Evaluation of condylar position in anterior mandibular fractures using 3 dimensional miniplate osteosynthesis versus conventional miniplates: Randomized clinical trial. 2022

Omar Al-Husseiny Mohammad, and Essam Mohamed Ashour, and Fahmy Abd-El Aal Hassanein
Resident of Oral and Maxillofacial Surgery, Faculty of Dentistry, October 6 University, Giza, Egypt; M.Sc. of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt. Electronic address: omar.alhusseiny.mohammad@gmail.com.

To compare clinically and radiographically between the 3-D plates and the conventional two Champy's miniplates in the treatment of anterior mandibular fractures. It is a randomized clinical and radiographic comparative study between 2 equal groups of patients with isolated anterior mandibular fractures. Open reduction and internal rigid fixation was accomplished in the study group using 3D miniplates fixation while in the control group using the two Champy's miniplates. The 3D miniplate osteosynthesis consumed less operative time than the two miniplates osteosynthesis. Independent t-test revealed that the difference between the 2 groups was 8.4 ± 3.11 min. This difference was statistically significant (p=0.012). Occlusion was slightly disturbed in two patients in the study group in comparison to three patients in the control group. The difference between the 2 groups was not statistically significant (p=0.62). None of the cases of both groups showed mobility between the reduced and fixed fractured segments, immediately post-operatively and at the end of follow-up intervals. The 3D miniplate osteosynthesis (study group) recorded less intercondylar distance than two miniplates osteosynthesis (control group) immediately post-operatively and after 3 months. Independent t-test revealed that the difference between the 2 groups was not statistically significant, immediately postoperative (p=0.322) and after 3 months (p=0.263). Pre-operatively to 3 months postoperatively, the 3D miniplate osteosynthesis (study group) recorded a lower median percent increase in the intercondylar distance than the two miniplates osteosynthesis (control group). The difference between the 2 groups was not statistically significant (p=0.917). Regarding the intercondylar angle, the3D miniplate osteosynthesis (study group) recorded higher intercondylar angle than the two miniplates osteosynthesis (control group) immediately post-operative (p=0.333) and after 3 months (p=0.255). Independent t-test revealed that the difference between the 2 groups was not statistically significant. The 3-Dimensional strut miniplates should be considered an alternative for internal rigid fixation of anterior mandibular fractures for their ease of adaptation and insertion, while providing the advantage of reduced operative time compared to the conventional two Champy's miniplates.

UI MeSH Term Description Entries
D008337 Mandibular Fractures Fractures of the lower jaw. Fracture, Mandibular,Fractures, Mandibular,Mandibular Fracture
D001860 Bone Plates Implantable fracture fixation devices attached to bone fragments with screws to bridge the fracture gap and shield the fracture site from stress as bone heals. (UMDNS, 1999) Bone Plate,Plate, Bone,Plates, Bone
D003766 Dental Occlusion The relationship of all the components of the masticatory system in normal function. It has special reference to the position and contact of the maxillary and mandibular teeth for the highest efficiency during the excursive movements of the jaw that are essential for mastication. (From Jablonski, Dictionary of Dentistry, 1992, p556, p472) Canine Guidance,Occlusal Guidance,Occlusal Plane,Occlusion, Dental,Dental Occlusions,Guidance, Canine,Guidance, Occlusal,Occlusal Guidances,Occlusal Planes,Occlusions, Dental,Plane, Occlusal,Planes, Occlusal
D005593 Fracture Fixation, Internal The use of internal devices (metal plates, nails, rods, etc.) to hold the position of a fracture in proper alignment. Osteosynthesis, Fracture,Fixation, Internal Fracture,Fixations, Internal Fracture,Fracture Fixations, Internal,Fracture Osteosyntheses,Fracture Osteosynthesis,Internal Fracture Fixation,Internal Fracture Fixations,Osteosyntheses, Fracture
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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