Evaluation of stability of fixation using conventional miniplate osteosynthesis in comminuted and non-comminuted Le Fort I, II, III fractures – A dynamic finite element analysis

Abstract

Purpose: The purpose of the present study was to evaluate and compare the stability of fixation using conventional miniplate osteosynthesis in comminuted and non-comminuted Le Fort I, II, and III fractures in open and closed jaw movements under masticatory loading conditions.
Materials and Methods: About 23 dimensional models of comminuted and non-comminuted Le Fort I, II, and II with traditional miniplate fixation were simulated virtually using a CT scan of the patient and analyzed using ANSYS Workbench 2020 R1 software. The dynamic finite element method was applied by the simulation of the forces of the muscles of mastication upon the fractured midface. The von Mises stress was analyzed and collated for each model; thereby, the stability of conventional miniplate fixation was interpreted.
Results: The von Mises stress over the regions of fixation were compared and the tabulated data was interpreted. Considerable von Mises stress was generated on the bone and deformation over the hardware was noted on the pyriform rim in the Le Fort I model, infraorbital rim in the Le Fort II model, and frontonasal region in the Le Fort III model in the closing phase of jaw movement.
Conclusion: The findings implicated that the biomechanical stability of conventional miniplate osteosynthesis is insufficient to secure the midface fractured bone under masticatory load.