Akademik Veri Yönetim Sistemi
KILINÇ A. (Yürütücü), YETER T.
Yükseköğretim Kurumları Destekli Proje, 2021 - 2022
The Effect of Coronoidectomy on Mandible and Plate Stress in Mandibular
Models with Reconstruction Plate After Segmental Mandibular Resection: Finite
Element Analysis
Objective: In this study, it was aimed to investigate how the coronoidectomy
procedure affects the stress distributions on the plate and bone in mandible models with
reconstruction plate after segmental mandibular resection performed at different levels,
using the finite element method.
Material and Method: In this study, a mandible model with defects resected from
3 different levels was created. Defects were reconstructed with a 2.5 mm thick
conventional plate and a 9 mm long screw. Coronoid incision was made in all of the
defected mandible models prepared. Thus, 6 groups were obtained. While the incision
lines were determined in 6 models prepared, the distal of the canine tooth at the proximal
was considered fixed. In the distal region, 3 different incision lines were determined. In
all groups, the proximal incision line is fixed and just distal to the canine tooth: Resection
line in the distal region in Group 1; It was created in such a way that it was just distal to
the 8th tooth. In group 2, coronoidectomy was performed in addition to group 1.
Resection line in the distal region in Group 3; It was created to contain and just above the
angulus of the mandible. In group 4, coronoidectomy was performed in addition to group
3. In Group 5, the resection line in the distal region was made approximately 1 cm higher
than the distal resection line in Group 3. In group 6, coronoidectomy was performed in
addition to group 5. Natural muscle forces and muscle vectors were imitated and applied
to models. Three-dimensional finite element analysis was performed.
Results: The highest von mises stress value in the reconstruction plate body
applied to the mandible model under appropriate loading conditions was found as 1416.97
Mpa, 1021.42 Mpa, 1145.79 Mpa, 395.007 Mpa, 1171.85 Mpa and 383.007 Mpa in the
groups, respectively. It was observed that the stress values occurring in all other elements
examined significantly decreased after the coronoidectomy procedure.
Conclusion: Coronoidectomy (temporal muscle elimination) procedure
significantly reduced the stress accumulated on the plate-screw-bone system. As a result,
the coronoidectomy procedure should be taken into consideration while making surgical
planning in terms of the prognosis of the reconstruction procedure to be performed.
Keywords: Coronoidectomy, reconstruction, resection