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. 2018 Jun 12;8(1):8971.
doi: 10.1038/s41598-018-27186-7.

Finite Element Stress Analysis of Keyhole Plate System in Sagittal Split Ramus Osteotomy

Ju-Won Kim  1   2   3 , Kang-Nam Park  1   2 , Chang-Hyeon Lee  1   2 , Yong-Su Kim  1   2 , Young-Hee Kim  4   2 , Byoung-Eun Yang  5   6   7
Affiliations

Finite Element Stress Analysis of Keyhole Plate System in Sagittal Split Ramus Osteotomy

Ju-Won Kim et al. Sci Rep. .

Abstract

A new miniplate applied differently from conventional application method for bone fixation has been developed. The novel approach is the insertion of the screw into the bone before miniplate installation. This study aimed to assess the stress distribution of a newly designed Yang's Keyhole (YK)- plate for segmental-bone fixation during sagittal split ramus osteotomy (SSO). Moreover, the effectiveness of the YK-plate system based on the clinical results was determined. The YK-plate system has a widened hole in the anterior region to permit a screw-head to be screwed through the system. The stress distribution using the finite-element analysis method was compared between in the case of the YK-plate system and the case of existing mini-plate fixation technique. Moreover, the clinical results of patients were evaluated during the follow-up examination periods. No critical complications in any of the six patients were reported during the four-month follow-up period. The result of the stress distribution using finite-element analysis showed a similar trend in all four fixation methods. The YK-plate system can be applied to fixation during SSO and allow for mechanically stable and convenient application.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Finite-element model demonstrating stresses in the sliding-plate model. (a) Sliding-plate, (b) Four screws, (c) Distal segment (buccal view) and (d) Proximal segment (buccal view).
Figure 2
Figure 2
Finite-element model demonstrating stresses in the 4-hole bridge plate model. (a) Four-hole bridge plate, (b) Four Screws, (c) Distal segment (buccal view) and (d) Proximal segment (buccal view).
Figure 3
Figure 3
Finite-element model demonstrating stresses in the YK-plate model. (a) YK-plate, (b) Three screws, (c) Distal segment (buccal view) and (d) Proximal segment (buccal view).
Figure 4
Figure 4
Finite-element model demonstrating stresses in the YK-plate with the oversized head screw model. (a) YK-plate, (b) Three screws and one oversized head screw, (c) Distal segment (buccal view) and (d) Proximal segment (buccal view).
Figure 5
Figure 5
Three-dimensional ConeBeam CT and Panoramic radiographs demonstrating the use of a YK- plate after SSO. (a) Preoperative view, a 23-year-old patient with mandibular prognathism (b) 2 days after the operation, Bimaxillary operation was done. YK-plates were used on mandible (c) four months after the surgery, the bone remodeling is in progress, and the YK-plates are stable.
Figure 6
Figure 6
Four types of fixation after SSO. (a) Sliding-plate with four screws, (b) Four-hole bridge plate with four screws (c) YK-plate with three screws and (d) YK-plate with three screws and one oversized head screw (black arrow).
See this image and copyright information in PMC

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