Dental and Medical Problems

Dent Med Probl
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Dental and Medical Problems

2017, vol. 54, nr 2, April-June, p. 129–133

doi: 10.17219/dmp/73718

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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Pullout force comparison of selected screws for rigid fixation in maxillofacial surgery

Porównanie siły wyciągającej wybranych śrub stabilizujących w chirurgii szczękowo-twarzowej

Marcin Kozakiewicz1,A,C,E,F, Piotr Sołtysiak1,B,D

1 Department of Maxillofacial Surgery, Medical University of Lodz, Łódz, Poland

Abstract

Background. Screws used in open reduction and internal rigid fixation need a large amount of force to effectively stabilize the plate. Currently, there is no worldwide standard screw design and there are no publications available comparing the pullout strength of different maxillofacial osteosynthesis systems.
Objectives. The aim of the study was to compare the pullout strength of different screw types.
Material and Methods. The study used 75 screws made by the main manufacturers (DePuy Synthes, KLS Martin and Medartis). The screws were inserted into polyurethane up to 3.6 mm or 9.6 mm deep. The 1–100 kN Insight Material Testing System (MTS Systems Corporation), a twin-column floor-standing model for high-force applications, was used for the electromechanical measurement of the screws’ axial pullout strength from the blocks of polyurethane. The method was based on the standard specification and test methods for metallic medical bone screws (ASTM F543-07 and Annex A3).
Results. Among the self-tapping microscrews 6 mm in length and 1.5 mm in diameter, DePuy Synthes screws had the greatest average pullout force (226.0 ± 7.52 N; p < 0.05). Among the self-drilling 6 mm × 1.5 mm microscrews, DePuy Synthes screws also had the highest score (253.6 ± 4.39 N; p < 0.05). Among self-tapping miniscrews 6 mm in length and 2.0 mm in diameter, Medartis screws attained the highest scores (228.8 ± 9.73 N; p < 0.05). Among self-drilling 6 mm × 2.0 mm screws, KLS Martin screws had the best results (320.8 ± 9.09 N; p < 0.05).
Conclusion. There are significant differences in fixing force among screws of the same diameter but originating from different manufacturers.

Key words

screw, maxillofacial surgery, bone fracture treatment, pullout strength

Słowa kluczowe

śruba, chirurgia szczękowo-twarzowa, leczenie złamań kości, siła wyciągająca

References (22)

  1. Motamedi MH, Dadgar E, Ebrahimi A, Shirani G, Haghighat A, Jamalpour MR. Pattern of maxillofacial fractures: A 5-year analysis of 8,818 patients. J Trauma Acute Care Surg. 2014;77:630–634.
  2. Srinivasan I, Kumar N, Jaganathan U, Bhandari A. Miniplate for osteosynthesis in a 9-year-old with symphysis fracture: Clinical report. Int J Clin Pediatr Dent. 2013;6:213–216.
  3. Valentino J, Levy FE, Marentette LJ. Intraoral monocortical miniplating of mandible fractures. Arch Otolaryngol Head Neck Surg. 1994;120:605–612.
  4. Neff A, Dingiria F, Schütz K, Karoglan M, Steinhäuser E. Retentive values of different screw types in the spongious bone of the condylar head. Proceedings 18 EACMFS Congress, Barcelona, Spain, September 12–15, 2006.
  5. Kozakiewicz M, Swiniarski J. “A” shape plate for open rigid internal fixation of mandible condyle neck fracture. J Cranio-Maxillofac Surg. 2014;42,730–737.
  6. Barber FA. Pullout strength of bone-patellar tendon-bone allograft bone plugs: A comparison of cadaver tibia and rigid polyurethane foam. Arthroscopy. 2013;29:1546–1551.
  7. Kim DS, Lee WJ, Choi SC, et al. Comparison of dental implant stabilities by impact response and resonance frequencies using artificial bone. Medical Engineering & Phisics. 2014;36:715–20.
  8. Ryken TC, Clausen JD, Traynelis VC, et al. Biomechanical analysis of bone mineral density, insertion technique, screw torque, and holding strength of anterior cervical plate screws. J Neurosurg. 1995;83:324–329.
  9. Zanetti EM, Salaorno M, Grasso G, Audenino AL. Parametric analysis of orthopedic screws in relation to bone density. Open Med Inform J. 2009;3:19–26.
  10. Cho W, Cho SK, Wu C. The Biomechanics of pedicle screw-based instrumentation. J Bone Jt Surg. 2010;92:1061–1065.
  11. Benzel EC. Implant-bone interfaces. In Benzel EC, editor. Biomechanics of spinal stabilization. New York: Thieme 2011;155–170.
  12. Heidemann W, Gerlach KL, Grobel KH, Köllner HG. Drill free screws: A new form of osteosynthesis screw. J Craniomaxillofac Surg. 1998;26:163–168.
  13. Kincaid B, Schroder L, Mason J. Measurement of orthopedic cortical bone screw insertion performance in cadaver bone and model materials. Experimental Mechan. 2007;47:595–607.
  14. Pitzen T, Franta F, Barbier D, Wolf-Ingo S. Insertion torque and pullout force of rescue screws for anterior cervical plate fixation in a fatigued initial pilot hole. J Neurosurg. 2004; 2:198–201.
  15. Porto MA, Silva P, Rosa R, et al. Experimental in vivo acute and chronic biomechanical and histomorphometrical comparison of self-drilling and self-tapping anterior cervical screws. Eur Spine J. 2012;21:956–963.
  16. Silva P, Rosa R, Shimano A, Defino H. Effect of pilot hole on biomechanical and in vivo pedicle screw–bone interface. Eur Spine J. 2013;22:1829–1836.
  17. Heidemann W, Terheyden H, Gerlach KL. In vivo studies of screw-bone contact of drill-free screws and conventional self-tapping screws. Mund Kiefer Gesichtschir. 2001;5:17–21.
  18. Kim JW, Ahn SJ, Chang YII. Histomorphometric and mechanical analysis of the drill-free screw as orthodontic anchorage. Am J Orthod Dentofacial Orthop. 2005;128:190–194.
  19. Heidemann W, Gerlach KL. Clinical applications of drill free screws in maxillofacial surgery. J Craniomaxillofac Surg. 1999;27:252–255.
  20. Lohr J, Gellrich NC, Buscher P, Wahl D, Rahn BA. Vergleichende In-vitro-Untersuchungen von selbstbohrenden und selbstschneidenden Schrauben. Histomorphologische und physikalisch-technische Untersuchungen des Lagerknochens. Mund Kiefer Gesichtschir. 2000;4:159–163.
  21. Mischkowski RA, Kneuertz P, Florvaag B, Lazar F, Koebke J, Zöller JE. Biomechanical comparison of four different miniscrew types for skeletal anchorage in the mandibulo-maxillary area. Int J Oral Maxillofac Surg. 2008;37:948–954.
  22. Gupta N, Kotrashetti SM, Naik V. A comparitive clinical study between self tapping and drill free screws as a source of rigid orthodontic anchorage. J Maxillofac Oral Surg. 2012;11: 29–33.
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