Craniomaxillofacial Trauma & Reconstruction

1 pages, 49 KiB

Open AccessEditorial

Trust in Science

by Sat Parmar, Seenu Susarla and Rui Fernandes

Craniomaxillofac. Trauma Reconstr. 2021, 14(1), 3; https://doi.org/10.1177/1943387520973158 - 5 Feb 2021

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Like no other time in history, many have questioned the independence of research and scientists through COVID [...] Full article

5 pages, 114 KiB

Open AccessReview

Current Role of Radiotherapy in the Management of Oral Cavity Squamous Cell Carcinoma

by William M. Mendenhall, Adam L. Holtzman, Roi Dagan, Curtis M. Bryant, Kathryn E. Hitchcock, Robert J. Amdur and Rui P. Fernandes

Craniomaxillofac. Trauma Reconstr. 2021, 14(1), 79-83; https://doi.org/10.1177/1943387520971418 - 3 Nov 2020

Cited by 6 | Viewed by 84

Abstract

Study Design: Literature review. Objective: To review the current role of radiotherapy (RT) in the management of oral cavity squamous cell carcinoma (SCC). Methods: Review of selected literature. Results: T1-T2N0 SCCs may be treated with either RT alone or surgery with a high [...] Read more.

Study Design: Literature review. Objective: To review the current role of radiotherapy (RT) in the management of oral cavity squamous cell carcinoma (SCC). Methods: Review of selected literature. Results: T1-T2N0 SCCs may be treated with either RT alone or surgery with a high likelihood of cure. The pendulum swung toward surgery with postoperative RT (PORT) added depending on the pathological findings in the mid 1980s. Patients with positive margins, extranodal extension (ENE), and/or 4 or more positive nodes receive concomitant chemotherapy (POCRT). Patients with T3-T4 and/or positive regional nodes are treated with surgery and PORT alone or POCRT. The likelihood of cure is moderate to low depending on extent of disease. The likelihood of major complications ranges from 10% to 30% depending on the method of reconstruction and the aggressiveness of postoperative PORT/ POCRT. Patients with very advanced disease are treated with palliative RT, chemotherapy, or supportive care. Conclusions: The role of RT in the management of oral cavity SCC is primarily in the postoperative setting with palliative RT being reserved for those with very advanced disease where the likelihood of cure is remote. Full article

6 pages, 423 KiB

Open AccessArticle

A Retrospective Cohort Study of 45 Cases Treated With Surgery First Approach in Orthognathic Surgery and a Short Review

by Gaurav Singh, Utsav Singh Gurung, Madan Mishra and Amit Gaur

Craniomaxillofac. Trauma Reconstr. 2021, 14(1), 64-69; https://doi.org/10.1177/1943387520950082 - 13 Aug 2020

Cited by 2 | Viewed by 85

Abstract

Study Design: Retrospective cohort study. Objective: The purpose of this study was to evaluate and share our experience with the surgery first approach (SFA) for correction of skeletal malocclusion. Methods: After consultation with the department of orthodontics, 45 patients with skeletal malocclusions suitable [...] Read more.

Study Design: Retrospective cohort study. Objective: The purpose of this study was to evaluate and share our experience with the surgery first approach (SFA) for correction of skeletal malocclusion. Methods: After consultation with the department of orthodontics, 45 patients with skeletal malocclusions suitable to undergo SFA were enrolled in this study (14 bimaxillary protrusion and 31 skeletal class III malocclusion). Le Fort I maxillary osteotomy, bilateral sagittal split ramus osteotomy, subapical osteotomy, and genioplasty were performed as required. After a healing period of 2 weeks, postoperative orthodontic treatment was started to achieve the final occlusion. Results: The mean duration of postoperative orthodontic treatment was 15.2 months, which is much shorter than the conventional orthodontic first approach (OFA) where presurgical orthodontic duration alone takes 12–24 months according to an individual. In the bimaxillary protrusion group, it was 18 months, which was significantly longer than for the other group (p < 0.05). Conclusions: SFA offers an efficient alternative to conventional OFA with shorter total treatment duration, immediate marked improvement in facial profile, reduced biological costs, and similar operative stability. However, it comes at the cost of heightened challenges regarding case selection, accurate prediction, and surgical precision. With a joint venture between skilled and experienced surgeons and orthodontists, the outcome can be very promising. Full article

