하악골골절시 각종 고정법의 응력분산에 대한 광탄성학적 연구

A photoelastic analysis on stress distribution of various fixation method of mandibular fracture

The primary goals of treatment of the mandibular fracture are to reestablish proper occlusion, adequate function, and esthetic harmony. The main surgical objective is to provide sufficient immobilization of the fragments to allow normal bony healing. This was most often achieved by closed reduction using intermaxillary fixation. However, oral and maxillofacial surgeons involved in treatment of the mandibular fracture have long been aware of complicating situations that can limit or preclude the intermaxillary fixation. As a result, a number of techniques have been introduced to provide a rigid internal fixation to minimize or eliminate the need for intermaxillary fixation. The purpose of this study is to compare various fixation methods of mandibular fracture by photoelastic analysis. The results obtained from this study were as follows; 1. Under the vertical load, tensile stress at the upper border and compressive stress at the lower border were widely produced. 2. Distraction of the upper border was noticed in multiple loop wiring. 3. The gap of interosseous wiring was wider than that of miniplate fixation. 4. In the miniplate osteosynthesis group, the middle positioned miniplate fixation was superior to the others. 5. In all the models without intramaxillary fixation, the gap was opened. 6. The combined fixation of intramaxillary arch bar and the middle positioned miniplate was excellent in mechanical aspect.