Fracture Fixation Technique and Chewing Side Impact Jaw Mechanics in Mandible Fracture Repair

Hyab Mehari Abraha, José Iriarte-Diaz, Russell R. Reid, Callum F. Ross, Olga Panagiotopoulou

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Lower jaw (mandible) fractures significantly impact patient health and well-being due to pain and difficulty eating, but the best technique for repairing the most common subtype—angle fractures—and rehabilitating mastication is unknown. Our study is the first to use realistic in silico simulation of chewing to quantify the effects of Champy and biplanar techniques of angle fracture fixation. We show that more rigid, biplanar fixation results in lower strain magnitudes in the miniplates, the bone around the screws, and in the fracture zone, and that the mandibular strain regime approximates the unfractured condition. Importantly, the strain regime in the fracture zone is affected by chewing laterality, suggesting that both fixation type and the patient's post-fixation masticatory pattern—ipsi- or contralateral to the fracture— impact the bone healing environment. Our study calls for further investigation of the impact of fixation technique on chewing behavior. Research that combines in vivo and in silico approaches can link jaw mechanics to bone healing and yield more definitive recommendations for fixation, hardware, and postoperative rehabilitation to improve outcomes.

Original languageEnglish
Article numbere10559
Number of pages9
JournalJBMR Plus
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • FINITE ELEMENT ANALYSIS
  • IMPLANTS
  • MANDIBLE
  • MASTICATION
  • MAXILLOFACIAL SURGERY
  • RHESUS MONKEY
  • TRAUMA

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