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Lynn JV, Daniel MC, Jackson CMK, Ulma RM, Vercler CJ, Kasten SJ, Buchman SR. Reasons for Removal of Rigid Internal Fixation Devices in Craniofacial Surgery: A 20-year Update. J Craniofac Surg 2024; 35:1052-1056. [PMID: 38349348 DOI: 10.1097/scs.0000000000010032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 01/03/2024] [Indexed: 06/04/2024] Open
Abstract
The hardware utilized for rigid internal fixation of the craniofacial skeleton has evolved over time. Thus, the reasons for the unplanned removal of hardware continue to change. The purpose of this study is to compare past (1989-1995) and present (2000-2020) patient cohorts to establish trends related to unplanned removal of craniofacial hardware. A retrospective review study was designed. Data from our institution's original publication describing the unplanned removal of craniofacial hardware (1989-1995) was obtained. Data related to patients who underwent unplanned removal of hardware from 2000 to 2020 was collected from the electronic medical record. A descriptive statistical analysis was performed to compare demographics, reasons for hardware placement, and reasons for unplanned hardware removal between cohorts. This study includes 55 patients treated from 1989 to 1995 and 184 patients treated from 2000 to 2020. The average age at hardware placement decreased from 32 years (1989-1995) to 28 years (2000-2020). The most common reason for hardware placement changed from motor vehicle accident (1989-1995) to congenital deformity (2000-2020). The length of time with hardware in situ increased from 13 months (1989-1995) to 25 months (2000-2020). The most common reason for hardware removal changed from prominent hardware (1989-1995) to hardware exposure (2000-2020). In summary, patients who underwent rigid internal fixation of the craniofacial skeleton from 2000 to 2020 retained their hardware 2 times longer than patients treated from 1989 to 1995. Factors potentially contributing to increased retention include improved surgical technique, decreased profile of hardware, and increased surgeon experience. Further studies are warranted to define preoperative risk factors for unplanned hardware removal.
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Affiliation(s)
- Jeremy V Lynn
- Section of Plastic Surgery, University of Michigan, Ann Arbor, MI
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Daqiq O, Roossien CC, Wubs FW, van Minnen B. Biomechanical assessment of mandibular fracture fixation using finite element analysis validated by polymeric mandible mechanical testing. Sci Rep 2024; 14:11795. [PMID: 38782942 PMCID: PMC11116419 DOI: 10.1038/s41598-024-62011-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
The clinical finite element analysis (FEA) application in maxillofacial surgery for mandibular fracture is limited due to the lack of a validated FEA model. Therefore, this study aims to develop a validated FEA model for mandibular fracture treatment, by assessing non-comminuted mandibular fracture fixation. FEA models were created for mandibles with single simple symphysis, parasymphysis, and angle fractures; fixated with 2.0 mm 4-hole titanium miniplates located at three different configurations with clinically known differences in stability, namely: superior border, inferior border, and two plate combinations. The FEA models were validated with series of Synbone polymeric mandible mechanical testing (PMMT) using a mechanical test bench with an identical test set-up. The first outcome was that the current understanding of stable simple mandibular fracture fixation was reproducible in both the FEA and PMMT. Optimal fracture stability was achieved with the two plate combination, followed by superior border, and then inferior border plating. Second, the FEA and the PMMT findings were consistent and comparable (a total displacement difference of 1.13 mm). In conclusion, the FEA and the PMMT outcomes were similar, and hence suitable for simple mandibular fracture treatment analyses. The FEA model can possibly be applied for non-routine complex mandibular fracture management.
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Affiliation(s)
- Omid Daqiq
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | - Charlotte Christina Roossien
- Engineering and Technology Institute Groningen, Department of Bio-Inspired MEMS and Biomedical Devices, University of Groningen, Nijenborgh 4, 9747 AG, Groningen, The Netherlands
| | - Frederik Wilhelm Wubs
- Bernoulli Institute for Mathematics, Computer Science and Artificial Intelligence, University of Groningen, Nijenborgh 9, 9747 AG, Groningen, The Netherlands
| | - Baucke van Minnen
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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Parvan M, Khaghaninejad MS, Karimi MT. The comparison between various methods of mandibular reconstruction based on finite element analysis. Proc Inst Mech Eng H 2024; 238:423-429. [PMID: 38415325 DOI: 10.1177/09544119241232282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
The Mandible can be damaged by pathological factors, tumors, trauma, infection, and needs a surgical operation for reconstruction and restoring function. There are different methods for the reconstruction of mandible. Based on the surgical approach, primary reconstruction of mandible by reconstruction plate after resection is necessary for maintaining mandibular symmetric and esthetic of the lower third of the face. A finite element model of mandible and masticatory muscles was produced from a normal person (male with 35-year-old). The normal model was resected from the left sixth tooth to the second tooth. The pathological model was reconstructed in different conditions by macro plate. Different conditions were analyzed and compared based on bite force on right fifth tooth, stress developed on screws and macro plate. The finite element analysis results showed that maximum bite force and lower stress on screws were seen in the pathological model (condition 5) when one macro plate and six screws were inserted in the mid-body. The findings showed that the use of two macro plates causes lower stress on it than when we use one. Use of one macro plate and six screws is the best choice in mandibular immobilization which decrease the stress applied on bone and increase the bite force. Because of less stress developed on macro plates and screws, use of two macro plates or one macro plate in mid-body area are also preferred.
