After drilling eccentric bicortical holes, the screws are inserted such that they are pushed, together with the bone fragment, towards the fracture, resulting in a compression effect. Fracture segments can be reduced using various methods, including bone reduction forceps, manual anatomic reduction, interdental fixation, and a combination of these.
The tension zone stabilised by this wire corresponds, in the fractured mandible, to the alveolar process, which is stabilised by intermaxillary fixation in the tension zone.
Bicortical screws can be inserted in the compression zone of the mandible. The gap in the area of the alveolar process generated by muscle traction requires additional tension banding.
Wiring and basal dynamic compression plate without IMF 2. Primary closure of the wound may or may not require local flaps to maintain well-vascularized soft tissue coverage.
Plates without basal grooves are intended for intra-oral approaches. The mandible is drilled using a drill guide to protect the soft tissue and skeletal pins are inserted into the fractured segments.
Holes for the compression screws are drilled on the narrower outer side. Adequate exposure of fracture segments is carried out while not compromising the adjacent blood supply. Stability is improved by the insertion of retaining screws in the outer holes.
Tension and compression zones Course of the nerve pic Bicortical osteosynthesis is not possible in the tooth-bearing alveolar area or along the course of the alveolar nerve. Ideally, two pins with a large distance between them should be placed into each large segment to prevent rotation.
It is not possible to fix a plate using bicortical screws in this area without risking damage to the teeth and the inferior alveolar nerve. The screws are inserted monocortically. Smaller shards of comminuted bone generally do not require fixation because they can be immobilized as they are sandwiched between larger externally fixated segments.
Maintaining blood supply is essential to the healing of these fractures. This effect is known as tension banding. Plates with basal grooves and locating pins which grasp the lingual side of the mandible are available for extra-oral approaches.
The stabilisation screws are inserted after the compression screws have been tightened Stable plate for fixation on the compression side of the mandible Bicortical fixation.Key words: Dynamic compression miniplates, mandibular angle fractures, Trocar. 1. Visiting resident, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University.
Trifocal distraction-compression osteosynthesis in conjunction with passive self-ligating brackets for the reconstruction of a large bony defect and multiple missing teeth were lengthening the mandible, reconstructing segmen-tal or large bony defects in the mandible, and advance.
Today, most mandibular plating modules include dynamic compression plates for surgeons who wish to use compression osteosynthesis. Although efficient in creating absolute stability in mandibular fractures, compressive plating techniques, even with the advent of the dynamic compression plate, are extremely technique-sensitive and.
Antagonist impact of forces of the various directions of muscle pull cause tension/compression zones in the mandible. In mandibular fractures they result in the fracture opening towards the alveolus and must be neutralised by appropriate osteosynthesis.
COMPRESSION PLATING (COMPRESSION OSTEOSYNTHESIS) OF MANDIBLE FRACTURES ROBERT M. KELLMAN, MD Compression osteosynthesis implies the use of rigid fixation across a fracture or osteotomy so that the fragments are compressed together even when the body part is at rest (no functional load).
Plate osteosynthesis has become standard treatment for patients with fractures of the mandible by affording anatomic reduction, rigid fixation, and immediate function. Miniplate osteosynthesis offers several advantages over compression osteosynthesis.Download