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Locking versus nonlocking plates in mandibular reconstruction with fibular graft—a biomechanical ex vivo study

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Abstract

Objectives

The main goal of the present study was to compare the biomechanical stability of locking plates and conventional miniplate combinations in human mandibles reconstructed with fibular grafts.

Materials and methods

A specially developed and well-proven testing device reproduced the in vivo loading conditions on the mandible. Cadaveric human mandibles (n = 12) reconstructed with harvested human fibular bone grafts were divided into two groups, and different osteosynthesis systems were applied using two lines of plates per osteotomy. On the test apparatus, the specimens were stressed to failure, and interfragmentary movement was monitored and quantified with a contact-free optical measurement system.

Results

The relevant interfragmentary movement results from a Euclidean summary calculation which considered all three spatial angles around the axes. Using values up to a maximum load of 300 N, the conventional six-hole miniplates (profile 1.0) had an average value of 7.45° ± 1.46°, and the locking six-hole plates (profile 1.3) had an average value of 12.16° ± 2.37° for rotational interfragmentary movement. The miniplate system exhibited a significantly superior performance in fixation compared to the fixed-angle system (p < 0.05).

Conclusion

According to these biomechanical experiments, both osteosynthesis devices provided sufficient stabilization at loads of up to 300 N. The six-hole miniplate system provided better stabilization of the osteotomy gap for mandibles reconstructed with fibular grafts.

Clinical relevance

The osteosynthesis system is essential for primary stability and the avoidance of pseudarthrosis formation. This study demonstrates that the miniplates provide sufficient stabilization and offers a method to improve fixation in reconstructed mandibles.

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Acknowledgments

We would like to thank the International Bone Research Association (IBRA), Basel, Switzerland, for making these studies possible by providing essential support in the form of a research grant.

Conflict of interest

On behalf of all of the authors of this manuscript, we certify that there is no actual or potential conflict of interest in relation to this article. Additionally, we declare that there exists no financial or personal relationship with other people or organizations that could inappropriately influence this work.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Universitätsklinikum Aachen, RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany

    Susanne Trainotti, Stefan Raith, Bernd Lethaus, Frank Hölzle & Timm Steiner

  2. Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany

    Susanne Trainotti, Stefan Raith, Marco Kesting, Florian Bauer & Andreas Kolk

  3. Department of Orthopaedics and Trauma Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany

    Stefan Eichhorn

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  1. Susanne Trainotti
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  2. Stefan Raith
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  3. Marco Kesting
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  4. Stefan Eichhorn
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Correspondence to Susanne Trainotti.

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Trainotti, S., Raith, S., Kesting, M. et al. Locking versus nonlocking plates in mandibular reconstruction with fibular graft—a biomechanical ex vivo study. Clin Oral Invest 18, 1291–1298 (2014). https://doi.org/10.1007/s00784-013-1105-1

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  • DOI: https://doi.org/10.1007/s00784-013-1105-1

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