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8 pages, 262 KiB

Open AccessArticle

Orbital Implants in Orbital Fracture Reconstruction: A Ten-Year Series

by Sophia Seen, Stephanie Young, Stephanie S. Lang, Thiam-Chye Lim, Shantha Amrith and Gangadhara Sundar

Craniomaxillofac. Trauma Reconstr. 2021, 14(1), 56-63; https://doi.org/10.1177/1943387520939032 - 11 Aug 2020

Cited by 20 | Viewed by 101

Abstract

Study Design: Retrospective comparative interventional series of all patients who had undergone orbital fracture repair by 2 senior orbital surgeons in a single tertiary trauma center from January 2005 to December 2014. Objective: To compare the outcomes of different implants used for various [...] Read more.

Study Design: Retrospective comparative interventional series of all patients who had undergone orbital fracture repair by 2 senior orbital surgeons in a single tertiary trauma center from January 2005 to December 2014. Objective: To compare the outcomes of different implants used for various types of orbital fractures. Methods: Patients were evaluated by age, gender, etiology of fracture, clinical findings, type of fractures, and implant used. Main outcome measures included restoration of premorbid state without morbidity and complications including enophthalmos, diplopia, infraorbital hypoesthesia, and ocular motility restriction 1 year after fracture repair. Implantrelated complications were collected for analysis. Results: There were a total of 274 patients with 307 orbits reconstructed. Thirty-three (12.0%) patients sustained bilateral injuries; 58.0% (n = 178) of orbits had simple fractures (isolated orbital floor, medial wall, or combined floor and medial wall). The distribution of implants used were bioresorbable (n = 117, 38.1%) and prefabricated titanium plates (n = 98, 31.9%) depending upon the nature of fracture. Bioresorbables, titanium plate, and porous polyethylene were used significantly more than titanium mesh for simple fractures, and prefabricated anatomic titanium implants were used significantly more than the other implants for complex fractures. There was a statistically significant improvement in diplopia, enophthalmos, ocular motility, and infraorbital hypoesthesia (p-value < 0.001) 1 year following orbital fracture reconstruction. Conclusions: When used appropriately, diverse alloplastic materials used in orbital fracture repair tailored to the indication aid orbital reconstruction outcomes with each material having its own unique characteristics. Full article

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7 pages, 125 KiB

Open AccessArticle

Prevalence of Neurologic Deficits in Combined Facial and Cervical Spine Injuries: A Retrospective Analysis

by Manju Roby Philip and C. S. Soumithran

Craniomaxillofac. Trauma Reconstr. 2021, 14(1), 49-55; https://doi.org/10.1177/1943387520940182 - 30 Jul 2020

Cited by 1 | Viewed by 56

Abstract

Study design: A retrospective data analysis of maxillofacial trauma patients with combined cervical spine injuries. Objective: This study is based on investigating the importance of timely diagnosis of patients who suffer with cervical spine injuries along with maxillofacial trauma by estimating the prevalence [...] Read more.

Study design: A retrospective data analysis of maxillofacial trauma patients with combined cervical spine injuries. Objective: This study is based on investigating the importance of timely diagnosis of patients who suffer with cervical spine injuries along with maxillofacial trauma by estimating the prevalence of neurologic deficits and its relation with etiology. Methods: A database of 4460 patients suffering from maxillofacial injuries and admitted in specialized environment surgery of Government Medical College, Trivandrum, Kerala was taken under consideration. The prevalence and types of neurologic deficits and its relation with etiology were assessed in patients with combined facial and cervical spine injuries. Results: Of 4460 patients, 48 were having cervical spine injury along with facial damage with the prevalence of 0.01%. Neurologic deficits were seen highest with etiology of road traffic accidents followed by falls from height. Most of the accidents occurred in bike riders and helmets were absent. Conclusions: It was concluded that most of the accidents engage bike riders and drivers, due to unethical and unsafe driving. There was no significant correlation found between facial and cervical spine injuries. Full article

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6 pages, 206 KiB

Open AccessArticle

Impact of the Rising Number of Rentable E-Scooter Accidents on Emergency Care in Berlin 6 Months After the Introduction: A Maxillofacial Perspective

by Jonas Wüster, Jan Voß, Steffen Koerdt, Benedicta Beck-Broichsitter, Kilian Kreutzer, Sven Märdian, Tobias Lindner, Max Heiland and Christian Doll

Craniomaxillofac. Trauma Reconstr. 2021, 14(1), 43-48; https://doi.org/10.1177/1943387520940180 - 16 Jul 2020

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Abstract

Study Design: Retrospective study of all patients presented at our emergency department after an accident while riding an e-scooter between 15 June 2019 and 15 December 2019. Out of this group, we subgrouped all patients with injuries to the head and neck area. [...] Read more.

