Evaluation of Polymethylmethacrylate (PMMA) Cement for Stabilizing Loosened Screws in Mandibular Angle Fracture Fixation: A Biomechanical Study

Year 2025, Volume: 7 Issue: 1, 173 - 177, 15.01.2025

Metin Berk Kasapoğlu , Betül Gedik , Gözde Gökçe , Gülce Ecem Doğancalı , Abdulkadir Burak Çankaya , Mehmet Ali Erdem

https://doi.org/10.37990/medr.1589459

Abstract

Aim: Mandibular angle fractures account for 23-42% of all mandibular fractures, with treatment options often debated due to the region's anatomical complexity. While single miniplate fixation has shown low complication rates, issues like screw loosening remain a challenge. Polymethylmethacrylate (PMMA) has been widely used in orthopedic surgery to improve screw stability. This study aimed to evaluate the effect of PMMA on the stability of loosened screws in mandibular angle fractures.
Material and Method: Twenty hemimandibles from sheep cadavers were divided into control and experimental groups. In the control group, standard 2.0 mm screws were inserted without PMMA augmentation. In the experimental group, a 1.6 mm pilot hole was used to simulate screw loosening, and PMMA was injected into the screw tracts before screw insertion. Both groups underwent vertical force testing using a hydraulic device, with displacement values measured at 50 N of force. Statistical analysis was performed using the Student t-test, with significance set at p<0.05.
Results: The mean maximum displacement in the control group was 5.60±2.22 mm, while in the experimental group it was 6.49±3.21 mm. There was no statistically significant difference between the two groups (p=0.479). The biomechanical behavior of both groups was similar, indicating that PMMA did not significantly affect displacement values under the tested conditions.
Conclusion: PMMA cement did not significantly improve the stability of loosened screws in mandibular angle fractures. Further research with different force applications and screw conditions may provide more insights into the potential benefits of PMMA augmentation.

Keywords

Mandibular angle fractures , polymethylmethacrylate , screw loosening , miniplate fixation , biomechanical stability

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