Comparison of 3-Dimensional and Standard Miniplate Fixation in the Management of Mandibular Fractures

• Published in: Journal of oral and maxillofacial surgery Vol. 68; no. 7; pp. 1568 - 1572
• Main Authors: Jain, Manoj Kumar, MDS, Manjunath, K.S., MDS, Bhagwan, B.K., MDS, Shah, Dipit K., BDS
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-07-2010; Elsevier
• Subjects: Adult; Biological and medical sciences; Bone Plates; Bone Regeneration; Dentistry; Equipment Design; Female; Follow-Up Studies; Fracture Fixation, Internal - instrumentation; Fracture Fixation, Internal - methods; Humans; Injuries of the limb. Injuries of the spine; Internal Fixators; Male; Mandibular Fractures - classification; Mandibular Fractures - diagnostic imaging; Mandibular Fractures - therapy; Medical sciences; Otorhinolaryngology. Stomatology; Prospective Studies; Radiography; Surgery; Traumas. Diseases due to physical agents; Treatment Outcome; Mandible; Clinical management; Fixation; Treatment; Stomatology; Surgery; Diseases of the osteoarticular system; Fracture; Trauma; Comparative study; Standards
• ISSN: 0278-2391; 1531-5053
• DOI: 10.1016/j.joms.2009.07.083

Purpose The aim of this follow-up study was to compare 3-dimensional (3D) and standard (Champy's) miniplate fixation in the management of mandibular fractures, and to analyze advantages and disadvantages of one over the other. Patients and Methods A prospective randomized clinical trial was carried out in patients with well-defined inclusion and exclusion criteria. Patients were followed for 2 months for wound dehiscence, infection, segmental mobility, postoperative occlusion, significant period of postoperative complications, and radiological evaluation of reduction and fixation. Results Twenty patients were enrolled in both the groups with no case of wound dehiscence. In group 1, 2 patients had mild segmental mobility ( P = .07), 2 patients had surgical site infection ( P = .07), and 2 patients involving mental nerve had involved roots of teeth ( P = .07). Radiological evaluation did not show any statistically significant difference in reduction ( P = 1.4), but showed a significant difference ( P = .03) in fixation between the 2 groups, especially in cases involving the mental nerve (ie, fracture near or involving the mental foramen) and oblique fractures. Conclusion Champy's miniplate system is a better and easier method than the 3D miniplate system for fixation of mandibular fractures. In comparison, the 3D miniplate system is unfavorable for use in cases of oblique fractures and those involving the mental nerve, and is also difficult to adapt. In most cases, it provides good stability but with excessive implant material because of extra vertical bars incorporated for countering the torque forces. However, operative time is less because of simultaneous stabilization at both superior and inferior borders.