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Lag screw effect on the biomechanical torsion stability in the I.S.I monocortical mandible angle systemEhlers, Hendrik Petrus 14 December 2010 (has links)
In a recent in vitro biomechanical stability study by F.J. Jacobs, a unique, patented inclined screw insertion (I.S.I.) mandibular angle, intra-oral trauma-plate was evaluated for torsion and compression stability and compared to conventional plating of simulated angle fractures in polyurethane mandibular replicas. This in vitro comparative pilot study is an extension of the above-mentioned study. Similar I.S.I. mini-plates with 45º inclined screw holes in quadrant 3 (Fig 1), were used but in the one sample 13mm-long lag screws were used to transect the fracture lines where in the other group non-lagging screws of similar length were used to fixate simulated mandibular angle fractures in polyurethane mandible replicas. A uniquely designed and manufactured jig, incorporated in a Zwick machine, was utilized to apply torsion forces within clinical relevant load values. The load-displacement values for torsion forces was determined and compared for the two groups. It was established that 5 lag screws significantly improved the torsion stability of the lag-plate group to that of the non-lag group. During the stability testing, two factors were identified, which had a critical influence on the compression generated by the lag screw between the fracture fragments. An adequate amount of bone must be maintained between the first screw hole, directly distal to the fracture line, and the fracture line. All screws must be inserted in the correct sequence in order to insure sufficient compression between the fracture fragments as a result of the lag-effect. AFRIKAANS : In `n onlangse in vitro studie deur F.J. Jacobs, is `n gepatenteerde, unieke geanguleerde miniplate, waarvan die skroefgate geanguleer is, die sg. Inklineerde Skroef Inplasing (I.S.I.) kaak-hoek, intra-orale traumaplaat geevalueer vir torsie en kompressie stabiliteit en vergelyk met konvensionele plate op gesimuleerde kaakhoek frakture in poli-uretaan mandibular replikas. In hierdie in vitro loodstudie, is I.S.I. miniplate met skroefgate wat teen 45º geanguleer is, gebruik in kombinasie met `n enkele 13mm lange grypskroef (“lag screw”) om gesimuleerde kaakhoek frakture in poli-uretaan mandibula replikas te fikseer. Deur gebruik te maak van `n spesiaal ontwerpte en vervaardigde monterings-apparaat wat binne in `n Zwick masjien geïnkorporeer word, is die I.S.I gefikseerde replikas onderwerp aan torsie kragte, binne klinies relevante ladingswaardes. Die verplasings en ladingswaardes is geregistreer en vergelyk met identiese I.S.I miniplate sonder `n grypskroef. Die loodstudie resultate het getoon dat die frakture wat gefikseerd is met die I.S.I. miniplaat-grypskroef kombinasie betekenisvol beter stabiliteit toon as die frakture wat met slegs die miniplaat, sonder `n grypskroef, gefikseerd is vir klinies relevante ladingsen verplasingswaardes. Tydens biomeganiese toetsing van die mandibula replikas, is twee faktore wat `n kardinale rol speel in die stabiliteit wat verkry word deur `n miniplaat grypskroef kombinasie te gebruik, geïdentifiseer. Voldoende hoeveelheid been tussen die eerste skroefgat, direk distaal van die fraktuurlyn, en die fraktuurlyn asook die korrekte volgorde waarin die skroewe geplaas word, moet gehandhaaf word om maksimale kompressie van die fragmente deur die grypskroef te verseker. Deur `n I.S.I miniplaat, met geanguleerde skroefgate van 45º, te kombineer met `n grypskroef, kan die stabiliteit van die gefikseerde mandibulere kaakhoek betekenisvol verbeter word en verleen dit meer stabiliteit wanneer vergelyk word met frakture gereduseer met `n I.S.I miniplaat sonder grypskroef plasing. / Dissertation (MSc)--University of Pretoria, 2010. / Maxillo-Facial and Oral Surgery / unrestricted
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