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Affiliation(s)
- Mehdi Parvan
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Saleh Khaghaninejad
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Taghi Karimi
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Sobrero F, Roccia F, Vilaplana V, Roig AM, Raveggi E, Ramieri G, Goetzinger M, Bottini GB, Rizvi AO, Laverick S, Knežević P, Dediol E, Kordić M, Sivrić A, Ganasouli D, Zanakis SN, Jelovac D, Konstantinovic VS, Birk A, Vesnaver A, Rabufetti A, Scolozzi P, Derkuş FE, Yilmaz UN, Politis C, Dubron K. Manual versus rigid intraoperative maxillo-mandibular fixation in the surgical management of mandibular fractures: A European prospective analysis. Dent Traumatol 2023; 39:448-454. [PMID: 37140473 DOI: 10.1111/edt.12851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/18/2023] [Accepted: 04/11/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE Intraoperative stabilisation of bony fragments with maxillo-mandibular fixation (MMF) is an essential step in the surgical treatment of mandibular fractures that are treated with open reduction and internal fixation (ORIF). The MMF can be performed with or without wire-based methods, rigid or manual MMF, respectively. The aim of this study was to compare the use of manual versus rigid MMF, in terms of occlusal outcomes and infective complications. MATERIALS AND METHODS This multi-centric prospective study involved 12 European maxillofacial centres and included adult patients (age ≥16 years) with mandibular fractures treated with ORIF. The following data were collected: age, gender, pre-trauma dental status (dentate or partially dentate), cause of injury, fracture site, associated facial fractures, surgical approach, modality of intraoperative MMF (manual or rigid), outcome (minor/major malocclusions and infective complications) and revision surgeries. The main outcome was malocclusion at 6 weeks after surgery. RESULTS Between May 1, 2021 and April 30, 2022, 319 patients-257 males and 62 females (median age, 28 years)-with mandibular fractures (185 single, 116 double and 18 triple fractures) were hospitalised and treated with ORIF. Intraoperative MMF was performed manually on 112 (35%) patients and with rigid MMF on 207 (65%) patients. The study variables did not differ significantly between the two groups, except for age. Minor occlusion disturbances were observed in 4 (3.6%) patients in the manual MMF group and in 10 (4.8%) patients in the rigid MMF group (p > .05). In the rigid MMF group, only one case of major malocclusion required a revision surgery. Infective complications involved 3.6% and 5.8% of patients in the manual and rigid MMF group, respectively (p > .05). CONCLUSION Intraoperative MMF was performed manually in nearly one third of the patients, with wide variability among the centres and no difference observed in terms of number, site and displacement of fractures. No significant difference was found in terms of postoperative malocclusion among patients treated with manual or rigid MMF. This suggests that both techniques were equally effective in providing intraoperative MMF.
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Affiliation(s)
- Federica Sobrero
- Division of Maxillofacial Surgery, Department of Surgical Science, University of Turin, Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Department of Surgical Science, University of Turin, Turin, Italy
| | - Valentines Vilaplana
- Department of Oral and Maxillofacial Surgery, University Hospital of Bellvitge, Barcelona, Spain
| | - Antonio Mari Roig
- Department of Oral and Maxillofacial Surgery, University Hospital of Bellvitge, Barcelona, Spain
| | - Elisa Raveggi
- Division of Maxillofacial Surgery, Department of Surgical Science, University of Turin, Turin, Italy
| | - Guglielmo Ramieri
- Division of Maxillofacial Surgery, Department of Surgical Science, University of Turin, Turin, Italy
| | - Maximilian Goetzinger
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Gian Battista Bottini
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Ali O Rizvi
- Department of Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Sean Laverick
- Department of Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Predrag Knežević
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Mario Kordić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Anamaria Sivrić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Dimitra Ganasouli
- Department of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Stylianos N Zanakis
- Department of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Drago Jelovac
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Vitomir S Konstantinovic
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Anže Birk
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Aleš Vesnaver
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Alessandro Rabufetti
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Fatma Eriş Derkuş
- Department of Oral and Maxillofacial Surgery, Dicle University, Diyarbakir, Turkey
| | - Utku Nezih Yilmaz
- Department of Oral and Maxillofacial Surgery, Dicle University, Diyarbakir, Turkey
| | - Constantinus Politis
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Kathia Dubron
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
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Pinho JNA, da Mota Santana LA, de Souza LN, Kumar PN, Júnior PA, de Almeida Souza LM. Accidental Intraoperative Mandibular Fracture in a Third Molar Surgery: When Surgical Skills Are Mandatory in the Face of Empiricism. Case Rep Dent 2023; 2023:2263554. [PMID: 37546575 PMCID: PMC10400297 DOI: 10.1155/2023/2263554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/03/2023] [Accepted: 07/11/2023] [Indexed: 08/08/2023] Open
Abstract
Iatrogenic mandible fractures are rare complications from third molar removal surgeries. While most documented cases stress risk factors inherent to the patient and tooth presentation in fractures' etiology, appreciation of the risk factors underlying the practitioner's skills is scarce. Here, we describe an intraoperative fracture in a healthy 26-year-old female resulting from an incompatible surgical technique during the right mandibular third molar removal. The patient showed facial swelling, pain, malocclusion, and significant mobility of the fractured segment. The surgical management involved an intraoral open reduction with the installation of titanium plates for the fixation of the bone segments. Thus, we highlight that acknowledging the extent of the operator's surgical skills should be part of comprehensive treatment planning, serving as a valuable measure to prevent iatrogenic mandible fractures besides avoiding a traumatic experience for the patient.
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Affiliation(s)
| | | | - Leandro Napier de Souza
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Paulo Nand Kumar
- Department of Oral and Maxillofacial Surgery, Urgency Hospital of Sergipe (HUSE), Aracaju, SE, Brazil
| | - Paulo Almeida Júnior
- Department of Oral and Maxillofacial Surgery, Urgency Hospital of Sergipe (HUSE), Aracaju, SE, Brazil
| | - Liane Maciel de Almeida Souza
- Department of Dentistry, Federal University of Sergipe (UFS), Aracaju, SE, Brazil
- Department of Oral and Maxillofacial Surgery, Urgency Hospital of Sergipe (HUSE), Aracaju, SE, Brazil
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Kwofie M, Policeni B. Reconstructive Surgeries After Head And Neck Trauma: Imaging Appearances. Semin Roentgenol 2023; 58:311-330. [PMID: 37507172 DOI: 10.1053/j.ro.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/10/2023] [Accepted: 04/22/2023] [Indexed: 07/30/2023]
Affiliation(s)
- Michael Kwofie
- Department of Radiology, The University of Iowa Hospital and Clinics, Iowa City, IA.
