Novel design of miniplate for fixation of fractures at transition zone of parasymphysis-body region of mandible – A clinical randomised study

Effective strategies in the management of anterior mandibular fractures: a comprehensive systematic review

This review examines the prevailing modalities for fractures of the anterior mandible, which represent a significant proportion of the maxillofacial injuries commonly treated by oral and maxillofacial surgeons. The article traces the historical shift from conservative techniques to the dominant management strategies of open reduction and fixation. Encompassing a range of studies, the review, in accordance with PRISMA 2020 recommendations, meticulously examines various fixation methods, assessing their efficacy in achieving stability of fracture, early healing, and mobilisation. The comparison of these methods highlights their unique advantages and limitations, and demonstrates the need for more nuanced and precise approaches. The review emphasises evidence-based methodology in the management of anterior mandibular fractures (AMF), highlighting the benefits offered by innovative techniques such as 3D miniplates. It also acknowledges the advantages provided by older fixation devices such as lag screws. The importance of postoperative outcomes and the need for tailored treatment strategies are recognised, considering the complex nature of these fractures.

Evaluation of bite force recovery in patients with maxillofacial fracture

The aim of this study was to measure the maximum voluntary bite force and recovery time in patients treated for different types of the maxillofacial fracture. Patients aged between 18 and 60 years, who received surgical treatment for a single isolated fracture of the maxillofacial structure, were included in this study. Healthy individuals without any maxillofacial abnormality were selected as the control group. Bite force (in kg) was measured at the first incisor tooth, bilaterally, prior to surgery and 2 weeks, 6 weeks, 3 months, and 6 months after surgery. Of 120 patients, 89 (74.17%) were male and 31 (25.83%) were female. Mean patient age (±SD) was 31.21 (±11.64) years. Bite forces relating to fractures of the zygomaticomaxillary complex (ZMC) with involvement of the arch and zygomaticofrontal suture reached normal levels after 6 weeks (from 3.89 (±1.11) to 10.82 (±1.29); p = 0.296 and from 4.20 (±0.93) to 10.70 (±1.70); p = 0.192, respectively). Bite force returned to normal after 3 months in fractures of the symphysis (from 2.05 (±0.97) to 12.18 (±0.77); p = 0.222), body (from 2.21 (±1.26) to 11.9 (±0.73); p = 0.750), angle (from 2.45 (±1.24) to 11.89 (±0.76); p = 0.769), condyle (from 2.45 (±1.27) to 11.25 (±0.82); p = 0.968), and ZMC with and without infraorbital rim involvement (from 3.83 (±0.93) to 11.92 (±0.84); p = 0.724 and from 3.7 (±1.21) to 12.03 (±0.82); p = 0.482, respectively). Patients with ZMC fracture involving the arch and zygomaticofrontal suture require fewer follow-ups in comparison with those with other maxillofacial fractures. Measurement of maximal bite force can help to evaluate dentofacial deformities before and after surgical treatment.

Change of body composition, physical strength, and nutritional status of patients with mandibular fractures

The aim was to determine changes in various parameters indicating physical conditions and nutritional status of patients during surgical and conservative treatment of mandibular fractures. A round by a nutrition support team was done once postoperatively for the surgical treatment group. For the conservative treatment group, three rounds were performed during the period of intermaxillary fixation. Data obtained from the rounds were compared between the groups. There were 29 patients surgically and 30 patients conservatively treated. A significant weight loss was observed in both groups postoperatively. The mean weight loss of the surgical treatment group measured at the postoperative round was 1.73 kg (SD ± 1.78) (P < 0.001) and that of the conservative treatment group at the third round was 2.74 kg (SD ± 2.35) (P < 0.001). During the entire treatment period, weight loss, body fat percentage, skeletal muscle percentage, grip strength and parameters indicating body composition and nutritional status of the conservative treatment group did not substantially differ from those of the surgical group. The influence of the conservative procedure on the nutritional condition of the patients seems to be limited and reversible at the end of the treatment. The weight loss observed here suggests that systematic nutrition support is necessary during both surgical and conservative treatment.

A mechanical study of novel additive manufactured modular mandible fracture fixation plates - Preliminary Study with finite element analysis.✰

The paper presents an innovative osteofixation system designed for bone fracture stabilization. Its special feature, which makes it different from other similar systems, is the possibility to precisely adjust the implant to the shape of the bone. Such a precise adjustment is particularly important in the case of multiple fractures, where proper stabilization is a condition for restoring bone geometry and thus obtaining the biomechanical function of a given segment of the body lost due to fracture. Based on the tested properties of the implant material, the presented system structure was verified for loading, stress, and share forces in multi-site fractures of the mandible. Numerical tests were performed for three different fracture models: unilateral double fracture of the body of mandible, unilateral double fracture of the body and the angle of mandible, and bilateral fracture of the mandible at the angle and body of the mandible. The results indicate that the proposed system may be used to stabilize broken bone fragments successfully, and the obtained stabilization would allow unrestricted use of the chewing function during bone healing and remodeling. The authors point out the advantages of the proposed implantation method thanks to which it is possible to obtain any shape of the implant and thus stabilize bone fragments in any case.