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A biomechanical comparison of 2 techniques for reconstructing atrophic edentulous mandible fractures

Identifieur interne : 007080 ( Main/Exploration ); précédent : 007079; suivant : 007081

A biomechanical comparison of 2 techniques for reconstructing atrophic edentulous mandible fractures

Auteurs : Matthew J. Madsen [États-Unis] ; Richard H. Haug [États-Unis]

Source :

RBID : Pascal:06-0170065

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English descriptors

Abstract

Objectives: The purpose of this investigation was to evaluate and compare the biomechanical behavior of 2 techniques for the reconstruction of atrophic edentulous mandible fractures. Materials and Methods: Thirty polyurethane atrophic edentulous mandible replicas (Sawbones, Vashon Island, WA) were used in this investigation (10 controls, 10 replicas of 2 different fixation techniques). The first reconstruction technique was a traditional titanium locking reconstruction plate affixed to the lateral border (buccal surface) of the mandible. The second reconstruction technique used the same type of plate, but placed it on the inferior border of the mandible. Both constructs were subjected to vertical loading at the symphysis and torsional loading at the body regions of the mandible replicas by an Instron 1331 (Instron, Canton, MA) servohydraulic mechanical testing unit. Mechanical deformation data within a 0 -900 N range were recorded. Maximum load, displacement at maximum load, and stiffness were determined. Means and standard deviations were derived and compared for statistical significance using a Fisher's Protected Least Significant Differences Test with a confidence level of 95% (P <.05). Second- and third-order polynomial best-fit curves were also created for each group to further evaluate the mechanical behavior. Results: For symphysis loading, statistically significant differences were noted between the control group and both of the plating techniques for displacement at maximum load. However, no differences were noted between the experimental groups for displacement at maximum load, stiffness, or maximum load. For body loading, statistically significant differences were noted between the control group and the inferior border plating group for displacement at maximum load. However, no differences were noted between the experimental groups for displacement at maximum load, stiffness, or maximum load. Conclusion: During this bench top investigation, there were no significant differences noted in mechanical behavior between the 2 specific experimental groups for any of the conditions measured. When placed in the context of functional parameters, both of the plating techniques met or exceeded the requirements for loading.