| | - Bruno Policeni
- Department of Radiology, The University of Iowa Hospital and Clinics, Iowa City, IA
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Pavithra SK, Vivek N, Saravanan C, Karthik R, Prashanthi G, Cynthia S. Comparison of Conventional Versus Right Angled Fixation Technique in Management of Mandibular Angle Fractures - A Prospective Randomized Clinical Study. J Oral Maxillofac Surg 2023:S0278-2391(23)00384-1. [PMID: 37160255 DOI: 10.1016/j.joms.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 04/04/2023] [Accepted: 04/10/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE The treatment of mandibular angle fractures ranges from observation to closed reduction with maxillomandibular fixation to open reduction and internal fixation. The study aims to compare the effectiveness of three different techniques (transoral, transbuccal, and right-angled fixation technique) for single adaptational monocortical upper border plating in mandibular angle fracture. METHODS The study conducted at our center was a prospective randomized study. The study duration was from November 2019 to August 2021. The three groups included in our study were transoral, transbuccal, and transoral approach using the right-angled drill. Patients who required open reduction and internal fixation of mandibular angle fracture were included in the study. Computer-generated randomization method was used to allot the participants in any of the three groups, ie, transoral, transbuccal, or right-angled fixation technique. The primary outcome clinical variables were mouth opening (MO), occlusion stability, scar or laceration, facial nerve weakness, infection, and the radiological variables were gap between the fracture segments and displacement of the fracture segment. The secondary outcome of our study is a comparison of the perioperative complications including plate exposure during the entire fracture healing period. The covariates of the study were age, sex, etiology, and tooth in line of fracture. Statistical analysis was done using ANOVA, post hoc Tukey test, and Pearson χ2 test. A P value less than 0.05 was considered statistically significant. RESULTS A total of 48 patients were included in our study. According to randomization, each group was allotted 16 patients. In the study, 66.7% of the study population were male and 33.3% were female; 75% of the study population were victims of road traffic accidents, and 25% were injured due to assault. The mean and standard deviation for MO at 1 month were 31.3 ± 2.9 for the transoral group, 35.8 ± 1.7 for the transbuccal group, and 35.5 ± 1.3 for the right-angled fixation group. On intergroup comparison, statistically significant results were seen at the 1-month postoperative MO clinical parameter. The P value here was 0.02 which was statistically significant. CONCLUSION The comparison of the right-angled fixation technique to transoral and transbuccal fixation methods have not been documented. Our study is the first of its kind to compare the right-angled fixation technique to various other approaches. Our study showed that the MO was better postoperatively with the transbuccal approach. The other variables showed no difference among the three techniques.
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Affiliation(s)
- Sarda K Pavithra
- Resident, Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College
| | - Narayanan Vivek
- Professor, Department of oral and maxillofacial surgery, SRM Kattankulathur Dental College
| | - Chandran Saravanan
- Professor, Department of oral and maxillofacial surgery, SRM Kattankulathur Dental College
| | - Ramakrishnan Karthik
- Professor, Department of oral and maxillofacial surgery, SRM Kattankulathur Dental College
| | - Gurram Prashanthi
- Associate Professor, Department of oral and maxillofacial surgery, SRM Kattankulathur Dental College
| | - Scott Cynthia
- Assistant Professor, Department of oral and maxillofacial surgery, SRM Kattankulathur Dental College.
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Soliman L, King V, Yeoh MS, Woo AS. Update on ladder plates for mandibular angle fractures. Curr Opin Otolaryngol Head Neck Surg 2023:00020840-990000000-00056. [PMID: 36977126 DOI: 10.1097/moo.0000000000000893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
PURPOSE OF REVIEW Fractures of the mandibular angle are surgically challenging with high rates of postoperative complications. Among established fixation techniques for these injuries, Champy's tension band approach with miniplate fixation has held prominence. Rigid fixation, using two plates, also remains commonly used. More recently, geometric ladder plates, which confer greater three-dimensional stability have been developed to overcome the shortcomings of conventional fixation approaches. Herein, we aim to summarize the recent evidence surrounding the use of ladder plates and offer our own opinion for optimal treatment of these fractures. RECENT FINDINGS In high-powered studies, the rates of hardware failure, malocclusion, and malunion are lower among cohorts managed with ladder plates relative to miniplate groups. Rates of infection and paresthesia remain similar. Ladder plates have also been shown to decrease operative time in preliminary study. SUMMARY Ladder plates show superiority to miniplate approaches across several outcomes. However, the relatively larger strut plate constructs may not be necessary for minor, uncomplicated fractures. It is our belief that reasonable outcomes may be achieved with either approach depending on surgeon experience and comfort with the given fixation technique.
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Affiliation(s)
- Luke Soliman
- Division of Plastic and Reconstructive Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Victor King
- Division of Plastic and Reconstructive Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Melvyn S Yeoh
- Division of Oral and Maxillofacial Surgery, University of Kentucky College of Dentistry, Lexington, Kentucky, USA
| | - Albert S Woo
- Division of Plastic and Reconstructive Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Saxena S, Giri KY, Sharma P, Niranjanaprasad IB, Dandriyal R, Abhishek K, Vishal G. Comparative Assessment of Clinical and Quality of Life Outcomes in Mandibular Angle Fractures Treated with Standard and Three-Dimensional Mini-Plates. J Maxillofac Oral Surg 2022; 21:1386-1392. [PMID: 36896055 PMCID: PMC9989096 DOI: 10.1007/s12663-022-01699-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/29/2022] [Indexed: 11/29/2022] Open
Abstract
Aims and Objectives To undertake a multidimensional comparative assessment of the standard and three dimensional (3D) mini-plates in managing isolated mandibular angle fractures (MAFs). Patients and Methods Thirty-six subjects were divided equally into two groups. Group A underwent fixation with a standard 2 mm miniplate, while group B with 2 mm 3D mini-plates. Evaluations were done preoperatively (T0), postoperatively at one week (T1), one month (T2) and three months (T3). Maximal inter-incisal mouth opening (MIO) and mean bite force (MBF) at the central incisors, right and left molars were calculated. Postoperative complications and Quality of life (QoL) outcomes were evaluated using the short form Oral Health Impact Profile (OHIP-14). Results Mean operative time was almost similar for both groups. Although mean MIO improved significantly from T1 to T3 in both groups, intergroup comparison of MIO was not significant. The MBF values were significantly higher in group B on the right and left molars at T2 and T3. Although significant improvement in OHIP-14 scores was seen from T2 to T3 in both the groups, intergroup comparison of OHIP was not significant. Conclusion 3D plates demonstrated similar clinical and QoL outcomes compared to the standard mini-plates.
