Jaw surgery point that is very important and nobody talks about

[TcEfforts]

Conventional(non-locking) plates and locking plates

https://www.thejcdp.com/doi/JCDP/pdf/10.5005/jp-journals-10024-1303

PPT - Locking Plates Advantages & Indications PowerPoint Presentation - ID:6642536

Locking Plates Advantages & Indications. Objectives. Describe locking plates and how they differ in design from other bone plates Identify the advantages of locking plates over other plates Become familiar with the indications for use of locking plates. Locking Plates are an evolution.

www.slideserve.com

You can choose a very skilled surgeon but if your insurance covers only the cheapest material which is conventional plate you are taking risks with regard to fractures and stability. I have heard some reports from patients saying after months of surgery they started to feel the screws were loosening and moving out slightly from the bone.

There are different techniques for both type of screws involving angular fixation. I should research more. However the main question is cost, one costs more than other, depending on your insurance I doubt they will purchase top-tier material. Perhaps the most expensive thing for your surgery.

Probably I would end up with conventional plates so I must have to (cope) studying how to prepare my organism with the right nutrients to try to have a good post-op without, who knows, bad luck.

 

[TcEfforts]

Nobody wants to talk about that and clear it up for me?

Who is the most expert on osteotomy here? Mention @ them please

Another one

Thanks in advance

 

[ChristianChad]

Tagging High IQ niggas:

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[Deleted member 7725]

I don't get it? The plate is only there temporarily until your bone heals. Once the 6-8 weeks is up, the plate is irrelevant.

 

[randomvanish]

I don't get it? The plate is only there temporarily until your bone heals. Once the 6-8 weeks is up, the plate is irrelevant.

then how do you think relapse happens on the 1/5 of the surgeries? custom 3d plates is the only problem can prevent this. the old style line shaped plates are prone to errors like relapse.
your bone can go back the old shape even after months, but generally within the 2 months period at most.

 

[Deleted member 7725]

then how do you think relapse happens on the 1/5 of the surgeries? custom 3d plates is the only problem can prevent this. the old style line shaped plates are prone to errors like relapse.
your bone can go back the old shape even after months, but generally within the 2 months period at most.

Usually relapse is dental and not from the actual bone. Same away as after you get braces your teeth can relapse if you don't wear a retainer.

 

[ChristianChad]

I don't get it? The plate is only there temporarily until your bone heals. Once the 6-8 weeks is up, the plate is irrelevant.

I didn't know the plates were removed. I just read it's not very common to remove them without a specific reason because it's another operation.

 

[Deleted member 7725]

I didn't know the plates were removed. I just read it's not very common to remove them without a specific reason because it's another operation.

You don't need to.

 

[Marco Polo]

Another example of "If you want the best result, don't cheap out"

 

[Aypo129]

Good info

 

[Foreverbrad]

With bone being such a soft substance and prone to resorption I am not surprised that using locking screws gives a better result.

The only thing that keeps a bolted joint together is the preload generated by stretching the bolt. This stretch is fractions of a millimetre and some bone resorption could easily allow slackening of the bolt and then looseness of the fixation plate.

It's unlikely the screw would actually feel loose at first but the joint would be weak and compromised and eventually would "work" to the point of noticeable looseness.

This is also of interest for implants, potentially even more interest as the fixation for implants is the only thing holding them on whilst with jaw surgery the cuts will ossify over time.

 

[Deleted member 8869]

Conventional(non-locking) plates and locking plates

https://www.thejcdp.com/doi/JCDP/pdf/10.5005/jp-journals-10024-1303

PPT - Locking Plates Advantages & Indications PowerPoint Presentation - ID:6642536

Locking Plates Advantages & Indications. Objectives. Describe locking plates and how they differ in design from other bone plates Identify the advantages of locking plates over other plates Become familiar with the indications for use of locking plates. Locking Plates are an evolution.

www.slideserve.com

View attachment 1865644


You can choose a very skilled surgeon but if your insurance covers only the cheapest material which is conventional plate you are taking risks with regard to fractures and stability. I have heard some reports from patients saying after months of surgery they started to feel the screws were loosening and moving out slightly from the bone.

There are different techniques for both type of screws involving angular fixation. I should research more. However the main question is cost, one costs more than other, depending on your insurance I doubt they will purchase top-tier material. Perhaps the most expensive thing for your surgery.

Probably I would end up with conventional plates so I must have to (cope) studying how to prepare my organism with the right nutrients to try to have a good post-op without, who knows, bad luck.

these plates arent relevant after 6 to 8 weeks most good maxfacs use custom plates anyways.