Study Design: Retrospective study of all patients presented at our emergency department after an accident while riding an e-scooter between 15 June 2019 and 15 December 2019. Out of this group, we subgrouped all patients with injuries to the head and neck area. Objective: Shared e-scooter systems have recently been introduced in many big cities worldwide and are becoming increasingly popular. This retrospective study aimed to give a detailed overview of clinical data on consequences of escooter accidents, with particular attention to the maxillofacial point of view. Methods: We performed a single-center retrospective study of all patients presented at our emergency department after an accident while riding an e-scooter between 15 June 2019 and 15 December 2019. Results: Within the observation period, 43 patients (mean age of 32 years; range: 17–64 years) suffered from an accident while riding an e-scooter. Of these, 25 patients (58%) required maxillofacial treatment whereby 9 patients (36%) suffered a fracture (56% fracture of the mandible; 33% fracture of the nasal bone; 11% fracture of the maxilla). Six patients required maxillofacial surgical treatment. Twelve patients (28%) stated to have been driving under the influence of alcohol at the time of the accident (blood alcohol level between 0.77 g/L and 2.32 g/L). None of the patients used body protection, and only one patient wore a helmet (2%). Conclusions: With the introduction of shared e-scooter systems, health-care facilities are faced with an increasing number of accidents related to the use of e-scooters, suffering from a high percentage of injuries in the maxillofacial region. Facial injuries might be reduced by the mandatory use of a helmet with faceguard. The trauma mechanism, in particular, seems to differ from other common trauma cases and needs to be examined more closely. Full article

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7 pages, 351 KiB

Open AccessArticle

Use and Evaluation of a Computer-Assisted Examination Method for the Diagnosis and Analysis of Medication-Related Osteonecrosis of the Jaw

by Max Wilkat, Daman Deep Singh, Isabelle Lutz, Henriette Möllmann, Nils-Claudius Gellrich and Majeed Rana

Craniomaxillofac. Trauma Reconstr. 2021, 14(1), 36-42; https://doi.org/10.1177/1943387520922767 - 15 Jul 2020

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Abstract

The aim of the present study was to analyze the size of the preoperatively calculated defect volume of MRONJ patients (medication-related osteonecrosis of the jaw) and to develop a computer-aided tool based on techniques of AI (artificial intelligence) that facilitates diagnostics of MRONJ. [...] Read more.

The aim of the present study was to analyze the size of the preoperatively calculated defect volume of MRONJ patients (medication-related osteonecrosis of the jaw) and to develop a computer-aided tool based on techniques of AI (artificial intelligence) that facilitates diagnostics of MRONJ. For this purpose, on the basis of 3D (three-dimensional) data sets of 175 MRONJ patients, the outline of the necrosis was marked with the software iPlan 3.0.5 (BrainLAB AG) thus determining the respective volume. The correlation of this volume with other 31 collected parameters was analyzed retrospectively. There was a significant correlation between the defect volume on the one hand, and the MRONJ stage, the number of performed operations, and the therapy invasiveness on the other hand. Furthermore, it could be shown that in one third of the cases no defects could be recognized in the 2D imaging by panoramic radiograph, while in the 3D data sets defects already had been demarcated. On the basis of these data, a computer-aided tool based on the principles of AI was developed and validated, which might allow the automated calculation of the 3D defect extension and classification of the MRONJ cases into a ranking system. In conclusion, preparation of a 3D image can be recommended for reliably making the diagnosis “MRONJ.” Moreover, knowledge of the exact defect volume serves as a decision-making aid with regard to the choice of therapy, ensures intraoperative certitude, and allows an assessment of the prognosis. Full article

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7 pages, 346 KiB

Open AccessArticle

Computer-Assisted Secondary Orbital Reconstruction

by Daman D. Singh, Lara Schorn, E. Bradley Strong, Michael Grant, Alexander Schramm, Karsten Hufendiek, Nils-Claudius Gellrich and Majeed Rana

Craniomaxillofac. Trauma Reconstr. 2021, 14(1), 29-35; https://doi.org/10.1177/1943387520935004 - 9 Jul 2020

Cited by 14 | Viewed by 61

Abstract

Study Design: This study presents a case-control study of 33 patients who underwent secondary orbital reconstruction, evaluating techniques and outcome. Objective: Adequate functional and aesthetical appearance are main goals for secondary orbital reconstruction. Insufficient premorbid orbital reconstruction can result in hypoglobus, enophthalmos, and [...] Read more.