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Affiliation(s)
| | - K. Y. Giri
- Department of Oral and Maxillofacial Surgery, Drs. S. & N. R. Siddhartha Institute of Dental Sciences, Gannavaram Mandal, Krishna District, A. P. 521286 India
| | - Preeti Sharma
- Department of Oral and Maxillofacial Surgery, Government Medical College and Hospital, Chandigarh, 160030 India
| | - Indra B. Niranjanaprasad
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, Uttar Pradesh 243006 India
| | - Ramakant Dandriyal
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, Uttar Pradesh 243006 India
| | | | - Gaurav Vishal
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, Uttar Pradesh 243006 India
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10
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Mathew N, Singh I, Gandhi S, Solanki M, Bedi NS. The Efficacy of Fixation of Unilateral Mandibular Angle Fracture with Single 3D Plate vs Single Miniplate Using Transbuccal Approach. J Maxillofac Oral Surg 2022; 21:405-412. [DOI: 10.1007/s12663-020-01465-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/06/2020] [Indexed: 11/28/2022] Open
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11
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Antonio Pereira-Filho V, Fernando de Oliveira Gorla L, Cleveilton Dos Santos J, Silva Monnazzi M, Maurício dos Santos Nunes Reis J, de Moraes M, Francisco Real G M. In vitro mechanical test of grid plates for mandibular angle fractures. Br J Oral Maxillofac Surg 2022; 60:1125-1130. [DOI: 10.1016/j.bjoms.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
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12
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SANCAR B, ÜSTÜNDAĞ İ. Comparison of self-tapping and self-drilling screws in open reduction of mandible fracture. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1021921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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13
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Salavadi RK, Sinha R, Vadepally AK, Uppada UK. Comparative Evaluation of Conventional Miniplates, Three-Dimensional Miniplates and Lag Screws for Internal Fixation of Parasymphysis Fracture of Mandible-A Double-Blind Randomized Clinical Study. J Maxillofac Oral Surg 2022; 21:283-289. [PMID: 35400928 PMCID: PMC8934819 DOI: 10.1007/s12663-021-01647-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 09/17/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose The aim of this study is to clinically and radiographically evaluate the stability of parasymphysis fracture managed with lag screws, miniplates and 3D miniplates. Materials and Method Ninety- eight patients diagnosed with parasymphysis fracture were treated using lag screws in group 1, two 4-hole miniplates in group 2 and 3D miniplates in group 3. Intraoperative stability and duration of fixation was assessed. Postoperative clinical evaluation was done at 1 week, 1 month, 3rd month, 6th month and 1 year for complications and oral function. Radiological evaluation was done at 3rd and 6th month. Only 92 patients were considered for statistical analysis since 6 patients were lost during follow-up. Results Road traffic accident (65.3%) was the primary cause of mandibular fractures. Postoperative pain score showed a statistically significant difference after 1 week and 1 month duration (P value < 0.001). ANOVA test showed VAS was significantly higher at pre-op followed by 1st day and 1 week, but no significant difference after 3 months in all groups. Radiographic analysis did not show significant difference in approximation of fracture segment among 3 groups after 6 months (P-value = 0.117). Chewing efficiency at 6 months and occlusion by surgeon evaluation at 3 months showed a significant difference (P value < 0.001). Conclusion Lag screw fixation was technique-sensitive, relatively inexpensive and was less time consuming method when compared to miniplates and 3D plates. Lag screws and 3D plates are superior in reducing the incidence of complications and better in oblique or sagitally displaced mandibular fractures. Supplementary Information The online version contains supplementary material available at 10.1007/s12663-021-01647-5.
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Affiliation(s)
- Revanth Kumar Salavadi
- Department of Dentistry, ESIC Medical College and Hospital, Sanathnagar, Hyderabad, Telanagana 500038 India
| | - Ramen Sinha
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana India
| | - Ashwant Kumar Vadepally
- Department of Oral and Maxillofacial Surgery, VSK’s Sri Sai Superspeciality Dental Hospital, Uppal, Hyderabad, Telangana India
| | - Uday Kiran Uppada
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana India
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14
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Medial Epicanthoplasty With the Classic and Modified Skin Redraping Method: A Retrospective Case Control Study. J Craniofac Surg 2022; 33:1987-1990. [PMID: 35184114 DOI: 10.1097/scs.0000000000008585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 01/30/2022] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT The skin redraping method for medial epicanthoplasty is characterized by some shortcomings which warrants modification. In this study, clinical data of 193 patients who underwent medial epichanthoplasty by the modified skin redraping technique or the classic skin redraping technique were reviewed retrospectively. The patients underwent operation between May 2018 and June 2020 and were followed up for not less than 6 months. Interepicanthal distance , interpupillary distance, patient satisfaction, and postoperative complications were evaluated. In terms of interepicanthal distance/interpupillary distance ratio (P > 0.05) and satisfaction score (P = 0.759), the modified skin redraping technique and the classic skin redraping technique were similar. In the classic skin redraping group, there were 3 cases of visible scarring in the lower eyelid, corresponding to significantly more cases than in the modified skin redraping group (n = 0, P < 0.001). There were more out-fold cases in the modified skin redraping group (76/90) than in the classic skin redraping group (17/88) (P < 0.001). Utilizing the modified skin redraping medial epicanthoplasty can prevent medial hooding of the upper eyelid, reduce the probability of visible scarring, and produce more out-fold with concurrent double eyelidplasty compared with classic skin redraping epicanthoplasty.Level of evidence: IV.
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Minimally Invasive "Trocar-Free" Approach for Rear Mandibular Fractures Management. J Craniofac Surg 2021; 33:1583-1586. [PMID: 34974460 DOI: 10.1097/scs.0000000000008459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 12/16/2021] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT The request of minimally invasive surgery is progressively expanding the indications of endoscopically assisted intraoral access for mandibular traumas. The aim of our study is to assess how much the use of the angled drill may affect the outcome of patients treated for rear mandibular fracture.In our retrospective case-control trial we enrolled 36 patients with mandibular rear fractures treated through endoscopically assisted intraoral access. Eighteen patients were treated by using an angled drill "trocar free," and 18 treated by linear drills placed through trocars. Surgical times, hospitalization times (HT), and major complications rate were compared between the 2 groups.Group 1 showed a significant reduction in HT (1.72 versus 2.22 days, P = 0.024) and an increase in the surgical times (3.0 versus 2.53 hours, P = 0.019). Significant reduction of total amount of complication was seen in group 1 versus group 2 (P = 0.007).The "trocar free" approach allowed by angled drills, in our hands, greatly reduces the invasiveness of the surgery resulting in a significant reduction in HT and smaller share of vascular-nervous sequelae. Our results suggest the "trocar free" approach as a valuable choice when indicated for the treatment of rear mandibular fractures.
