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Finite Element Modeling was used to compare the efficacy of common screw-plate configurations used for fixation of parasymphyseal fractures of the mandible. Measures of Von Mises stress on the screw bone interface, as well as principal strain in the reduced fracture region, were used in this comparison. This study also explored differences between orthotropic and isotropic modeling practices and compared the effect of mastication forces on both the fractured and intact halves of the mandible. The results of this analysis showed no major differences between configurations from a mechanistic point of view. This suggests that the use of any of the studied screw-plate configurations will not increase chances for post-operative complications. Furthermore, little difference is seen between analyses with either orthotropic or isotropic material properties. The inclusion of orthotropic properties can thus be avoided in future studies with similar boundary and plating conditions. Mastication ipsilateral to the fracture increases Von Mises stress 2 to 4 times, and should be avoided during early healing periods. These recommendations only apply to patients whose fractures mimic the finite-element model.
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