Comparison of biomechanical behaviour of maxilla following Le Fort I osteotomy with 2- versus 4-plate fixation using 3D-FEA

• Published in: International journal of oral and maxillofacial surgery Vol. 38; no. 2; pp. 173 - 179
• Main Authors: Erkmen, E, Ataç, M.S, Yücel, E, Kurt, A
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.02.2009
• Subjects: 3D finite element analysis; inferior repositioning surgery; internal fixation; Le Fort I osteotomy; Surgery; 3D finite element analysis; internal fixation; inferior repositioning surgery; Le Fort I osteotomy
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2008.10.006

Abstract Having studied the effect of maxillary advancement and maxillary impaction in parts 1 and 2 of this research, the purpose of this study was to investigate the biomechanical behavior of different fixation models in inferiorly and anteriorly repositioned maxilla following Le Fort I osteotomy. Two separate three-dimensional finite element models, simulating the inferiorly advanced maxilla at Le Fort I level, were used to compare 2- and 4-plate fixation. Model INF-2 resulted in 247 897 elements and 53 247 nodes and INF-4 consisted of 273 130 elements and 59 917 nodes. The stresses occurring in and around the bone and plate–screw complex were computed. The highest Von Mises stresses on the plates and maximum principal stresses on the bones were found in INF-2, especially under horizontal and oblique loads, when compared with INF-4. The present biomechanical study shows that the traditionally used 4-plate fixation technique, following Le Fort I inferior and anterior repositioning surgery, without bone grafting, provides fewer stress fields on the maxillary bones and fixation materials.