Mechanical evaluation of different sagittal osteotomy fixation techniques used in minimally invasive surgery
Avaliação mecânica de diferentes técnicas de fixação da osteotomia sagital utilizada na cirurgia minimamente invasiva
DOI:
https://doi.org/10.53660/CLM-1797-23M24Palavras-chave:
Sagittal split ramus osteotomy, Bone plate, Minimally invasive surgery, Orthognathic SurgeryResumo
Minimally invasive orthognathic surgery has advantages such as faster recovery, less paresthesia, and lower morbidity in the immediate postoperative period. However, there is no consensus regarding which fixation method is safer. The aim of the present study is to compare different methods of fixation of the short sagittal osteotomy like the Cordier G modification performed in minimally invasive surgery. An in vitro study was performed, consisting of 54 standardized polyurethane synthetic hemimandibles with Short sagittal osteotomy divided into 6 groups comprising 09 hemimandibles each. The groups consisted of bicortical screws, 4-hole straight plates, 0.8 mm and 1.0 mm thick curved plates, and 0.8 mm thick double Y and 1.0 mm thick double Y plates. All groups are System 2.0 and trademark Artfix®. The loading test was carried out, at a speed of 1mm/min, with a 50 Kgf load note for progressive load application on the system. Peak load (Kgf) and peak displacement (mm) were evaluated. Greater load resistance was found in the groups that received bicortical screws and 0.8mm and 1.0mm thick double Y plates.
Downloads
Referências
ALASSERI, N.; SWENNEN G. Minimally invasive orthognathic surgery: a systematic review. International Journal of Oral and Maxillofacial Surgery, v. 47, n. 10, p. 1299-1310, 2018.
ANUCUL, B.; WAITE, P. D.; LEMONS, J. E. In vitro strength analysis of sagittal split osteotomy fixation: noncompression monocortical plates versus bicortical position screws. Journal of Oral and Maxillofacial Surgery, v. 50, n. 12, p.1295-1299, 1992.
BRASILEIRO, B. F.; GROTTA-GREMPEL, R.; AMBROSANO, G. M.; PASSERI L. A. An in vitro evaluation of rigid internal fixation techniques for sagittal split ramus osteotomies: setback surgery. Journal of Oral and Maxillofacial Surgery, v. 70, n. 4, p. 941-951, 2012.
CORDIER, G.; SIGAUX, N.; IBRAHIM, B.; CRESSEAUX P. The intermediate length BSSO: Finding the balance between the classical and short designs. Journal of Stomatology Oral and Maxillofacial Surgery, v. 121, n. 1, p. 70-73, 2020.
DAL PONT, G. Retromolar osteotomy for the correction of prognathism. Journal of Oral Surgery, Anesthesia and Hospital Dental Service, v. 19, p. 42-45, 1961.
DEANGELIS, V. Orthodontic camouflaging of skeletal malocclusions: a clinical perspective. Journal of the Massachusetts Dental Society, v. 57, n. 4, p. 20-23, 2009.
DE ASSIS, G. M. Análise mecânica da resistência da fixação na osteotomia sagital do ramo após diferentes movimentos de avanço mandibular: estudo in vitro. 2017. 58f. Dissertação (Mestrado em Saúde Coletiva) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2017.
DE OLIVEIRA, L. B.; REIS, J. M.; SPIN-NETO, R.; GABRIELLI, M. A.; OGUZ, Y.; PEREIRA-FILHO, V. A. Mechanical evaluation of six techniques for stable fixation of the sagittal split osteotomy after counterclockwise mandibular advancement. British Journal of Oral and Maxillofacial Surgery, v. 54, n. 5, p. 573-578, 2016.
EPKER, B. N. Modifications of the sagittal osteotomy of the mandible. Journal Oral Surgery, v. 35, p. 157-159, 1977.
HERNÁNDEZ-ALFARO, F.; RAFFAINI, M.; PAREDES-DE-SOUSA-GIL, A.; MAGRI, A. S.; GUIJARRO-MARTÍNEZ, R.; VALLS-ONTAÑÓN, A. Three-Dimensional Analysis of Long-Term Stability After Bilateral Sagittal Split Ramus Osteotomy Fixed With a Single Miniplate With 4 Monocortical Screws and 1 Bicortical Screw: A Retrospective 2-Center Study. Journal of Oral and Maxillofacial Surgery, v. 75, n. 5, p. 1036-1045, 2017.
HUNDSUCK, E. E. Modified intraoral splitting technique for correction of mandibular prognatism. Journal Oral Surgery, v. 26, n. 4, p. 250-253, 1968.
HUNTER, J. G. Minimally invasive surgery: the next frontier. World Journal of Surgery, v. 23, n. 4, p. 422-424, 1999.
OZDEN, B.; ALKAN, A.; ARICI, S.; ERDEM, E. In vitro comparison of biomechanical characteristics of sagittal split osteotomy fixation techniques. International Journal of Oral and Maxillofacial Surgery, v. 35, n. 9, p. 837-841, 2006.
POSNICK, J. C.; KINARD, B.E. Use of a 'low and short' medial cut limits sagittal ramus osteotomy interferences. International Journal of Oral and Maxillofacial Surgery, v. 50, n. 12, p. 1583-1587, 2021.
SATO, F. R.; ASPRINO, L.; CONSANI, S.; DE MORAES, M. Comparative biomechanical and photoelastic evaluation of different fixation techniques of sagittal split ramus osteotomy in mandibular advancement. Journal of Oral and Maxillofacial Surgery, v. 68, n. 1, p. 160-166, 2010.
SWENNEN, G. R. J. Surgical Efficiency and Minimizing Patient Morbidity by Using a Novel Surgical Algorithm in Orthognathic Surgery. Atlas of the Oral and Maxillofacial Surgery Clinics of North America, v. 28, n. 2, p. 95-109, 2020.
TRAUNER, R.; OBWEGESER, H. The surgical correction of mandibular prognathism e retrognathia with consideration of genioplasty. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, v. 10, n. 7, p. 677-689, 1957.
WOLFORD, L. M.; DAVIS W. M. JR. The mandibular split: A modification in the sagittal split osteotomy. Journal of Oral and Maxillofacial Surgery, v. 48, p. 92-94, 1990.