Study Design: This study presents a case-control study of 33 patients who underwent secondary orbital reconstruction, evaluating techniques and outcome. Objective: Adequate functional and aesthetical appearance are main goals for secondary orbital reconstruction. Insufficient premorbid orbital reconstruction can result in hypoglobus, enophthalmos, and diplopia. Computer-assisted surgery and the use of patient-specific implants (PSIs) is widely described in the literature. The authors evaluate the use of selective laser-melted PSIs and hypothesize that PSIs are an excellent option for secondary orbital reconstruction. Methods: The sample was composed of 33 patients, previously treated with primary orbital reconstruction, presenting themselves with indications for secondary reconstruction (i.e., enophthalmos, diplopia, or limited eye motility). Computed tomography and/or cone beam data sets were assessed before and after secondary reconstruction comparing intraorbital volumes, infraorbital angles, and clinical symptoms. Clinical outcomes were assessed using a standardized protocol. Results: Results show a significant change in intraorbital volumes and a reduction of clinical symptoms after secondary reconstruction. Conclusions: Outcomes of this study suggest that secondary orbital reconstruction can be performed routinely using selective laser-melted PSIs and titanium spacers. Full article

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6 pages, 210 KiB

Open AccessArticle

Pediatric Palate Fractures: An Assessment of Patterns and Management at a Level 1 Trauma Center

by Zachary Gala, Jordan N. Halsey, Kavita Kapadia, Lauren Otaguro, Ian C. Hoppe, Edward S. Lee and Mark S. Granick

Craniomaxillofac. Trauma Reconstr. 2021, 14(1), 23-28; https://doi.org/10.1177/1943387520935013 - 7 Jul 2020

Cited by 3 | Viewed by 69

Abstract

Study Design: Literature discussing palate fractures in the pediatric population is limited. We performed a retrospective review of pediatric palatal fractures at our institution to better understand the impact of this fracture pattern in the pediatric patient. Objectives: The goal of our study [...] Read more.

Study Design: Literature discussing palate fractures in the pediatric population is limited. We performed a retrospective review of pediatric palatal fractures at our institution to better understand the impact of this fracture pattern in the pediatric patient. Objectives: The goal of our study is to analyze our institutional experience with pediatric palate fractures, focusing on epidemiology, concomitant injuries, and fracture management. Methods: Records were collected for all palatal fractures in pediatric patients diagnosed between 2000 and 2016 at an urban Level I trauma center. Patient imaging was reviewed. Demographic characteristics and inpatient clinical data were recorded. Results: Nine pediatric patients were diagnosed with fracture of the bony palate. Average age was twelve with male predominance (66%). Pedestrian struck injuries (33%) and motor vehicle accidents (33%) were the most common etiologies. Five patients sustained skull fractures. Three patients were found to have intracranial hemorrhage, two required emergent bolt placement. Two patients sustained cervical spine injury. One patient had severe facial hemorrhage requiring embolization. According to the Hendrickson classification, there were three type I fractures, two type II fractures, one type III fracture, one type IV fracture, and one type V fracture. Lefort I and/or alveolar fracture was present in every patient. Four patients underwent surgical treatment with open reduction and restoration of facial height with maxillomandibular fixation. Three patients underwent concomitant mandible fracture repair. Conclusions: Pediatric palatal fractures are rare and are usually accompanied by devastating concomitant injuries. Surgical repair of the palate in the pediatric patient is often necessary to restore facial height. Full article

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7 pages, 311 KiB

Open AccessArticle

Serial Perioperative Assessment of Free Flap Perfusion with Laser Angiography

by Anthony Massaro, Juliana Gomez, Ashleigh Michelle Weyh, Anthony Bunnell, Matthew Warrick, Philip Pirgousis and Rui Fernandes

Craniomaxillofac. Trauma Reconstr. 2021, 14(1), 16-22; https://doi.org/10.1177/1943387520930608 - 15 Jun 2020

Cited by 3 | Viewed by 69

Abstract

Study Design: Prospective cohort study. Objective: Reconstruction with microvascular free flaps is quite predictable but excessive fluids intraoperatively and excessive use of vasopressors have been implicated in postoperative complications. However, vasopressors assist in limiting fluid administration and counteract vasodilatory effects of general anesthetics, [...] Read more.