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Management of Mandible Angle Fractures With a Right Angle Drill: Description of Technique. J Craniofac Surg 2021; 33:e359-e360. [PMID: 34387263 DOI: 10.1097/scs.0000000000008087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Management of mandible angle fractures can be challenging within the confines of the oral cavity where the use of linear instruments may result in structural weakness or malalignment secondary to improper placement. A right angle drill can facilitate a more ergonomic approach, with direct perpendicular placement of the instrument over the angle fracture. In addition, local soft tissue strain is minimized, and the need for a transcutaneous exposure can be avoided for additional plate placement. The right angle drill technique is simple, reproducible, and can be easily incorporated into routine mandible angle fracture management.
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Three-Dimensional Osteosynthesis Plates for the Surgical Treatment of Mandibular Fractures. J Craniofac Surg 2021; 32:e728-e735. [PMID: 34172684 DOI: 10.1097/scs.0000000000007709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Mandible fractures can be treated with different plate systems, that is, miniplates or three-dimensional (3D) plates. This systematic review describes the effectiveness and clinical outcomes of 3D plates used in fractures of the mandible and aims to critically evaluate its risks and benefits. MATERIALS AND METHODS A comprehensive electronic search was conducted without date but with restriction to articles written in English. Studies in humans, including randomized or quasi-randomized controlled trials and retrospective studies, were included. The outcome parameters measured were number of patients, fracture classification, results, follow-up period, postoperative complications, and mean age of patients. Major complications were defined as those needing additional surgical intervention, for example, malocclusion, infection or plate fracture. Accordingly, complications not needing additional surgical intervention were defined as minor (ie, dehiscence, trismus). RESULTS Guided by the PRISMA statement and the Cochrane Handbook for Systematic Reviews of Interventions, the authors identified 44 publications with a total of 1790 patients. Among the articles selected for the final review, there were 32 reported prospective studies, 12 reported retrospective studies. Regarding the evaluation of quality, 8 studies showed a low value of the risk of bias, 17 a moderate risk, and 19 a high risk. There were statistically significant advantages for 3D plates in mandibular fractures in terms of postoperative complications, for example, wound dehiscences or plate fracture. CONCLUSIONS The 3D plate is an effective treatment modality for mandibular fractures, with low incidence of major complications, decreased length of operation time, and increased stability of osteosynthesis.
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Management of mandibular angle fractures through single and two mini-plate fixation systems: Retrospective study of 112 cases. Int J Surg Case Rep 2021; 80:105690. [PMID: 33640644 PMCID: PMC7921495 DOI: 10.1016/j.ijscr.2021.105690] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/21/2021] [Accepted: 02/21/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The aim of this paper is to compare the clinical results between the different methods of fixation of standard mini-plates for the management of mandibular angle fractures. STUDY DESIGN This was a retrospective analysis study of 196 patients with mandibular angle fractures divided into 3 groups at our hospital 20 august 1953 specialist hospital, which is a referral center between January 2015 and January 2020. The patients were assessed for malocclusion, infection, wound dehiscence, neuro-sensory deficit, mouth opening, stability, operating time, blood loss, and hardware failure. Group (I) comprised 72 men and 40 women with a mean age of 43 years. Group (II) comprised 36 men and 12 women with a mean age of 47 years. Group (II) comprised 29 men and 7 women with a mean age of 33 years. The assessment of surgical outcomes after the last follow-up visit clearly showed a lack of stability in patients group II compared to the other groups. The operating time was reduced in group I compared to Group II/ III. (P = 0.03) The wound dehiscence occurred mostly in Group III unless it was statistically no significant. The infection events occurred in 36 patients of the sample, which was not statistically significant (Table 4). DISCUSSION Fractures of the mandibular angle represent 23-42% of all mandibular fractures, in our context road accidents followed by aggression are the most frequent mechanisms found. A various types of treatment approaches for the treatment of angular fractures have been described. Our analysis revealed that surgical time and complication rate has been reduced when using the Group I technique compared to the other groups. CONCLUSION The use of the monocortical external oblique miniplate provides the best results. Successful treatment of mandibular fractures depends on stability in the ideal anatomical position since abnormal mobility at the fracture site will lead to non-union, malocclusion, and infection.
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Subramaniyan D, Sathyanarayanan R, Suresh V, Subramaniyan M, Venugopalan, Guna T. A comparative study evaluating the efficacy of 2.0-mm mini locking plate and 2.0-mm three-dimensional locking miniplates in mandibular angle fractures. FORMOSAN JOURNAL OF SURGERY 2021. [DOI: 10.4103/fjs.fjs_36_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Scott C, Ramakrishnan K, Vivek N, Saravanan C, Prashanthi G. Does Three-Dimensional Plate Offer Better Outcome and Reduce the Surgical Time Following Open Reduction and Internal Fixation of Adult Mandibular Unilateral Subcondylar Fractures. A Randomized Clinical Study. J Oral Maxillofac Surg 2020; 79:1330.e1-1330.e12. [PMID: 33524326 DOI: 10.1016/j.joms.2020.12.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/13/2020] [Accepted: 12/14/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE The management of the condyle fractures continue to be a source of perineal controversy in the field of oral and maxillofacial trauma. The aim of this study was to compare the surgical feasibility, functional outcome, and stability of fixation between the conventional miniplate and 3-dimensional plate in the management of adult mandibular unilateral subcondylar fractures. MATERIALS AND METHODS A prospective randomized clinical study with well-structured inclusion and exclusion criteria was carried out. Patients were allocated into Group A (Miniplates) and Group B (3-D Plates). The primary outcome variables were time taken for fixation, maximum mouth opening, occlusal stability, increase in angulation, and increase in the gap between fractured segments in the radiograph. The secondary outcome variables were needed for intermaxillary fixation (IMF) with guiding elastics and jaw movements. Statistical analysis was done using χ2 test and student's t test with P value less than 0.05 indicating statistical significance. RESULTS Forty-four patients (40 male and 4 female) were enrolled, with 22 patients in each group. Time taken for fixation using 3-D plates was significantly lower than conventional miniplates (9.6 ± 0.9 minutes with P value 0.001). Although clinical parameters showed improved results for Group B, there was no statistical significance. Radiological parameters ie increase in angulation, and increase in the gap, showed statistically significant results. Group A had significant increases in the angulation of the fractured condyle at the end of the third and sixth months with a P value of 0.008 and 0.0001, respectively. The gap between the fractured segments was significantly increased in Group A at the end of the first and third months, with a P value of 0.022 and 0.003, respectively. CONCLUSIONS Our results concluded that 3-D plate offers superior fracture fragment stability and less displacement of the fractured segments. It has an added advantage of the ease of adaptation and shorter operating time.
