Biomechanical comparison of polylactide-based versus titanium miniplates in mandible reconstruction in vitro

C Steffen; K Sellenschloh; V Polster; M Heyland; M Vollmer; M M Morlock; M Heiland; G Huber; C Rendenbach

doi:10.1016/j.jormas.2019.12.001

Biomechanical comparison of polylactide-based versus titanium miniplates in mandible reconstruction in vitro

J Stomatol Oral Maxillofac Surg. 2020 Sep;121(4):377-382. doi: 10.1016/j.jormas.2019.12.001. Epub 2019 Dec 18.

Authors

C Steffen¹, K Sellenschloh², V Polster², M Heyland³, M Vollmer², M M Morlock², M Heiland⁴, G Huber², C Rendenbach⁵

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: claudius.steffen@charite.de.
² Institute of Biomechanics, TUHH Hamburg University of Technology, Denickestraße 15, 21703 Hamburg, Germany.
³ Julius-Wolff-Institute, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
⁴ Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany.
⁵ Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany; Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany.

PMID: 31863927
DOI: 10.1016/j.jormas.2019.12.001

Abstract

Objectives: Evaluation of the mechanical integrity and reliability of polylactide-based miniplates for osseous free flap fixation at the mandible in an experimental study setup of a mandible reconstruction model.

Material and methods: 1.0mm titanium miniplates (group TI) (MatrixMandible, DePuy Synthes, Umkirch, Germany) and 1.5mm polylactide miniplates (group PL) (Inion CPS, Inion Oy, Tampere, Finland) were used to fix a polyurethane (PU) fibula segment to a PU mandible reconstruction model using monocortical non-locking screws. Mastication was simulated via unilateral cyclic dynamic loading at 1Hz with increasing loads (+ 0.15N/cycle, Bionix, MTS, USA). A 3D optical tracking system (Aramis, GOM, Braunschweig, Germany) was used to determine interosteotomy movements (IOM).

Results: IOM were higher in the polylactide group (distal: P=0.001, mesial: P=0.001). Differences in mean stiffness (titanium: 478±68N/mm; polylactide: 425±38N/mm, P=0.240) and mean force at a vertical displacement of 1.0mm (titanium: 201.6±87.1N; polylactide: 141.3±29.9N, P=0.159) were not significant.

Conclusions: The results of this study suggest that polylactide-based miniplates provide reduced mechanical integrity and higher interosteotomy movements in comparison to titanium miniplates in vitro. Indications for clinical use of polylactide-based miniplates in mandible reconstruction have to be placed critically. Future studies will focus on clinical complications of polylactide-based plates in risk patients.

Keywords: Biomechanics; Fatigue strength; Fibula free flap; Mandible reconstruction; Mechanical integrity; Polylactide.

MeSH terms

Bone Plates*
Humans
Mandible / surgery
Polyesters
Reproducibility of Results
Titanium*

Substances

Polyesters
poly(lactide)
Titanium