Dental and Medical Problems

Dent Med Probl
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ISSN 1644-387X (print)
ISSN 2300-9020 (online)
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Dental and Medical Problems

2017, vol. 54, nr 4, October-December, p. 319–326

doi: 10.17219/dmp/78913

Publication type: original article

Language: English

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Creative Commons BY-NC-ND 3.0 Open Access

Finite element analysis of newly introduced plates for mandibular condyle neck fracture treatment by open reduction and rigid fixation

Metoda elementów skończonych w ocenie nowo wprowadzanych płytek do ograniczenia otwierania i sztywnej stabilizacji w leczeniu złamania szyjki wyrostka kłykciowego żuchwy

Marcin Kozakiewicz1,A,C,D,F, Jacek Świniarski2,A,B,C,E,F

1 Clinic and Department of Maxillofacial Surgery, Medical University of Lodz, Łódź, Poland

2 Department of Strength of Materials and Structures, Faculty of Mechanical Engineering, Lodz University of Technology, Poland

Abstract

Background. Fractures of the mandibular condyle have been a topic of controversy and discussion in the area of maxillofacial trauma for many years. Any treatment should provide accurate reduction and stability of fractured bony fragments to enable further uncomplicated mandibular function. Recently, 2 novel plates were introduced: strut and rhombus.
Objectives. To compare the newly introduced plates for mandibular condyle neck fracture treatment.
Material and Methods. A total of 6 variants of fixing by 5 screws were tested by finite element analysis: strut plate in the normal position (T1), strut plate in an inverted position (T2), rhombus plate with 2 screws positioned close to the lower border sliding middle holes (T3), rhombus one with a mesial screw positioned close to the upper border of the sliding hole and distal screw positioned close to the lower border of the sliding hole (T4), rhombus one with both screws in sliding holes positioned close to the upper border of the holes (T5), and modified rhombus plate where all holes are round (T6). Equivalent maximal stress in the fixing material and relative displacement in the fracture line were calculated, and the influence of the act of mastication on fatigue failure was evaluated.
Results. The position of the plate and location of the fixing screws are crucial for stabilization of the reduced bone fragments. Any adjustments of these 2 plates by bending, flattening or cutting are unsafe. Mean relative displacement in the fracture line and equivalent maximal stress were T1: 958 ±312 μm (the worst p < 0.05), 869 MPa; T2: 463 ±130 μm, 915 MPa; T3: 625 ±222 μm, 1150 MPa; T4: 624 ±273 μm, 1160 MPa; T5: 485 ±192 μm, 544 MPa; and T6: 467 ±172 μm, 549 MPa, respectively.
Conclusion. It should be noted, comparing both plates, that the rhombus plate equipped only with round holes (not sliding holes) presented its superiority within this pairing. It is mechanically relatively resistant and relatively durable in spite of the design being only partially according to compression and traction force propagation in the mandibular condyle.

Key words

treatment, finite element method, fracture, mandibular condyle neck, fixing material

Słowa kluczowe

leczenie, metoda elementów skończonych, złamanie, szyjka wyrostka kłykciowego żuchwy, materiał zespalający

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