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Affiliation(s)
- Cynthia Scott
- Assistant Professor, Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Potheri, Kattankulathur, Chengalpattu District, Tamil Nadu, India.
| | - Karthik Ramakrishnan
- Associate Professor, Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Potheri, Kattankulathur, Chengalpattu District, Tamil Nadu, India
| | - Narayanan Vivek
- Professor, Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Potheri, Kattankulathur, Chengalpattu District, Tamil Nadu, India
| | - Chandran Saravanan
- Professor, Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Potheri, Kattankulathur, Chengalpattu District, Tamil Nadu, India
| | - Gurram Prashanthi
- Associate Professor, Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Potheri, Kattankulathur, Chengalpattu District, Tamil Nadu, India
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Virgilio F, Bourbos A, Cinti F, Pisani G. Right mandibular angle and left comminuted mandibular body fractures stabilised with a combination of an acetabular plate and secured pin intermandibular ventral epoxy resin (SPIVER) frame in a four‐month‐old puppy. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2020-001131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Alexandros Bourbos
- SurgeryClinica Veterinaria Pisani Carli ChiodoLuni MareOrtonovoItaly
- SurgeryClinica Veterinaria VezzoniCremonaCremonaItaly
| | - Filippo Cinti
- SurgeryClinica Veterinaria Pisani Carli ChiodoLuni MareOrtonovoItaly
- SurgeryEastcott referralsSwindonUnited Kingdom
| | - Guido Pisani
- SurgeryClinica Veterinaria Pisani Carli ChiodoLuni MareOrtonovoItaly
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Transbuccal Approach in Management of Mandible Angle Fracture. Indian J Otolaryngol Head Neck Surg 2020; 72:457-462. [PMID: 33088775 DOI: 10.1007/s12070-020-01904-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/08/2020] [Indexed: 10/24/2022] Open
Abstract
With expanding dimensions and an eminent member of trauma team many Ear Nose Throat specialists are exposed to Oro-maxillofacial trauma. Mandibular angle is a difficult region to operate owing to its unique anatomy. Anglefractures form around 30-40% of the mandibular fracture. Open reduction and internal plating is the management of choice in most angle fractures and various approaches have been described in literature. We conducted a study of trans-buccal approach for management of mandibular angle fractures. It was a non-randomised observational study. 57 patients of mandible angle fractures were included in the study. The ORIF was done in these pts under general anaesthesia after careful surgical planning using trans-buccal approach. This approach included an intraoral exposure with stab incision for the trans-buccal passage of drill and screw diver. Out of 57 cases in our study 33 were males and 24 were females. 23/57 patients were in age group 25-35 years whereas 19/57 patients were in age group 15-25 years All 57 patients had good fracture healing. Occlusion dysfunction was seen in only 1 case. Infection was seen 3 cases while intraoral exposure of plates occurred in 2 cases. Average mouth opening was 43.3 mm at 6 weeks with progressive improvement on follow up. Extraoral scar healed well with very good cosmesis in all cases. We strongly suggest the use of transbuccal approach for ORIF in mandibular angle fractures owing to the ease of procedure, comfort of surgeon and less complication rate.
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Patussi C, Sassi LM, Cruz R, Klein Parise G, Costa D, Rebellato NLB. Evaluation of different stable internal fixation in unfavorable mandible fractures under finite element analysis. Oral Maxillofac Surg 2019; 23:317-324. [PMID: 31240571 DOI: 10.1007/s10006-019-00774-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 05/02/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The mandibular angle fracture is the most common fracture between this type of injury in jaw bone and also is the type of fracture treatment that presents a larger number of complications, and a series different osteosynthesis types have been studied over the years by the world literature. The finite element method is a form of mathematical analysis, which is based on dividing a structure into a finite number of small areas. It has the ability tomathematically model structures, making it possible to apply forces anywhere. MATERIAL AND METHODS For this study, a three-dimensional mandible with an unfavorable angle fracture was simulated. Five different types of fixations were evaluated: group 1, Champy technique with one 4-holes miniplate, 2.0 system; group 2, technique with two parallel 4-holes conventional miniplates, 2.0 system; group 3, technique with two parallel 4-holes locking miniplates, 2.0 system; group 4, technique with one reconstruction 6-holes plate, 2.8 system in base jaw; and group 5, technique with one reconstruction 6-holes plates, 2.8 system in jaw body + one parallel 4-holes conventional miniplate, 2.0 system. RESULTS The results showed that strains are better distributed through the locking miniplate and screws system and presented less stress concentration when compared with the conventional ones. The Champy technique had the worst results about of all groups. The use of the locking system shows less stress compared to the non-locking system, and the presence of a reconstruction plate associated with a mini plate does not lead to increased stability compared with an isolated reconstruction plate.
