Mechanical stability of 2-plate versus 4-plate osteosynthesis in advancement Le Fort I osteotomy. An in vitro study

J Stomatol Oral Maxillofac Surg. 2017 Feb;118(1):2-4. doi: 10.1016/j.jormas.2016.03.001. Epub 2017 Feb 3.

Abstract

Introduction: Stability in orthognathic surgery is nowadays considered as efficient and adequate. The objective of this study was to determine and to compare the mechanical resistance to vertical load of a Le Fort I advancement osteotomy stabilized by mean of two different osteosynthesis techniques, one using two 10-hole pre-bent T-shaped plates, the other using four manually bent 4-hole L- and J-shaped plates.

Materiel and methods: Standardized Le Fort I advancement osteotomies have been made on polyurethane models. The maxillary advancement was 5mm. Two groups of five models each were created. Group 1 was stabilized by mean of two 10-hole pre-bent T-shaped plates fixed by monocortical screws in the paranasal region. Group 2 was stabilized by mean of manually bent four 4-hole L-shaped plates fixed monocortical screws in the zygomatic and paranasal regions. A testing machine was used to load vertically the models at the range of 1mm/min linear displacement until peak load and system failure. Statistical analysis was realized using ANOVA and t-test, considering P as significant if <0.005.

Results: The maximal tolerated load was 15N in group 1and 42.71N in group 2 (P=0.003).

Discussion: The use of two T-shaped 10-holes pre-bent plates allows for less resistance in vertical loading than the use of four 4-holes manually bent L-shaped plates.

Keywords: Internal fixation; Le Fort I; Pre-bend plate.

MeSH terms

  • Bone Plates* / adverse effects
  • Bone Screws / adverse effects
  • Equipment Design
  • Equipment Failure
  • Equipment Failure Analysis
  • Fracture Fixation, Internal* / instrumentation
  • Fracture Fixation, Internal* / methods
  • Humans
  • In Vitro Techniques
  • Materials Testing / methods
  • Mechanical Phenomena
  • Models, Anatomic
  • Osteotomy, Le Fort* / instrumentation
  • Osteotomy, Le Fort* / methods
  • Stress, Mechanical*