J Korean Assoc Oral Maxillofac Surg.  2012 Dec;38(6):332-336. 10.5125/jkaoms.2012.38.6.332.

A comparison of fixation methods using three-dimensional finite element analysis following anterior segmental osteotomy

• Yun KI
• Park MK
• Park MK
• Park JU

• KMID: 2136969
• DOI: http://doi.org/10.5125/jkaoms.2012.38.6.332

Abstract

OBJECTIVES
This study sought to evaluate fixation methods and determine the best method for the postoperative stabilization of maxillary osteotomy. For our analysis we performed a three-dimensional finite element analysis of stress distribution on the plate, screw, and surrounding bone, as well as displacement onto the plate.
MATERIALS AND METHODS
We generated a model using synthetic skull scan data; an initital surface model was changed to a solid model using software. Modified anterior segmental osteotomy (using Park's method) was made using the program, and four different types of fixation methods were used. An anterior load of 100 N was applied on the palatal surface of two central incisors.
RESULTS
The Type 1 (L-shaped) fixation method gave stresses of 187.8 MPa at the plate, 45.8 MPa at the screw, and 15.4 MPa at the bone around the plate. The Type 2 (I-shaped) fixation method gave stresses of 186.6 MPa at the plate, 75.7 MPa at the screw, and 13.8 MPa at the bone around the plate. The Type 3 (inverted L-shaped) fixation method gave stresses of 28.6 MPa at the plate, 29.9 MPa at the screw, and 15.3 MPa at the bone around the plate. The Type 4 (I-shaped) fixation method gave stresses of 34.8 MPa at the plate, 36.9 MPa at the screw, and 14.9 MPa at the bone around the plate. The deflection of the plates for the four fixation methods was 0.014 mm, 0.022 mm, 0.017 mm, and 0.018 mm, respectively.
CONCLUSION
The Type 3 (inverted L-shaped) fixation method offers more stability than the other fixation methods. We therefore recommend this method for the postoperative stabilization of maxillary osteotomy.

Keyword

Anterior segmental osteotomy; Fixation techniques; 3D finite element analysis

MeSH Terms

Displacement (Psychology)
Finite Element Analysis
Maxillary Osteotomy
Osteotomy
Skull

Figure

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  Fig. 1 Four types of anterior segmental osteotomy model fixed with different pattern of plates and screws. A. Type 1. B. Type 2. C. Type 3. D. Type 4.

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  Fig. 2 The screw holes were numbered by their positions. A. Type 1. B. Type 2. C. Type 3. D. Type 4.

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  Fig. 3 Comparison of von Mises stress of plates, screws, bone near screw holes, and deflection of plates of 4 different types.

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