title: Assessment of sagittal split ramus osteotomy rigid internal fixation techniques using a finite element method.
abstract: In this study, finite element analysis (FEA) was used to evaluate nine rigid internal fixation techniques for sagittal split ramus osteotomy. To achieve this, a computed tomography (CT) scan of a healthy patient was obtained and used to generate the geometry of a half-mandible. The geometries of bicortical screws, miniplates, and monocortical screws were designed and combined with the mandible in nine models simulating various techniques. Four models used bicortical screws in various arrangements and four used miniplates of various designs. One model represented a hybrid technique. A load of 500 N was applied to the posterior teeth and FEA was applied. The most stable techniques were the hybrid technique and a single straight miniplate, presenting the least displacement among all models. Bicortical screws, while presenting reasonable stability, showed high strain areas near the anterior ramus ridge, superoposterior to the screws, implying a risk of bone fracture in this area. On the other hand, the T-shaped and double Y-shaped miniplates were associated with high von Mises stresses that would impair their rigidity, especially where angles appeared in their designs. We recommend the use of a single straight miniplate because it provides sufficient stable fixation with minimal risks or disadvantages.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Dental Faculty, Damascus University, Damascus, Syria.
authors.forename: S
authors.initials: S
authors.lastname: Albougha
authors.affiliation: Department of Oral and Maxillofacial Surgery, Dental Faculty, Damascus University, Damascus, Syria.
authors.forename: K
authors.initials: K
authors.lastname: Darwich
authors.affiliation: Faculty of Technical Engineering, Tartous University, Syria; Faculty of Biomedical Engineering, Al Andalus University for Medical Sciences, Syria.
authors.forename: M A
authors.initials: MA
authors.lastname: Darwich
authors.affiliation: Section of Orthodontics and Dentofacial Orthopedics, Dental Graduate School, Kyushu University, Japan; Department of Orthodontics, Faculty of Dental Medicine, Damascus University, Syria. Electronic address: hassanbuga@hotmail.com.
authors.forename: M H
authors.initials: MH
authors.lastname: Albogha
mesh_terms: D001696:Biomechanical Phenomena; D020342:Finite Element Analysis; D006801:Humans; D016268:Internal Fixators; D019248:Jaw Fixation Techniques / Q000295:instrumentation*; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods*; D012984:Software; D013314:Stress, Mechanical; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: bicortical screws; finite element method; miniplates; rigid internal fixation; sagittal split ramus osteotomy