In vitro biomechanical evaluation of the effect of an additional L-shaped plate on straight or box plate fixation in sagittal split ramus osteotomy using a bioabsorbable plate system
In vitro biomechanical evaluation of the effect of an additional L-shaped plate on straight or box plate fixation in sagittal split ramus osteotomy using a bioabsorbable plate system
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DOI：
10.1007/s10006-011-0266-9
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发表时间：
2011-09-01
影响因子：
1.8
通讯作者：
Totsuka, Yasunori
中科院分区：
文献类型：
--
作者：
Matsushita, Kazuhiro;Inoue, Nobuo;Totsuka, Yasunori
目的下颌升支矢状劈开截骨术后，下颌骨远段（齿状段）在矢状面顺时针（张开）旋转引起的复发是常见的术后并发症之一。这个动作的力量主要由咀嚼肌和舌骨上肌施加。为了术后的稳定性，我们在每侧使用了两个钢板：一个直型钢板放置在第一磨牙颊侧表面的垂直截骨线上，一个L形钢板放置在截骨线上的最后一个磨牙的远端或外侧部分，刚好穿过颊侧架的上外侧边缘，以防止远端节段的尾部向上移动。虽然术后稳定性在临床上很好，但以前没有进行过实验评价。为了澄清的L形板的效果，我们进行了一项实验研究，使用生物可吸收板system.Methods定制的夹具来模拟旋转运动的节段。两个由聚甲醛树脂制成的节段用四孔直型或四孔箱型聚L-乳酸生物可吸收板固定。结果四孔直形接骨板的屈服载荷为152.4 ± 11.0N。增加L形接骨板后，这一数值显著增加至273.8+/-43.7 N（P< 0.05）。结论在生物可吸收接骨板系统中增加L形接骨板可显著提高四孔直形接骨板的刚度。
Purpose Relapse caused by clockwise (opening) rotation of the distal segment (dentate segment) in the sagittal plane is one of the postoperative complications sometimes seen after sagittal split ramus osteotomy. The force involved in this movement is primarily exerted by the masticatory and suprahyoid muscles. For postoperative stability, we have used two plates on each side: a straight plate placed over the vertical osteotomy line at the buccal surface of the first molar and an L-shaped plate placed at the distal or lateral part of the last molar over the osteotomy line, just crossing over the upper-lateral edge of the buccal shelf, to prevent the tail of the distal segment from moving upward. Although postoperative stability was clinically fine, experimental evaluations have not previously been performed. To clarify the effects of the L-shaped plate, we performed an experimental study using a bioabsorbable plate system.Methods A custom-fabricated jig was made to simulate rotational movement of the segments. Two segments made from polyoxymethylene resin were fixed with a four-hole straight or four-hole box poly-L-lactate bioabsorbable plate. An L-shaped plated was then added for rigidity, and mechanical testing was performed.Results The yield load exerted by the four-hole straight plate alone was 152.4+/-11.0 N. This increased significantly to 273.8+/-43.7 N with addition of an L-shaped plate (P< 0.05). Conclusion Addition of an L-shaped plate significant improves the rigidity of four-hole straight plate fixation in a bioabsorbable plate system.