Do mandibular titanium miniplates affect the biomechanical behaviour of the mandible? A preliminary experimental study.

Autor: Graillon N; Aix Marseille Univ, APHM, Univ Gustave Eiffel, LBA, bd Pierre Dramard, 13916 Marseille, France, Conception University Hospital, Department of Oral and Maxillofacial Surgery, 147 bd Baille, Marseille 13005, France.. Electronic address: nicolas.graillon@ap-hm.fr., Guyot L; Aix Marseille Univ, APHM, Univ Gustave Eiffel, LBA, bd Pierre Dramard, 13916 Marseille, France, Conception University Hospital, Department of Oral and Maxillofacial Surgery, 147 bd Baille, Marseille 13005, France., Thollon L; Aix Marseille Univ, Univ Gustave Eiffel, LBA, bd Pierre Dramard, Marseille 13916, France., Godio-Raboutet Y; Aix Marseille Univ, Univ Gustave Eiffel, LBA, bd Pierre Dramard, Marseille 13916, France., Roux ML; Aix Marseille Univ, APHM, Conception University Hospital, Department of Oral and Maxillofacial Surgery, 147 bd Baille 13005 Marseille, France., Foletti JM; Aix Marseille Univ, APHM, Univ Gustave Eiffel, LBA, bd Pierre Dramard, 13916 Marseille, France, Conception University Hospital, Department of Oral and Maxillofacial Surgery, 147 bd Baille, Marseille 13005, France.
Jazyk: angličtina
Zdroj: Journal of stomatology, oral and maxillofacial surgery [J Stomatol Oral Maxillofac Surg] 2022 Nov; Vol. 123 (6), pp. e675-e681. Date of Electronic Publication: 2022 Feb 19.
DOI: 10.1016/j.jormas.2022.02.007
Abstrakt: Introduction: Whether to conserve or remove titanium miniplates after rigid internal fixation of mandibular fractures still remains controversial. Miniplates could affect the biomechanical behaviour of the mandible in case of trauma, and therefore cause more complex fractures.
Materials and Methods: An experimental study, consisting in simulating a mandibular trauma, was designed in order to compare the fractures caused by an impact on the mandible in the presence or absence of an internal fixation. We simulated an impact on the right parasymphysis region in 10 post-mortem human subjects, according to the Charpy impact test method at an impact speed of 7.4 m/s, using a 5 kg test impactor.
Results: In the control group, the fracture lines were vertical and straight, without comminution. In the miniplate group, the fractures occurred close to the miniplates (4 cases) and under the miniplates (one case). The fracture lines were more complex, even comminuted in 2 cases. Thus, miniplates impacted the biomechanical behavior of the mandible, resulting in more complex fractures.
Conclusion: Our experimental study highlighted the impact of the presence of miniplates on the mandible in case of trauma, and the risk of causing more complex fractures. We therefore recommend further investigations to determine if titanium miniplates should be systematically removed after bone healing, in patients with a higher risk of trauma in relation with previous assault injuries, alcohol or substance abuse, the practice of fighting or contact sport/activities, and soldiers.
Competing Interests: Declarations of Competing Interest None.
(Copyright © 2022 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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