COMPARISON OF THE EFFECT OF TWO SURGICAL TECHNIQUES ON THE BIOMECHANICAL STRENGTH OF BICORTICAL SCREWS AND MINIPLATES IN THE ADVANCEMENT OF POLYURETHANE MANDIBLES

Yıl 2024, , 132 - 138, 04.06.2024

Sibel Aker , Çetin Kasapoğlu

https://doi.org/10.26650/JARHS2024-1379683

Öz

Objective: This study aims to compare the biomechanical strength of miniplate and bicortical screw fixation in polyurethane mandibles with bilateral sagittal split osteotomy using either the Obwegeser-DalPont (ODP) or Hunsuck-Epker (HE) surgical cutting techniques.

Materials and Method: Thirty-two (N=32) polyurethane mandible models were created from data obtained from a tomographic image of a patient. In these models, 4mm advancements were made using ODP and HE cutting techniques. For fixation, 1mm thick, 4-hole, 9mm spaced straight titanium mini plates and 8 titanium screws, 2mm in diameter and 5mm in length, or 6 bicortical screws, 2mm in diameter, were used. Based on the cutting and fixation techniques, four groups were formed, each with 8 (n=8) mandible models. These groups were named M-EPKER, M-DALPONT, B-EPKER, and B-DALPONT, respectively. Fixed models were placed in a universal testing machine, and linear, continuous, and progressively increasing forces were applied from the cutting region. Force magnitudes required to reach displacement values of 1mm, 3mm, and 5mm for the test interface were measured in Newtons (N) and statistically compared.

Results: To reach the 1mm displacement level of the test models, the B-EPKER group required a higher force magnitude than the M-EPKER group (p<0.05). At the 3mm level, the B-DALPONT group demonstrated higher force values compared to the M-DALPONT group (p<0.05). Similarly, at the same level, the B-EPKER group reached higher force values than the M-EPKER group (p<0.05). At the 5mm level, both groups using bicortical screws achieved higher values compared to the group using mini plates (p<0.05).

Conclusion: Within the limitations of this experimental study, it can be concluded that fixation procedures with bicortical screws in polyurethane models with mandibular advancement, regardless of the surgical technique, are more durable than those with mini plates.

Anahtar Kelimeler

Epker, DalPont, mini plate, bicortical screw, orthognathic surgery

Proje Numarası

2021/04

POLİÜRETAN ALT ÇENELERİN İLERLETİLMESİNDE İKİ CERRAHİ TEKNİĞİN BİKORTİKAL VİDA VE MİNİPLAKLARIN BİYOMEKANİK DAYANIMINDAKİ ETKİSİNİN KARŞILAŞTIRILMASI

Öz

Amaç: Bu çalışmanın amacı Obwegeser-DalPont (ODP) ya da Hunsuck-Epker (HE) cerrahi kesi yöntemleri kullanılarak bilateral sagital split osteotomi uygulanan poliüretan alt çenelerde miniplak ve bikortikal vida fiksasyonlarının biyomekanik dayanımını karşılaştırmaktır.

Gereç ve Yöntem: Bu çalışmada bir hastanın tomografik görüntüsünden elde edilen verilerle üretilen 32 adet (N=32) poliüretan alt çene modeli kullanılmıştır. Bu modellerde ODP ve HE kesi teknikleri kullanılarak 4mm ilerletme yapılmıştır. Fiksasyon için 1 mm kalınlığında, 4 delikli, 9mm ara lıklı 2 adet düz titanyum mini plak ve 8 adet 2mm çapında, 5mm uzunlu ğunda titanyum vidalar ya da 2mm çapında 6 adet bikortikal vida kullanıl mıştır. Çalışmada kesi ve fiksasyon tekniklerine göre her birinde 8 (n=8) alt çene olan 4 grup oluşturulmuştur. Bunlar sırasıyla M-EPKER, M-DALPONT, B-EPKER ve B-DALPONT olarak isimlendirilmiştir. Fikse edilmiş modeller bir evrensel test cihazına yerleştirilerek kesiciler bölgesinden doğrusal, devamlı ve giderek artan kuvvet uygulanmıştır. Deney arayüzünün 1 mm, 3mm, 5mm yer değiştirme değerlerine ulaşması için gereken Newton (N) cinsinden kuvvet büyüklükleri ölçülmüş ve istatistiksel olarak karşılaştırılmıştır.

Bulgular: Deney modellerinin 1 mm yer değiştirme seviyesine ulaşması için B-EPKER grubunda M-EPKER grubuna göre daha yüksek kuvvet büyük lüğü gerekli olmuştur (p<0,05). 3mm seviyesinde ise B-DALPONT grubu M-DALPONT grubuna göre daha yüksek kuvvet değerlerine dayanım gös termiştir (p<0,05). Aynı seviyede B-EPKER grubu M-EPKER grubuna göre daha yüksek kuvvet değerlerine ulaşmıştır (p<0,05). 5mm seviyesinde ise her iki kesi tekniğinde de bikortikal kullanılan grup, miniplak kullanılan gruba göre daha yüksek değerlere ulaşmıştır (p<0,05).

Sonuç: Bu deneysel çalışmanın sınırları dâhilinde, alt çene ilerletmesi yapılan poliüretan modellerde cerrahi teknik fark etmeksizin bikortikal vida ile yapılan fiksasyon işlemlerinin miniplak ile yapılanlara göre daha dayanıklı olduğu söylenebilir.

Anahtar Kelimeler

Epker, DalPont, miniplak, bikortikal vida, ortognatik cerrahi

Proje Numarası

2021/04

Kaynakça

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