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Affiliation(s)
- Cleverson Patussi
- Cirurgia Bucomaxilofacial, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
| | - Laurindo Moacir Sassi
- Oral Maxillofacial Surgery, Erasto Gaertner Hospital, Rua Dr. Ovande do Amaral, 201 Jardim das Américas, Curitiba, PR, Brazil
| | - Rafael Cruz
- Cirurgia Bucomaxilofacial, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Guilherme Klein Parise
- Oral Maxillofacial Surgery, Erasto Gaertner Hospital, Rua Dr. Ovande do Amaral, 201 Jardim das Américas, Curitiba, PR, Brazil
| | - Delson Costa
- Cirurgia Bucomaxilofacial, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
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Wusiman P, Abasi K, Maimaitishawuti D, Moming A. Management of Mandibular Angle Fractures Using One Miniplate or Two Miniplate Fixation System: A Systematic Review and Meta-Analysis. J Oral Maxillofac Surg 2019; 77:1673.e1-1673.e11. [DOI: 10.1016/j.joms.2019.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 04/08/2019] [Accepted: 04/08/2019] [Indexed: 11/26/2022]
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Bohluli B, Mohammadi E, Oskui IZ, Moaramnejad N. Treatment of mandibular angle fracture: Revision of the basic principles. Chin J Traumatol 2019; 22:117-119. [PMID: 31003853 PMCID: PMC6488520 DOI: 10.1016/j.cjtee.2019.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 11/15/2018] [Accepted: 11/30/2018] [Indexed: 02/04/2023] Open
Abstract
Biodynamics of mandibular angle fractures has been extensively discussed in the literature in search for the best way to fixate and expedite recovery of trauma patients. Pioneers like Michelet and Champy had the greatest impact on evolving of osteosynthesis in maxillofacial traumatology; they introduced their basic principles frequently used to describe the biomechanics of mandibular fixation. Their concept states when a physiologic load is applied on mandibular teeth a negative tension will be created at superior border and a positive pressure will appear at inferior border. These simple definitions are the basis for the advent of fixation modalities in mandibular angle fracture. This article sought to reassess these principals based on load location via finite elements method.
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Affiliation(s)
- Behnam Bohluli
- Department of Oral and Maxillofacial Surgery, University of Toronto, Canada
| | - Ebrahim Mohammadi
- Department of Oral and Maxillofacial Surgery, Babol University of Medical Science, Babol, Iran
| | - Iman zoljanah Oskui
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Nima Moaramnejad
- Department of Oral and Maxillofacial Surgery, Aydin University, Istanbul, Turkey,Corresponding author.
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Mishra N, Thakkar N, Kar I, Baig SA, Sharma G, Kar R, Sahu GR, Birmiwal KG. 3-D Miniplates Versus Conventional Miniplates in Treatment of Mandible Fractures. J Maxillofac Oral Surg 2019; 18:65-72. [PMID: 30728695 PMCID: PMC6328813 DOI: 10.1007/s12663-017-1068-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022] Open
Abstract
AIM To study whether the use of 3-D miniplate, when compared with conventional miniplate, gives better clinical outcomes with fewer complications in patients with fracture mandible. MATERIALS AND METHODS A prospective study was conducted in the Department of Oral and Maxillofacial Surgery, Trauma Care Centre, on 40 patients. They were randomly divided into Group-I and Group-II with 20 patients in each group. In Group-I, 3-D miniplate was used and in Group-II, conventional miniplate was used. Parameters such as fracture stability, occlusal status, mouth opening, nerve paresthesia, infection, pain, swelling, and complications were evaluated on 1st, 7th postoperative day, 1st month and 3rd month. RESULTS Fracture stability and occlusion were clinically better in Group-I than in Group-II on each follow-up; however, it was not statistically significant. Infection rate was lesser in Group-I than in Group-II (p = 0.003). Mouth opening was more in Group-II than in Group-I on immediate (p = 0.001) and 7th post-op day (p = 0.002). Overall complications were lesser in Group-I than in Group-II (p > 0.005). CONCLUSION There is no major difference observed in clinical outcomes between 3-D miniplate and conventional miniplate. Either method of fixation can be used successfully in treatment of mandible fractures with comparable rates of complications.
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Affiliation(s)
- Niranjan Mishra
- Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha India
| | - Nirav Thakkar
- Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha India
| | - Indubhusan Kar
- Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha India
| | - Shadab Ali Baig
- Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha India
| | - Gaurav Sharma
- Department of Public Health Dentistry, SCB Dental College and Hospital, Cuttack, Odisha India
| | - Rosalin Kar
- Department of Prosthetic Dentistry, SCB Dental College and Hospital, Cuttack, Odisha India
| | - Gyana Ranjan Sahu
- Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha India
| | - Krishna Gopal Birmiwal
- Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha India
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Balasundram S, Kovilpillai FJ, Royan SJ, Ma BC, Gunarajah DR, Adnan TH. A 4-Year Multicentre Audit of Complications Following ORIF Treatment of Mandibular Fractures. J Maxillofac Oral Surg 2019; 19:289-297. [PMID: 32346242 DOI: 10.1007/s12663-019-01204-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 02/15/2019] [Indexed: 11/28/2022] Open
Abstract
Purpose To ascertain the complications arising from open reduction and internal fixation of mandibular fractures and to elucidate if different osteosynthesis plating systems vary in treatment outcome. Materials and Methods This is a retrospective study. Parameters such as patient data, injury details, osteosynthesis implant system information, stability of fracture fragments, occlusion and complications were evaluated at different time intervals and logistic regression applied to determine the association of these factors with complications. Results Five hundred and ninety-three patients with mandibular fractures were included in this study (male 87.9% and female 12.1%), age range of 13-72 years (median = 22 years). Most fractures were caused by motor vehicle accidents (85.8%), assault (6.2%) and falls (4.7%). Parasymphyseal fractures were the most common (50.1%), followed by angle (35.2%) and body of mandible (25%). Median time interval between injury and intervention was 7 days (IQR 4-10). Median duration of follow-up from date of surgery was 72 days (IQR 30-230). 76.9% (456) were completely free of complications. Most complications (46%) occurred in the intermediate post-surgical period (1-6 weeks). Median interval period between surgery and complication was 15 days (IQR 7-67.5). Nerve injury and surgical site infection were the most common complications at 6.7% and 5.7%, respectively. There was a significant difference between the plating system in terms of complication outcome (p = 0.017). Conclusion Whilst the miniplate dimensions may be similar across different manufacturers, the complication outcome may differ between systems.
