Two versus three magnesium screws for osteosynthesis of mandibular condylar head fractures: a finite element analysis.

IF 3.1 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Clinical Oral Investigations Pub Date : 2024-09-27 DOI:10.1007/s00784-024-05927-5
Daphne Schönegg, Günter T Müller, Michael Blumer, Harald Essig, Maximilian E H Wagner
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Abstract

Objectives: Previous finite element analyses (FEA) have shown promising results for using two titanium screws in treating mandibular condylar head fractures but limited mechanical stability of a two-screw osteosynthesis with magnesium screws. Given the potential benefits of magnesium screws in terms of biocompatibility and resorption, this study aimed to compare two- and three-screw osteosynthesis solutions for a right condylar head fracture (AO CMF type p) with magnesium screws with a FEA.

Materials and methods: A previously validated finite element model simulating a 350 N bite on the contralateral molars was used to analyze von Mises stress within the screws, fragment deformation, and fracture displacement. All screws were modeled with uniform geometric specifications mirroring the design of Medartis MODUS® Mandible Hexadrive cortical screws.

Results: The three-screw configuration demonstrated lower values for all three parameters compared to the two-screw scenario. There was a 30% reduction in maximum von Mises stress for the top screw and a 46% reduction for the bottom screw.

Conclusions: Fracture treatment with three magnesium screws could be a valuable and sufficiently stable alternative to the established treatment with titanium screws. Further studies on screw geometry could help improve material stability under mechanical loading, enhancing the performance of magnesium screws in clinical applications.

Clinical relevance: The use of magnesium screws for osteosynthesis of mandibular condylar head fractures offers the benefit of reducing the need for second surgery for hardware removal. Clinical data is needed to determine whether the advantages of resorbable screw materials outweigh potential drawbacks in condylar head fracture treatment.

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下颌骨髁状头骨折截骨术中使用两颗镁螺钉还是三颗镁螺钉:有限元分析。
目的:以往的有限元分析(FEA)显示,使用两根钛螺钉治疗下颌骨髁状头骨折的效果很好,但使用镁螺钉进行双螺钉骨合成的机械稳定性有限。鉴于镁螺钉在生物相容性和吸收方面的潜在优势,本研究旨在通过有限元分析比较使用镁螺钉治疗右髁头骨折(AO CMF p型)的双螺钉和三螺钉骨合成方案:使用先前验证的有限元模型模拟对侧臼齿 350 N 的咬合,分析螺钉内的 von Mises 应力、碎片变形和骨折位移。所有螺钉均采用与 Medartis MODUS® Mandible Hexadrive 皮质螺钉设计一致的几何规格进行建模:结果:与双螺钉方案相比,三螺钉配置的所有三个参数值都较低。顶部螺钉的最大 von Mises 应力降低了 30%,底部螺钉降低了 46%:结论:使用三根镁制螺钉进行骨折治疗是一种有价值且足够稳定的方法,可替代现有的钛制螺钉治疗方法。对螺钉几何形状的进一步研究有助于提高材料在机械负荷下的稳定性,从而提高镁螺钉在临床应用中的性能:临床相关性:使用镁螺钉对下颌骨髁状头骨折进行骨合成,可减少二次手术取出硬件的需要。需要临床数据来确定可吸收螺钉材料在髁状头骨折治疗中的优势是否大于潜在的缺点。
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来源期刊
Clinical Oral Investigations
Clinical Oral Investigations 医学-牙科与口腔外科
CiteScore
6.30
自引率
5.90%
发文量
484
审稿时长
3 months
期刊介绍: The journal Clinical Oral Investigations is a multidisciplinary, international forum for publication of research from all fields of oral medicine. The journal publishes original scientific articles and invited reviews which provide up-to-date results of basic and clinical studies in oral and maxillofacial science and medicine. The aim is to clarify the relevance of new results to modern practice, for an international readership. Coverage includes maxillofacial and oral surgery, prosthetics and restorative dentistry, operative dentistry, endodontics, periodontology, orthodontics, dental materials science, clinical trials, epidemiology, pedodontics, oral implant, preventive dentistiry, oral pathology, oral basic sciences and more.
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