: A three-dimensional-printed individual titanium plate was applied for maxillary protraction to eliminate side effects and obtain the maximum skeletal effect. This study aimed to explore the stress distribution characteristics of sutures during maxillary protraction using individual titanium plates in various directions and locations.
: A protraction force of 500 g per side was applied at forward and downward angles between 0° and 60° with respect to the Frankfort horizontal plane, after which the titanium plate was moved 2 and 4 mm upward and downward, respectively. Changes in sutures with multiple protraction directions and various miniplate heights were quantified to analyze their impact on the maxillofacial bone.
: Protraction angle of 0-30° with respect to the Frankfort horizontal plane exhibited a tendency for counterclockwise rotation in the maxilla. At a 40° protraction angle, translational motion was observed in the maxilla, whereas protraction angles of 50-60° tended to induce clockwise rotation in the maxilla. Enhanced protraction efficiency at the lower edge of the pyriform aperture was associated with increased height of individual titanium plates.
: Various protraction directions are suitable for patients with different types of vertical bone surfaces. Furthermore, when the titanium plate was positioned lower, the protraction force exhibited an increase.

BACKGROUND: Although external penetrating laryngeal trauma is rare in the clinic, such cases often result in a high mortality rate. The early recognition of injury, protection of the airway, one-stage laryngeal reconstruction with miniplates and interdisciplinary cooperation are important in the treatment of such patients.
METHODS: A 58-year-old male worker sustained a penetrating injury in the left neck. After computed tomography scanning at a local hospital, he was transferred to our hospital, where he underwent tracheotomy, neck exploration, extraction of the foreign object, debridement and repair of the thyroid cartilage using titanium miniplates. An endo laryngeal stent was inserted, which was removed 12 days later. The patient recovered well and his voice rapidly improved after surgery.
CONCLUSIONS: Penetrating laryngeal trauma is uncommon. We successfully treated a patient with early laryngeal reconstruction and management by interdisciplinary cooperation.

Fibular flaps are usually used for the reconstruction of the mandible, but the use of plate systems, including miniplates and reconstruction plates, has recently been debated. We have made a retrospective study of 544 consecutive patients who had fibular grafts with miniplates used for fixation, and also made retrospective measurements of orthopantomographs from 37 patients to assess the stability of the miniplates used in the fibular flaps. When miniplates were used with fibular flaps there were 10.3% (56/544) complications, of which 4.8% (26/544) were loosening of the screws, 2.6% (14/544) fracture of the plate, 1.5% (8/544) exposure of the plate, and 6.4% (35/544) infection. The median (IQR) time at which the complications occurred was 24 (7-48) months. We conclude that loosening of screws is common at the binding interface near the condyle and in the molar region; plates are more likely to fracture near the binding interface in proximity to the molar region; and plates at the chin are the most likely to be exposed. Diabetes and the use of radiotherapy were associated with complications. Our data suggest that miniplates used for mandibular reconstruction are relatively reliable.