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Abstract
The biomechanical consequences of the interaction between titanium trauma plates and screws and the fractured mandible are still a matter of investigation. The mathematical and biomechanical models that have been developed show limitations and the experimental studies are not able to reproduce muscle forces and internal stress distributions in the bone-implant interface and mandibular structure. In the present article we show a static simulator of the masticatory system to demonstrate in epoxy resin mandibular models, by means of 3D (three-dimensional) photoelasticity, the stress distribution using different osteosynthesis methods in the mandibular angle fractures. The results showed that the simulator and 3D photoelasticity were a useful method to study interactions between bone and osteosynthesis materials. The “Lock” systems can be considered the most favourable method due to their stress distribution in the epoxy resin mandible. 3D photoelasticity in epoxy resin models is a useful method to evaluate stress distribution for biomechanical studies. Regarding to mandibular osteosynthesis, “lock” plates offer the most favourable stress distribution due to being less aggressive to the bone
Highlights
Cranio-maxillo-facial osteosynthesis principles were developed during the ‘60’s and 70’s, their universal application was delayed until the 80’s
The first retrospective studies with an acceptable follow-up did not appear until 1990. In these papers osteosynthesis showed its superiority over any other traditional method for fracture treatment [1, 2, 3]
In the field of mandibular osteosynthesis, research continues to focus on the size, shape, number, and biomechanics of plate/screw systems to improve surgical outcome
Summary
Cranio-maxillo-facial osteosynthesis principles were developed during the ‘60’s and 70’s, their universal application was delayed until the 80’s In this situation, the first retrospective studies with an acceptable follow-up did not appear until 1990. In conventional bone plating stability is achieved systems when the head of the screw compresses the fixation plate to the bone as the screw is tightened (Fig. 1). Morbidity with these systems is commonly related to: 1) mobility and hardware failure; 2) alterations in the alignment of the segments that cause changes in the occlusal relationship; 3) resorption of the bone cortex adjacent to the plate. If the plate is not contoured precisely and is not in intimate contact with the bone or if the host is compromised (medically or nutritionally), the “race” between fracture healing and cortex resorption will be lost and will result in unstable fixation [4]
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