar fractures can undergo closed treatment, but severely displaced fractures are indications for open surgical reduction and fixation with internal rigid devices, generally with plates and screws [2]. Lower condylar fractures that affect the subcondyle, condylar base, and condylar neck are generally treated by open reduction and internal fixation [3,4]. The surgical treatment of mandibular condylar fractures involves fixation of the fractured stumps with the use of plates and screws. There are several types of fixation for fractures of the mandibular condyle [5]; the most common fixation technique is to use two four-hole straight plates [6]. A titanium metal plate system has been used as a standard osteosynthesis material
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