Biomechanical competence of six different bone screws for reconstructive surgery in three different transplants: Fibular, iliac crest, scapular and artificial bone.
The goal of this study was to determine a combination of screw and transplantation type that offers optimal primary stability for reconstructive surgery. Fibular, iliac crest, and scapular transplants were tested along with artificial bone substrate. Six different kinds of bone screws (Medartis(©)) were compared, each type utilized with one of six specimens from human transplants (n = 6). Controlled screw-in-tests were performed and the required torque was protocolled. Subsequently, pull-out-tests were executed to determine the retention forces. The artificial bone substitute material showed significantly higher retention forces than real bone samples. The self-drilling screws achieved the significantly highest retention values in the synthetic bone substitute material. Cancellous screws achieved the highest retention in the fibular transplants, while self-drilling and cancellous screws demonstrated better retention than cortical screws in the iliac crest. In the scapular graft, no significant differences were found between the screw types. In comparison to the human transplant types, the cortical screws showed the significantly highest values in the fibula and the lowest values in the iliac crest. The best retention was found in the combination of cancellous screws with fibular graft (514.8 N + -252.3 N). For the flat bones (i.e., scapular and illiac crest) we recommend the cancellous screws.
Department of Oral and Maxillofacial Surgery, RWTH Aachen University Hospital, Pauwelstraße 30, 52074 Aachen, Germany.
Arnold P
AP
Pietsch
Department of Dental Materials and Biomaterials Research, RWTH Aachen University Hospital, Pauwelstraße 30, 52074 Aachen, Germany.
Stefan
S
Raith
Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Jan-Eric
JE
Ode
Department of Oral and Maxillofacial Surgery, RWTH Aachen University Hospital, Pauwelstraße 30, 52074 Aachen, Germany.
Jan
J
Teichmann
Department of Oral and Maxillofacial Surgery, RWTH Aachen University Hospital, Pauwelstraße 30, 52074 Aachen, Germany.
Bernd
B
Lethaus
Department of Orthodontics, RWTH Aachen University Hospital, Pauwelstraße 30, 52074 Aachen, Germany.
Stephan C
SC
Möhlhenrich
Department of Oral and Maxillofacial Surgery, RWTH Aachen University Hospital, Pauwelstraße 30, 52074 Aachen, Germany.
Frank
F
Hölzle
Julius Wolff Institute and Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Georg N
GN
Duda
Department of Oral and Maxillofacial Surgery, RWTH Aachen University Hospital, Pauwelstraße 30, 52074 Aachen, Germany. Electronic address: timm.steiner@gmx.de.
Timm
T
Steiner
D001696:Biomechanical Phenomena; D001863:Bone Screws; D018786:Bone Substitutes; D016025:Bone Transplantation / Q000295:instrumentation / Q000379:methods; D005360:Fibula / Q000637:transplantation*; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D012540:Scapula / Q000637:transplantation*; D013314:Stress, Mechanical
D018786:Bone Substitutes
Biomechanics; Bone screw; Fibular graft; Iliac crest; Scapular graft; Transplantation