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    Biomechanical evaluation of different fixation systems after Le Fort I osteotomy in polyurethane models of unilateral clefts
    (Churchill Livingstone, 2016) Esen, Alparslan; Isik, Kubilay; Saglam, Haci; Ozdemir, Yusuf Bugra; Dolanmaz, Dogan
    We compared the stability of three different titanium plate-and-screw fixation systems after Le Fort I osteotomy in polyurethane models of unilateral clefts. Thirty-six models were divided into 3 groups. In the first group, we adapted standard Plates 1 mm thick with 2.0 mm screws and placed them bilaterally on the zygomatic buttress and the piriform rim. In the second group, we did the same and added Plates 0.6 mm thick with 1.6 mm screws between the standard 2 mm miniplates on both sides. In the last group, we placed Plates 1.4 mm thick with 2.0 mm screws bilaterally on the maxillary zygomatic buttress and piriform rim. Each group was tested in the inferosuperior (IS) and anteroposterior (AP) directions with a servo-hydraulic testing unit. In the IS direction, displacement values were not significantly different up to 80 N, but between 80 and 210 N, those in the 2 x 1.4 mm group were better. In the AP direction, displacement values were not significantly different up to 40 N, but between 40 and 180 N, they were better in the standard with 1.6 x 0.6 mm group and the 2 x 1.4 mm group. When normal biting forces (90- 260 N) in the postoperative period are considered, the greatest resistance to occlusal loads was seen in the 2 x 1.4 mm group. In the others, the biomechanical properties were better in the AP direction. (C) 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
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    Evaluation of strain values of critical anatomic regions for two different pterygomaxillary approaches in Le Fort I osteotomy: An experimental study
    (Medicina Oral S L, 2017) Ozdemir, Yusuf-Bugra; Dolanmaz, Dogan; Esen, Alparslan; Terzioglu, Hakan; Saglam, Haci
    Background: The purpose of this experimental study was to measure stresses both on the pterygoid plates and the skull base following two different pterygomaxillary approaches in Le Fort I osteotomy. Material and Methods: The prepared skull models were randomly divided into 2 groups of 7. In the first group (A), the pterygomaxillary area was left intact. In the second group (B), pterygomaxillary separation was performed with a fine bur. The stresses were measured by using strain gauges. These strain gauges were attached to 6 different anatomical sites. The skull models were mounted on a servo-hydraulic testing unit. Each model was then subjected to a continuous linear tension until a plastic deformation was seen. Results: The statistical analyses showed that there were no significant differences (p>.05) between the 2 groups regarding the strain values. Moreover, no statistical differences (p>.05) were found between the two groups in terms of maximum applied forces. Conclusions: Considering the clinical conditions, the present study shows that when Le Fort I osteotomy performed without pterygomaxillary separation, there is no significant stress on the skull base during the downfracture. Moreover, it is considered that there is no need for an excessive force applied to perform downfracture in Le Fort osteotomies without pterygomaxillary separation.