Study Design: Prospective cohort study. Objective: Reconstruction with microvascular free flaps is quite predictable but excessive fluids intraoperatively and excessive use of vasopressors have been implicated in postoperative complications. However, vasopressors assist in limiting fluid administration and counteract vasodilatory effects of general anesthetics, while maintaining proper intravascular volume. This is of paramount importance during surgery to ensure adequate tissue and organ perfusion. The purpose of this study is to quantify perfusion changes in free flaps at specific time points during peri- and postoperative periods, incorporating SPY technology. Methods: A prospective study of patients who underwent free flap reconstruction was conducted (n = 9), using SPY laser angiography with indocyanine green to assess effects of general anesthetics and vasopressors on flap perfusion. Free flaps were evaluated prior to pedicle division, after inset and anastomosis, and in the immediate postoperative setting. Mean perfusion, mean arterial pressure, total operative time, fluid shifts, and vasopressor use were recorded. Data were analyzed with univariate and multivariable analyses. Results: Those with major complications in this cohort, on average received less vasopressors, had shorter operation times and less blood loss, however, they received more fluids intraoperatively. Conclusion: Changes in mean perfusion to the free flap during the intraoperative and immediate postoperative period are nominal. Full article

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5 pages, 134 KiB

Open AccessArticle

To What Extent Does Illicit Drug Use Predispose to Facial Injury? An Institutional Investigation for an Emergent Problem

by Anthony Febbo and Gary R. Hoffman

Craniomaxillofac. Trauma Reconstr. 2021, 14(1), 11-15; https://doi.org/10.1177/1943387520928637 - 28 May 2020

Cited by 7 | Viewed by 49

Abstract

Study Design: There are potential substantive linkages between illicit drug use and the occurrence of injury. Objective: The purpose of our study was to determine the prevalence, class of illicit drugs abused, and demographics in relation to a cohort of patients who sustained [...] Read more.

Study Design: There are potential substantive linkages between illicit drug use and the occurrence of injury. Objective: The purpose of our study was to determine the prevalence, class of illicit drugs abused, and demographics in relation to a cohort of patients who sustained facial injury. Methods: The authors undertook a retrospective observational study of a prospectively accessioned cohort of patients who had sustained a facial injury and presented to the John Hunter Hospital (Newcastle, NSW, Australia). The primary predictor variable was the presentation of a facial injury and the secondary outcome variables included illicit drug use, alcohol use, and socioeconomic factors. The study was carried out over a 12-month period. A descriptive analysis was undertaken on the assembled data. Results: Of the 465 patient medical records that were accessed for the study, 348 were male and 117 were female. Their average age was 42.6 years: 5.8% (n = 27) were under the influence of illicit drugs at the time of their presentation and 13.1% (n = 61) admitted to an intercurrent illicit drug habit. Those who were under the combined influence of alcohol and drugs comprised of 2.8% (n = 13). Conclusions: Our study found that illicit drug use plays a small, but nonetheless, demonstrable role in the presentation of maxillofacial trauma patients to an urban level I trauma center. Illicit drug users are an emergent sociodemographic group of patients who can sustain facial trauma and their presentation needs to be appropriately considered, assessed, and managed collectively. Full article

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4 pages, 288 KiB

Open AccessCase Report

Hemorrhage in Onodi Cell Leading to Traumatic Optic Neuropathy

by Aditi Mehta, Ramya Rathod, Chirag Ahuja, Manpreet Singh and Ramandeep S. Virk

Craniomaxillofac. Trauma Reconstr. 2021, 14(1), 70-73; https://doi.org/10.1177/1943387520922021 - 28 Apr 2020

Cited by 3 | Viewed by 55

Abstract

Traumatic optic neuropathy (TON) is an important cause of vision loss in the setting of cranial and/or facial trauma. Both direct and indirect variants exist, with the latter being more common. We describe the case of a young male presenting with loss of [...] Read more.

