Biomechanical comparison of polylactide-based versus titanium miniplates in mandible reconstruction in vitro - 24/12/19

Doi : 10.1016/j.jormas.2019.12.001

C. Steffen ^a,⁎ , K. Sellenschloh ^c, V. Polster ^c, M. Heyland ^d, M. Vollmer ^c, M.M. Morlock ^c, M. Heiland ^a, G. Huber ^c, C. Rendenbach ^a,^b
^a Department of Oral and Maxillofacial Surgery, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
^b Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany
^c Institute of Biomechanics, TUHH Hamburg University of Technology, Denickestraße 15, 21703 Hamburg, Germany
^d Julius-Wolff-Institute, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany

^⁎Corresponding author at: Department of Oral and Maxillofacial Surgery, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.Department of Oral and Maxillofacial Surgery, Charité Universitätsmedizin Berlin, Augustenburger Platz 1Berlin13353Germany

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Abstract

Objectives

Evaluation of the mechanical integrity and reliability of polylactide-based miniplates for osseous free flap fixation at the mandible in an experimental study setup of a mandible reconstruction model.

Material and methods

1.0mm titanium miniplates (group TI) (MatrixMandible, DePuy Synthes, Umkirch, Germany) and 1.5mm polylactide miniplates (group PL) (Inion CPS, Inion Oy, Tampere, Finland) were used to fix a polyurethane (PU) fibula segment to a PU mandible reconstruction model using monocortical non-locking screws. Mastication was simulated via unilateral cyclic dynamic loading at 1Hz with increasing loads (+ 0.15N/cycle, Bionix, MTS, USA). A 3D optical tracking system (Aramis, GOM, Braunschweig, Germany) was used to determine interosteotomy movements (IOM).

Results

IOM were higher in the polylactide group (distal: P=0.001, mesial: P=0.001). Differences in mean stiffness (titanium: 478±68N/mm; polylactide: 425±38N/mm, P=0.240) and mean force at a vertical displacement of 1.0mm (titanium: 201.6±87.1N; polylactide: 141.3±29.9N, P=0.159) were not significant.

Conclusions

The results of this study suggest that polylactide-based miniplates provide reduced mechanical integrity and higher interosteotomy movements in comparison to titanium miniplates in vitro. Indications for clinical use of polylactide-based miniplates in mandible reconstruction have to be placed critically. Future studies will focus on clinical complications of polylactide-based plates in risk patients.

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Keywords : Polylactide, Mandible reconstruction, Fibula free flap, Fatigue strength, Biomechanics, Mechanical integrity