Mehmet Melih ÖMEZLİ, Ferhat AYRANCI, Damla TORUL, Mustafa AY

Le Fort I İlerletme Osteotomisi Sonrası Farklı Fiksasyon Sistemlerinin Biyomekanik Olarak Karşılaştırması: İn Vitro Çalışma

Amaç: Bu çalışmanın amacı, poliüretan kafatası modellerinde Le Fort I osteotomisi sonrası beş farklı plak-vida sisteminin stabilite üzerindeki etkisini araştırmaktır. Ayrıca ikincil olarak mikro ve rezorbe olabilen fiksasyon sistemlerinin özellikle kasların kısmen ince olduğu bölgelerde yeterli stabilite sağlanmasındaki etkinliğini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Poliüretan kafataslarında yapay olarak oluşturulan Le Fort I osteotomisinin sabit fiksasyonu için standart titanyum mini plaklar, titanyum mikroplaklar ve rezorbe olabilen plakalar uygulandı. Isırma kuvvetlerini simüle etmek için aşağı-yukarı yönde yük uygulandı. Kuvvet-yer değiştirme değerleri kaydedildi. Bulgular: 120, 150, 180 ve 200 N yüklemede beş farklı fiksasyon sisteminin yer değiştirme değerleri arasında önemli farklılıklar gözlendi (p <0.05). En yüksek deplasman değerleri, artan yük ile 4RLt-Micro grubunda gözlendi. 4RLt-Mini ve 4LLt-Mini grupları en düşük yer değiştirme değerlerini gösterdi ve 4LLt-Mini grubu 4RLt-Mini grubundan daha az yer değiştirme gösterdi. 2Lt / 2It-Mini ve 2Lt / 2Ir-Mini grupları, 4RLt-Mini ve 4LLt-Mini grupları ile yaklaşık deplasman değerleri gösterdi. Sonuçlar: Bu çalışmanın sonuçları, sol taraftaki L mini plakaların sağ tarafa göre daha stabil sonuçlar verdiğini göstermektedir. Ayrıca yeterli stabilite elde edilirken, ince kaslı bölgelerde rezorbe olabilen plakların standart titanyum mini plaklar ile kombine halde kullanılmasıyla palpabilite probleminin de ortadan kalktığı söylenebilir. Bununla birlikte, bu sonuçları doğrulamak için daha geniş ilerleme değerlerine sahip daha fazla in vitro ve in vivo çalışmaların yapılması gerekmektedir.

Anahtar Kelimeler:

Rezorbe olabilen sistem, mikroplak, , stabilite, ilerletme, Le Fort osteotomisi

Biomechanical Comparison of Different Fixation Systems after Le Fort I Advancement Osteotomy: An in Vitro Study

Background: The aim of this study is to explore the effect of five different plate-screw systems on the stability after LeFort I osteotomy in polyurethane skull models. Also, we aimed secondarily to evaluate the efficiency of the use of micro and bioabsorbable fixation systems especially in the regions where the muscularity is relatively thin, in providing enough stability. Methods: Standard titanium miniplates, titanium microplates and bioabsorbable plates were applied for the internal fixation of artificially created LeFort I osteotomy on polyurethane skulls. Load applied in inferior-superior direction to simulate bite forces. The load-displacement values were recorded. Results: Significant differences were observed among the displacement values of five fixation systems at 120, 150, 180 and 200 N of loading (p< 0.05). The highest displacement values were observed in the 4RLt-Micro group with the increasing load. The 4RLt-Mini and 4LLt-Mini groups showed the least displacement values, and the 4LLt-Mini group showed less displacement than the 4RLt-Mini group. The 2Lt/2It- Mini and 2Lt/2Ir-Mini groups showed proximate displacement values with the 4RLt-Mini and 4LLt-Mini groups. Conclusions: The results of this study show that the left sided L miniplates provide more stable results than the right sided ones. Also, it may be said that while sufficient stability can be obtained, the problem of palpability is also eliminated with the use of bioabsorbable plates in the regions with thin muscularity in combination with standard titanium miniplates. However, further in vitro and in vivo studies with wider advancement values needs to be conducted to confirm these results.

Keywords:

Bioabsorbable system, microplate, stability, advancement, Le Fort osteotomy,

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