Traumatic optic neuropathy (TON) is an important cause of vision loss in the setting of cranial and/or facial trauma. Both direct and indirect variants exist, with the latter being more common. We describe the case of a young male presenting with loss of vision following trauma with an intact globe, an intraorbital foreign body, and Onodi cell hemorrhage. The challenges in diagnoses of type of TON, exact pathology, and management are discussed. We also highlight the role of thin section digital computed tomography imaging which is paramount for timely detection of subtle injuries and their management. Full article

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5 pages, 349 KiB

Open AccessTechnical Note

The Use of a Novel CAD-CAM Splint to Simplify Open Reduction and Internal Fixation of Mandibular Angle Fracture: A Technical Note

by Mrunalini Ramanathan, Elavenil Panneerselvam, Sriraam Kasi Ganesh and Krishna Kumar Raja

Craniomaxillofac. Trauma Reconstr. 2021, 14(1), 74-78; https://doi.org/10.1177/1943387520904897 - 12 Apr 2020

Cited by 3 | Viewed by 63

Abstract

Mandibular angle fractures are frequently encountered as they constitute an area of weakness. Complications after open reduction and internal fixation (ORIF) of angle fractures commonly arise due to improper reduction and fixation methods that fail to counteract the dynamic muscle forces present in [...] Read more.

Mandibular angle fractures are frequently encountered as they constitute an area of weakness. Complications after open reduction and internal fixation (ORIF) of angle fractures commonly arise due to improper reduction and fixation methods that fail to counteract the dynamic muscle forces present in this region. Conventional reduction methods such as digital manipulation, intermaxillary fixation, towel clip traction, and wiring are associated with various limitations. This technical note highlights the fabrication and use of a computer-aided designing/computer-aided manufacturing–generated splint for ORIF of a superiorly displaced mandibular angle fracture. The splint consisted of 2 components: (1) a distal tooth-borne component to guide the teeth into maximum intercuspation and (2) a proximal bone-borne component to reduce the angle fracture. This composite splint facilitates simultaneous restoration of occlusion as well as reduction of mandibular angle fractures. The advantages of this technique include the following: (1) easy fabrication of splint, (2) easy and precise anatomical reduction of angle fracture, and (3) less operative time. Full article

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7 pages, 1429 KiB

Open AccessArticle

Self-Drilling Versus Self-Tapping Screws: A 3D Finite Element Analysis

by Vineeth K. Kumar, Kavitha Prasad, Tanvy Sansgiri, K. Ranganath, Shwetha V. and Kubra Al-Khuteja

Craniomaxillofac. Trauma Reconstr. 2021, 14(1), 4-10; https://doi.org/10.1177/1943387520904212 - 12 Apr 2020

Cited by 4 | Viewed by 100

Abstract

Study Design: Self-tapping and self-drilling screws are twomodalities available for plate fixation. Whencompared to self-drilling, self-tapping screws have a few drawbacks like screw loosening, thermal osteolysis, equipment dependent, and time-consuming. Aim: The aim of this study was to compare the efficacy of self-tapping [...] Read more.

Study Design: Self-tapping and self-drilling screws are twomodalities available for plate fixation. Whencompared to self-drilling, self-tapping screws have a few drawbacks like screw loosening, thermal osteolysis, equipment dependent, and time-consuming. Aim: The aim of this study was to compare the efficacy of self-tapping and self-drilling screws with relation to plate retention and stability in internal fixation of mandibular fractures using 3D finite element analysis (FEA). Objectives: The objective of this study was to determine the influence of screw placement technique on stress concentration and deformation occurring at the screw–bone interface in self-drilling and self-tapping screws. Materials and Methods: A 3D computer-aided design modeling system was used to build a trilaminate mandibular bone, self-tapping screw and self-drilling screw, and a 2-holed miniplate with gap that were converted into finite element models using Hypermesh 13.0 software. Material properties and boundary conditions were assigned to these models. Pullout, torque, and torsional forces were applied to evaluate the stress concentration and deformation at the screw– bone interface. Results: The comparison of stress concentration and deformation values between the two types of screws was interpreted using ANSYS software version 14.5. Results of torque test, pullout test, and torsional test showed maximum Von Mises stress, and deformation around the screw–bone interface was higher in self-tapping screw than in self-drilling screw. Conclusion: Within the limitations of the 3D FEA, the findings provided significant evidence to suggest that self-tapping screws have a greater incidence of fatigue when compared to self-drilling screws as there was more stress distribution and deformation at their screw–bone interface. Full article

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Craniomaxillofac. Trauma Reconstr., Volume 14, Issue 1 (March 2021) – 14 articles

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