Aims and objectives: To compare the treatment outcomes pre- and postoperatively in mandibular fractures, in the symphysis region, parasymphysis, and body region, treated by conventional locking titanium miniplates and three-dimensional (3D) locking titanium miniplates on parameters such as postoperative occlusion, stability, infection, healing, distortion of plates, and duration of surgery.
Materials and methods: A cohort of 50 patients presenting with mandibular fractures (MFs) involving the symphysis, parasymphysis, and body regions was included in this study. The patient pool was evenly divided into two groups, denoted as groups I and II, each comprising 25 individuals. In group I, patients underwent treatment utilizing 2.0 mm titanium miniplates featuring a conventional locking system, while in group II, 2.0 mm titanium miniplates with a 3D locking system were employed. The therapeutic interventions were conducted under general anesthesia for both groups. Subsequent to the surgical procedures, patients underwent systematic follow-ups at 1 and 3-month intervals, during which evaluations were performed to assess parameters such as infection status, occlusion, stability of fracture segments, paresthesia, healing progress, and the occurrence of hardware failure.
Results: The fixation process using 3D plates exhibited a mean duration of 20–25 minutes, while the conventional locking plate method showed an average duration of 40–45 minutes. A statistically significant “p” value of 0.000 was obtained when comparing the duration of surgery between the two groups. However, no statistical significance was observed when evaluating other parameters between the groups.
Conclusion: A titanium plate with a 3D locking system can be used as an alternative to a conventional locking system because of its strength, malleability, and its aid in better reduction and stabilization of fractured segments into a single unit, thus providing 3D stability at the fracture site.
Clinical significance: This study contributes to addressing the need to reduce surgical duration. The utilization of 3D locking plates is demonstrated to integrate advanced techniques for mandibular fracture fixation, resulting in an expedited treatment process. This innovative approach envisions novel strategies for fracture management, ultimately aiming to enhance patient outcomes.
Peterson LJ, Hupp JR. Contemporary Oral and Maxillofacial Surgery, 2nd Edition. WB Sauders Company.
Chrcanovic BR, Freire-Maia B, Souza LN, et al. Facial fractures: a 1-year retrospective study in a hospital in Belo Horizonte. Braz Oral Res 2004;18(4):322–328. DOI: 10.1590/s1806-83242004000400009
Chrcanovic BR, Abreu MH, Freire-Maia B, et al. Facial fractures in children and adolescents: a retrospective study of 3 years in a hospital in Belo Horizonte, Brazil. Dent Traumatol 2010;26(3):262–270. DOI: 10.1111/j.1600-9657.2010.00887.x
Chrcanovic BR, Souza LN, Freire-Maia B, et al. Facial fractures in the elderly: a retrospective study in a hospital in Belo Horizonte, Brazil. J Trauma 2010;69(6):E73–E78. DOI: 10.1097/TA.0b013e3181cc847b
Chrcanovic BR. Factors influencing the incidence of maxillofacial fractures. Oral Maxillofac Surg 2012;16(1):3–17. DOI: 10.1007/s10006-011-0280-y
Chrcanovic BR, Abreu MH, Freire-Maia B, et al. 1,454 mandibular fractures: a 3-year study in a hospital in Belo Horizonte, Brazil. J Craniomaxillofac Surg 2012;40(2):116–123. DOI: 10.1016/j.jcms.2011.03.012
Azevedo AB, Trent RB, Ellis A. Population-based analysis of 10,766 hospitalizations for mandibular fractures in California, 1991 to 1993. J Trauma 1998;45(6):1084–1087. DOI: 10.1097/00005373-199812000-00020
Raveh J, Sutter F, Hellem S. Surgical procedures for reconstruction of the lower jaw using the titanium-coated hollow-screw reconstruction plate system: bridging of defects. Otolaryngol Clin North Am 1987;20(3):535.
Sutter F, Raveh J. Titanium-coated hollow screw and reconstruction plate system for bridging of lower jaw defects: biomechanical aspects. Int J Oral Maxillofac Surg 1988;17(4):267–274. DOI: 10.1016/s0901-5027(88)80055-9
Jonnson H Jr, Cesadni K, Petren-Mallmin M, et al. Locking screwplate lixation of cervical spine fractures with and without ancillary posterior plating. Arch Orthop Trauma Surg 1991;111(1):1–12. DOI: 10.1007/BF00390184
Soderholm AL, Lmdqvist C, Skutnabb K, et al. Bridging of mandibular defects with two different reconstruction systems: an experimental study. J Oral Maxillofac Surg 1991;49(10):1098–1105. DOI: 10.1016/0278-2391(91)90145-c
Raveh J. Lower jaw reconstruction with the THORP system for bridging of lower jaw defects. Head Neck Cancer 1990;2:344–349.
Collins CP, Pirinjian-Leonard G, Tolas A, et al. A prospective randomided clinical trail comparing 2.0 mm locking plates to 2.0 mm standardized plates in treatment of mandibular fractures. J Oral Maxillofacial Surg 2004;62(11):1392–1395. DOI: 10.1016/j.joms.2004.04.020
Prabhakar C, Shetty JR, Hemavathy OR, et al. Efficacy of 2.0-mm locking miniplates in the management of mandibular fractures without maxillomandibular fixation. Natl J Maxillofac Surg 2011;2(1):28–32. DOI: 10.4103/0975-5950.85850
Zix J, Lieger O, Iizuka T. Iizuka Use of straight and curved 3-dimensional titanium miniplates for fracture fixation at the mandibular angle. J Oral Maxillofac Surg 2007; 65(9):1758–1763. DOI: 10.1016/j.joms.2007.03.013
Hochuli-Vieira E, Ha TK, Pereira-Filho VA, et al. Use of rectangular grid miniplates for fracture fixation at the mandibular angle. J Oral Maxillofac Surg 2011; 69(5):1436–1441. DOI: 10.1016/j.joms.2010.06.182
Kirkpatrick D, Gandhi R, Van Sickels JE. Infections associated with locking reconstruction plates: a retrospective review. J Oral Maxillofac Surg 2003;61(4):462–426. DOI: 10.1053/joms.2003.50089
Feledy J, Caterson EJ, Steger S, et al. Treatment of mandibular angle fractures with a matrix miniplate: a preliminary report. Plast Reconstr Surg 2004;114(7):1711–1716. DOI: 10.1097/01.prs.0000142477.77232.f7
Guimond C, Johnson JV, Marchena JM. Fixation of mandibular angle fractures with a 2.0 mm 3-dimensional curved angle strut plate. J Oral Maxillofac Surg 2005;63(2):209–214. DOI: 10.1016/j.joms.2004.03.018
Vineeth K, Lalitha RM, Prasad K, et al. “A comparative evaluation between single noncompression titanium miniplate and three dimensional titanium miniplate in treatment of mandibular angle fracture”–a randomized prospective study. J Craniomaxillofac Surg 2013;41(2):103–109. DOI: 10.1016/j.jcms.2012.05.015
N CS, Shetty SK, Shetty SK, et al. Inferior alveolar nerve dysfunction in mandibular fractures: a prospective cohort study. J Korean Assoc Oral Maxillofac Surg 2021;47(3):183–189. DOI: 10.5125/jkaoms.2021.47.3.183
Feller KU, Richter G, Schneider M, et al. Combination of microplate and miniplate for osteosynthesis of mandibular fractures: an experimental study. Int J Oral Maxillofac Surg 2002;31(1):78–83. DOI: 10.1054/ijom.2000.0182
