Assessment of compression and strength of divergent screws mounted on miniplates for fixation of mandibular fractures: an in vitro experimental study

Br J Oral Maxillofac Surg. 2015 Sep;53(7):613-7. doi: 10.1016/j.bjoms.2015.03.017. Epub 2015 Apr 24.

Abstract

An efficient band of tension is critical for the adequate fixation of mandibular fractures, so fixation devices that compress are helpful. We aimed to evaluate the possibility of creating compression using screws inserted divergently into miniplates placed in the tension zone of mandibular fractures and record the effects on the strength of fixation. For this in vitro experimental study we prepared 20 sheep hemimandibles. After angle fractures had been created, the specimens were divided into standard and study groups (n=10 in each). In the standard group the tension zones were fixed in the standard manner with 4-hole miniplates and 4 parallel screws. Those in the study group were fixed as for the standard group but with 4×45° divergent screws. The differences in the gap in the fracture line before and after fixation were measured as indicators of compression. The strength of fixation was also assessed with a universal testing machine in vitro. The amount of compression was significant only in the study group (p<0.001), and there was no difference in the strength of fixation between the two groups (p=0.7). We conclude that divergent drilling and insertion of screws creates more horizontal force when miniplates are used, and results in reduction in the size of the probable gap in the fracture line. Insertion of divergent screws in miniplates may create compression between fractured segments without jeopardising the strength of fixation.

Keywords: Bone plates; Fracture fixation; Mandibular fractures.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Biocompatible Materials / chemistry
  • Biomechanical Phenomena
  • Bone Plates*
  • Bone Screws*
  • Equipment Design
  • Fracture Fixation, Internal / instrumentation*
  • Mandibular Fractures / pathology
  • Mandibular Fractures / surgery*
  • Materials Testing
  • Miniaturization
  • Sheep
  • Stress, Mechanical
  • Titanium / chemistry

Substances

  • Biocompatible Materials
  • Titanium