THE EVALUATION OF THE TREATMENT OPTIONS WITH INTERMAXILLARY FIXATION SCREWS AND MINIPLATES IN BILATERAL MANDIBULAR FRACTURES BY FINITE ELEMENT ANALYSIS

Abstract

Objective: The aim of this study is to assess the stress values and the amount of displacement (D) that occurs on the fracture line during the application of various numbers and ligation methods of intermaxillary fixation screws (IMFS) by using finite element analysis and to perform a comparison to the internal fixation technique with miniplates. Material and Method: A three-dimensional model of the maxilla, mandible, and temporomandibular joint was created using the DICOM data obtained from Digital Volumetric Computed Tomography (DVCT). The nonhomogeneous bone structure was transferred to the model based on the Hounsfield Unit (HU) values obtained from DVCT. In the scenario created, a mandible having parasymphysis and corpus fractures together was modeled. IMFS and internal fixation methods was analyzed in eight different scenarios. Results: Results of the analysis showed that the most successful fracture fixation models were the standard method of IMFS which is 4-point fixation (D:0,068 mm) or horizontal ligation (D:0,066 mm). It is observed that the increase in the number of IMFS has no effect on fracture displacement or the reduction of the stress formed in the bone surrounding the screws. The analysis of internal fixation shows that increasing the number of plates and screws does not change the amount of displacement, but it is influential on the distribution of stresses. Conclusion: It has been observed that number of IMFS has no effect on fracture fixation and stress distribution. It is observed that the amount of displacement is less in anterior fractures than it is in posterior fractures.

Keywords

• Mandibular fracture
• intermaxillary fixation
• intermaxillary fixation screw
• finite element analysis

SONLU ELEMAN ANALİZİ İLE BİLATERAL MANDİBULAR KIRIKLARDA INTERMAKSİLLER FİKSASYON VIDA VE MINİPLAKLARLA TEDAVİ SEÇENEKLERİNİN DEĞERLENDİRİLMESİ

Abstract

Amaç: Bu çalışmanın amacı, sonlu eleman analizi kullanılarak intermaksiller fiksasyon vidası (IMFS) uygulamalarında farklı sayı ve bağlama yöntemlerinin kırık hattında oluşturduğu gerilme değerlerini ve yer değiştirme miktarını (D) değerlendirmek ve miniplaklarla yapılan internal fiksasyon tekniği ile karşılaştırma yapmaktır. Materyal ve Metod: Maksilla, mandibula ve temporomandibular eklemin üç boyutlu modeli, Dijital Volumetrik Bilgisayarlı Tomografi (DVBT) verilerinden elde edilen DICOM verileri kullanılarak oluşturulmuştur. Homojen olmayan kemik yapısı, DVBT'den elde edilen Hounsfield Birimi (HU) değerlerine dayanarak modele aktarılmıştır. Oluşturulan senaryoda, parasimfizis ile korpus kırıklarının birlikte bulunduğu bir mandibula modellenmiştir. IMFV ve internal fiksasyon yöntemleri sekiz farklı senaryoda analiz edilmiştir. Sonuçlar: Analiz sonuçları, en başarılı kırık fiksasyon modellerinin, 4 noktalı fiksasyon (D: 0,068 mm) veya yatay bağlama (D: 0,066 mm) olan standart IMFV yöntemi olduğunu göstermiştir. IMFV sayısının artışının, kırık deplasman miktarının veya vida etrafındaki kemikte oluşan gerilmenin azalması üzerinde bir etkisi olmadığı gözlemlenmiştir. Internal fiksasyon analizinde, plak ve vida sayısının artırılmasının deplasman miktarını değiştirmediği, ancak gerilmelerin dağılımı üzerinde etkili olduğu görülmüştür. Sonuç: IMFV sayısının, kırığın fikse edilmesi ve gerilme dağılımı üzerinde bir etkisi olmadığı görülmüştür. Ayrıca Anterior kırıklarda deplasman miktarının, posterior kırıklara göre daha az olduğu gözlemlenmiştir.

Keywords

• Mandibular kırık
• İntermaksiller fiksasyon
• İntermaksiller fiksasyon vidaları
• sonlu eleman analizi

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