Integrity of a Single Superior Border Plate Repair in Mandibular Angle Fracture: A Novel Cadaveric Human Mandible Model

Publication date: Available online 6 August 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Somsak Sittitavornwong, Douglas Denson, David Ashley, David Cruz Walma, Sarah Potter, Jonathan Freind

Abstract

Purpose

The purpose of this study is to compare the integrity of the human mandibular angle fracture after fixation with a single titanium plate along the upper lateral border to the native human mandible.

Materials and Methods

This cross-sectional anatomic study involved the left hemi-mandibles of sixteen human cadavers. They were selected and divided in two groups by remaining dental status. Additional predictor variables such as height of the left mandibular body and gender were noted. The left hemisected native mandibles were mounted at the condyle and loaded on an Instron 5565 mechanical unit until fracture. The fractured left hemi-mandible were fixated with a titanium mini-plate and screws. After plate fixation, each hemi-mandible was again loaded on an Instron 5565 until fracture. Data pertaining to primary outcomes of load application was recorded in newtons at three different displacement values: 3.0, 5.0, and 7.0 mm, as well as displacement at fixation failure. Primary outcomes of maximum load and displacement at the maximum load were recorded in newtons and millimeters respectively. Descriptive statistics were used to summarize the sample characteristics. Statistical comparisons were performed using a t-test, chi-squared (or Fisher's exact) test and linear regression. Pearson correlation was used to examine the relationships between select biomechanical measurements.

Results

The study comprised of 12 females and 4 males. Donors ranged from 54 to 95 years old at time of death with a mean age of 78.94 years. The mean maximum load in the native and plated hemi-mandibles was 943.56 and 292.57 N, respectively (p < 0.0001).

Conclusion

Key clinical findings of this project include the inability of single plate mandible fixation to restore the mandible to pre-injury levels and verification that gender, dental status, and height of the mandible do not alter the stability of a single plate fixated mandible.

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