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<term>Alveolar Bone Loss (complications)</term>
<term>Alveolar Bone Loss (pathology)</term>
<term>Alveolar Bone Loss (physiopathology)</term>
<term>Analysis of Variance</term>
<term>Atrophy</term>
<term>Biomechanical Phenomena</term>
<term>Biomechanics</term>
<term>Bone Plates</term>
<term>Comparative study</term>
<term>Dental Stress Analysis</term>
<term>Edentulousness</term>
<term>Equipment Design</term>
<term>Equipment Failure Analysis</term>
<term>Fracture</term>
<term>Fracture Fixation, Internal (instrumentation)</term>
<term>Human</term>
<term>Humans</term>
<term>Jaw, Edentulous (complications)</term>
<term>Jaw, Edentulous (pathology)</term>
<term>Jaw, Edentulous (physiopathology)</term>
<term>Jaw, Edentulous (surgery)</term>
<term>Mandible</term>
<term>Mandible (pathology)</term>
<term>Mandibular Fractures (complications)</term>
<term>Mandibular Fractures (pathology)</term>
<term>Mandibular Fractures (physiopathology)</term>
<term>Mandibular Fractures (surgery)</term>
<term>Materials Testing</term>
<term>Models</term>
<term>Models, Anatomic</term>
<term>Polyurethanes</term>
<term>Statistics, Nonparametric</term>
<term>Stomatology</term>
<term>Stress, Mechanical</term>
<term>Surgery</term>
<term>Technique</term>
<term>Treatment</term>
<term>Urethane</term>
<term>Weight-Bearing</term>
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<term>Analyse de panne d'appareillage</term>
<term>Analyse de variance</term>
<term>Analyse du stress dentaire</term>
<term>Atrophie</term>
<term>Conception d'appareillage</term>
<term>Contrainte mécanique</term>
<term>Fractures mandibulaires ()</term>
<term>Fractures mandibulaires (anatomopathologie)</term>
<term>Fractures mandibulaires (physiopathologie)</term>
<term>Humains</term>
<term>Mandibule (anatomopathologie)</term>
<term>Mise en charge</term>
<term>Modèles anatomiques</term>
<term>Mâchoire édentée ()</term>
<term>Mâchoire édentée (anatomopathologie)</term>
<term>Mâchoire édentée (physiopathologie)</term>
<term>Ostéosynthèse interne (instrumentation)</term>
<term>Phénomènes biomécaniques</term>
<term>Plaques orthopédiques</term>
<term>Polyuréthanes</term>
<term>Résorption alvéolaire ()</term>
<term>Résorption alvéolaire (anatomopathologie)</term>
<term>Résorption alvéolaire (physiopathologie)</term>
<term>Statistique non paramétrique</term>
<term>Test de matériaux</term>
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<term>Polyurethanes</term>
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<term>Fractures mandibulaires</term>
<term>Mandibule</term>
<term>Mâchoire édentée</term>
<term>Résorption alvéolaire</term>
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<term>Alveolar Bone Loss</term>
<term>Jaw, Edentulous</term>
<term>Mandibular Fractures</term>
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<term>Alveolar Bone Loss</term>
<term>Jaw, Edentulous</term>
<term>Mandible</term>
<term>Mandibular Fractures</term>
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<term>Mâchoire édentée</term>
<term>Résorption alvéolaire</term>
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<term>Jaw, Edentulous</term>
<term>Mandibular Fractures</term>
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<keywords scheme="MESH" qualifier="surgery" xml:lang="en">
<term>Jaw, Edentulous</term>
<term>Mandibular Fractures</term>
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<term>Analysis of Variance</term>
<term>Atrophy</term>
<term>Biomechanical Phenomena</term>
<term>Bone Plates</term>
<term>Dental Stress Analysis</term>
<term>Equipment Design</term>
<term>Equipment Failure Analysis</term>
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<term>Analyse de variance</term>
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<term>Conception d'appareillage</term>
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<term>Edentation</term>
<term>Fracture</term>
<term>Chirurgie</term>
<term>Fractures mandibulaires</term>
<term>Humains</term>
<term>Mise en charge</term>
<term>Modèles anatomiques</term>
<term>Mâchoire édentée</term>
<term>Ostéosynthèse interne</term>
<term>Phénomènes biomécaniques</term>
<term>Plaques orthopédiques</term>
<term>Polyuréthanes</term>
<term>Résorption alvéolaire</term>
<term>Statistique non paramétrique</term>
<term>Test de matériaux</term>
<term>Uréthane</term>
<term>Biomécanique</term>
<term>Etude comparative</term>
<term>Technique</term>
<term>Modèle</term>
<term>Homme</term>
<term>Mandibule</term>
<term>Stomatologie</term>
<term>Traitement</term>
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<front>
<div type="abstract" xml:lang="en">Objectives: The purpose of this investigation was to evaluate and compare the biomechanical behavior of 2 techniques for the reconstruction of atrophic edentulous mandible fractures. Materials and Methods: Thirty polyurethane atrophic edentulous mandible replicas (Sawbones, Vashon Island, WA) were used in this investigation (10 controls, 10 replicas of 2 different fixation techniques). The first reconstruction technique was a traditional titanium locking reconstruction plate affixed to the lateral border (buccal surface) of the mandible. The second reconstruction technique used the same type of plate, but placed it on the inferior border of the mandible. Both constructs were subjected to vertical loading at the symphysis and torsional loading at the body regions of the mandible replicas by an Instron 1331 (Instron, Canton, MA) servohydraulic mechanical testing unit. Mechanical deformation data within a 0 -900 N range were recorded. Maximum load, displacement at maximum load, and stiffness were determined. Means and standard deviations were derived and compared for statistical significance using a Fisher's Protected Least Significant Differences Test with a confidence level of 95% (P <.05). Second- and third-order polynomial best-fit curves were also created for each group to further evaluate the mechanical behavior. Results: For symphysis loading, statistically significant differences were noted between the control group and both of the plating techniques for displacement at maximum load. However, no differences were noted between the experimental groups for displacement at maximum load, stiffness, or maximum load. For body loading, statistically significant differences were noted between the control group and the inferior border plating group for displacement at maximum load. However, no differences were noted between the experimental groups for displacement at maximum load, stiffness, or maximum load. Conclusion: During this bench top investigation, there were no significant differences noted in mechanical behavior between the 2 specific experimental groups for any of the conditions measured. When placed in the context of functional parameters, both of the plating techniques met or exceeded the requirements for loading.</div>
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