 

[bara]

Biomechanics of locked plates and screws - PubMed

Locked plates and conventional plates rely on completely different mechanical principles to provide fracture fixation and in so doing they provide different biological environments for healing. Locked plates may increasingly be indicated for indirect fracture reduction, diaphyseal/metaphyseal...

pubmed.ncbi.nlm.nih.gov

Locked plates and conventional plates rely on completely different mechanical principles to provide fracture fixation and in so doing they provide different biological environments for healing. Locked plates may increasingly be indicated for indirect fracture reduction, diaphyseal/metaphyseal fractures in osteoporotic bone, bridging severely comminuted fractures, and the plating of fractures where anatomical constraints prevent plating on the tension side of the bone. Conventional plates may continue to be the fixation method of choice for periarticular fractures which demand perfect anatomical reduction and to certain types of nonunions which require increased stability for union.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5366389/

The use of locking or non-locking plates provides a similar outcome in the treatment of distal fractures. However the locking plate is much more expensive than the non-locking plate.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3700150/

These findings show that the use of locking plates in mandibular fracture was efficacious enough to bear the masticatory loads during osteosynthesis of the fracture. The locking plates provide the advantage of a greater stability, with clinical results almost similar to those seen with non-locking plate osteosynthesis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5882372/

The overall results show better performance in bite force for the locking plates when compared with the non-locking plates in the incisor region (mean deviation [MD]: 1.18; 95% confidence interval [95%CI]: 0.13–2.23), right molar region (MD: 4.71; 95%CI: 0.63–8.79) and left molar region (MD: 10.34; 95%CI: 4.55–16.13). Although the results of this study indicated a better bite force result with the locking plates, there is still no sufficient evidence to support this information safely.

Are conventional reconstruction plates equivalent to precontoured locking plates for distal humerus fracture fixation? A biomechanics cadaver study - PubMed

In the early postoperative period, less expensive perpendicular conventional reconstruction plate constructs provide similar stiffness and load to failure properties to newer precontoured locking plate systems regardless of plate configuration.

pubmed.ncbi.nlm.nih.gov

There was no significant difference between the three groups for anterior bending, posterior bending, axial compression, or torsional stiffness. There was no significant difference in load to failure for any of the three groups.

In the early postoperative period, less expensive perpendicular conventional reconstruction plate constructs provide similar stiffness and load to failure properties to newer precontoured locking plate systems regardless of plate configuration.

I think it depends what you are getting plates for.

If it is for facial/jaw then the studies seem to point towards locked, but I don't have enough experience in this area anyway to suggest anything.

 

[RealSurgerymax]

Compression plates (conventional plates) are usually find for orthognathic surgery.

Locking plates are usually used for things like replacing the mandible with fibula graft.

Using a few more screws would be helpful for large advancements

 

[mvp2v1]

Usually relapse is dental and not from the actual bone. Same away as after you get braces your teeth can relapse if you don't wear a retainer.

I thought the relapse was airway related too?

then how do you think relapse happens on the 1/5 of the surgeries? custom 3d plates is the only problem can prevent this. the old style line shaped plates are prone to errors like relapse.
your bone can go back the old shape even after months, but generally within the 2 months period at most.

Are there studies showing relapse only occurred or occurre more often with certain kinds of plates?

 

[randomvanish]

I thought the relapse was airway related too?


Are there studies showing relapse only occurred or occurre more often with certain kinds of plates?

yeah there are. keywords ; custom plates, relapse, orthognathic surgery

 

[Agendum]

Tagging High IQ niggas:

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I can only speak for what I believe were conventional type screws in my MSEs. I got a minuscule amount of screw drag that happened with my 2nd MSE (and faint looseness.)

I cant say much about plates though as I havnt had anything like that.

 

[Deleted member 18361]

Just lol @ ppl conducting research on things your surgeon should already know

 

[hypergamy]

Conventional(non-locking) plates and locking plates

https://www.thejcdp.com/doi/JCDP/pdf/10.5005/jp-journals-10024-1303

PPT - Locking Plates Advantages & Indications PowerPoint Presentation - ID:6642536

Locking Plates Advantages & Indications. Objectives. Describe locking plates and how they differ in design from other bone plates Identify the advantages of locking plates over other plates Become familiar with the indications for use of locking plates. Locking Plates are an evolution.

www.slideserve.com

View attachment 1865644


You can choose a very skilled surgeon but if your insurance covers only the cheapest material which is conventional plate you are taking risks with regard to fractures and stability. I have heard some reports from patients saying after months of surgery they started to feel the screws were loosening and moving out slightly from the bone.

There are different techniques for both type of screws involving angular fixation. I should research more. However the main question is cost, one costs more than other, depending on your insurance I doubt they will purchase top-tier material. Perhaps the most expensive thing for your surgery.

Probably I would end up with conventional plates so I must have to (cope) studying how to prepare my organism with the right nutrients to try to have a good post-op without, who knows, bad luck.

I would ask a surgeon.

This is the problem with jaw surgery. So many variables. This forum learns a new vital thing every six months. Makes making a decision on movements/planning hard.

 

[TcEfforts]

Just lol @ ppl conducting research on things your surgeon should already know

I would ask a surgeon.

This is the problem with jaw surgery. So many variables. This forum learns a new vital thing every six months. Makes making a decision on movements/planning hard.

I talked to one surgeon months ago. I’m going to make an appointment with other surgeons in the next month.

It’s hard for surgeons to be full honest with patients if patients don’t know exactly what questions they are asking.

I felt rather worried about this surgeon I talked to, because he said in a way the surgery was quick and straightforward and I know it is not true at all.