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Affiliation(s)
- Sathesh Balasundram
- Department of Oral and Maxillofacial Surgery, Sultanah Nora Ismail Batu Pahat Hospital, Ministry of Health Malaysia (Johor), Jalan Korma, Taman Soga, 83000 Batu Pahat, Johor Malaysia
| | - Ferdinand J Kovilpillai
- 2Department of Oral and Maxillofacial Surgery, Taiping Hospital, Ministry of Health Malaysia (Perak), Taiping, Malaysia
| | - Stephen J Royan
- Department of Oral and Maxillofacial Surgery, Malacca Hospital, Ministry of Health Malaysia (Malacca), Malacca, Malaysia
| | - Bee Chai Ma
- 4Department of Oral and Maxillofacial Surgery, Sultanah Aminah Hospital, Ministry of Health Malaysia (Johor), Johor Bahru, Malaysia
| | - Dharmindra Rajah Gunarajah
- Department of Oral and Maxillofacial Surgery, Malacca Hospital, Ministry of Health Malaysia (Malacca), Malacca, Malaysia
| | - Tassha Hilda Adnan
- 5Clinical Research Centre, Kuala Lumpur Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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Dhara V, Kamath AT, Vineetha R. The influence of the mandibular gonial angle on the occurrence of mandibular angle fracture. Dent Traumatol 2019; 35:188-193. [PMID: 30793485 DOI: 10.1111/edt.12468] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/18/2019] [Accepted: 02/19/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIMS Angle fractures represent the largest percentage of mandibular fractures. They pose as a unique entity because of their codependent morphological dynamic factors, rendering the understanding of the mechanism, and treatment challenging. The aim of this study was to analyze the association between the mandibular gonial angle and the risk of mandibular angle fracture while highlighting its clinical relevance. MATERIALS AND METHODS A retrospective analysis of radiographs of patients treated for mandibular fractures was done. The factors studied were as follows: the presence of a high gonial angle and an impacted third molar. The outcome was mandibular angle fracture. The gonial angle was measured using Planmeca Digital Software 3.7.0.R. Status of the third molar was also noted. Data obtained were analyzed using SPSS 22 (IBM Corp, Armonk, NY). RESULTS The sample comprised 70 mandibular fractures (32 angle fractures and 38 non-angle fractures). The mean gonial angle in the angle fracture group was 128.5 ± 5.4º which was 10.2° larger than in the non-angle group (mean 118.5 ± 4.4º; P = 0.0001). Patients with a high gonial angle were 8.7 times more likely to sustain an angle fracture than those with normal or low gonial angles. A statistically significant relationship between the presence of impacted third molar and patients sustaining mandibular angle fractures was noted (P = 0.0001). CONCLUSION Subjects with a high gonial angle and an impacted third molar are at an increased risk for mandibular angle fracture due to direct and indirect morphological factors.
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Affiliation(s)
- Vasantha Dhara
- Department of Oral & Maxillofacial Surgery, Manipal College Of Dental Sciences, Manipal Academy Of Higher Education, Manipal, Karnataka, India
| | - Abhay T Kamath
- Department of Oral & Maxillofacial Surgery, Manipal College Of Dental Sciences, Manipal Academy Of Higher Education, Manipal, Karnataka, India
| | - Ravindranath Vineetha
- Department of Oral Medicine & Radiology, Manipal College Of Dental Sciences, Manipal Academy Of Higher Education, Manipal, Karnataka, India
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Ben Said M, Yildirimturk S, Sirin Y. The effect of the mandibular plane angle on fracture line stability: An ex vivo experimental study. Dent Traumatol 2019; 35:181-187. [PMID: 30714306 DOI: 10.1111/edt.12465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/25/2019] [Accepted: 01/25/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIMS Mandibular angle fractures fixated with plate osteosynthesis techniques have to withstand the effects of muscle attachments. Individual variations in the craniofacial morphology may alter the biomechanical resistance of the bone-plate construct. The aim of the present study was to determine the influence of variations in the mandibular plane angle (MPa) on the biomechanical stability of sheep mandibular angle fractures (MAFs). MATERIALS AND METHODS Sixty sheep hemi-mandibles were used. The mandibles were positioned on a test jig that simulated low (15°, group L), normal (25°, group N), and high (35°, group H) MPa. Unfavorable MAFs were created with thin diamond cutting disks. One four-hole, 9.0-mm-spacing, standard titanium miniplate of 2.0 mm thickness and 5.0-mm-long screws were inserted at the superior border of the alveolar bone in monoplanar orientation. Specimens were then subjected to vertical loads between 10 N and 150 N in a universal testing machine. The displacement values at each 10 N force increment and the load magnitude at which 3.0 mm displacement limit was reached were recorded. RESULTS Starting from 40 N, the displacement values at each 10 N increment in the H group were significantly higher than those of the L and N groups until 150 N (P < 0.05). The force magnitude required to reach 3.0 mm of displacement in the H group was significantly lower than that for the L and N groups (P < 0.05 for each). CONCLUSIONS The one-miniplate monoplanar fixation technique used in sheep MAF with high MPa is more likely to offer lower biomechanical resistance to the vertical forces applied over the molar region than do the normal and low MPa.
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Affiliation(s)
- Muhammed Ben Said
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Senem Yildirimturk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Yigit Sirin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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Three-dimensional versus standard miniplate, lag screws versus miniplates, locking plate versus non-locking miniplates: Management of mandibular fractures, a systematic review and meta-analysis. J Dent Sci 2019; 14:66-80. [PMID: 30988882 PMCID: PMC6445977 DOI: 10.1016/j.jds.2018.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 03/31/2018] [Indexed: 11/27/2022] Open
Abstract
Background/purpose The aims of the present study were to 1) evaluate the clinical outcomes between different fixation methods in the management of mandibular fractures (MFs) and 2) determine which fixation method is the best option for the treatment of mandibular fractures. Materials and methods A systematic review was conducted according to PRISMA guidelines, examining Medline-Ovid, Embase, and Pubmed databases. Inclusion criteria were studied in humans, including randomized controlled trials, controlled clinical trials, and retrospective studies, with the aim of comparing the two techniques. In addition, the incidence of complications was evaluated. Results Thirty-two publications were included: 20 randomized controlled trials, 4 controlled clinical trials, and 8 retrospective studies. There were statistically significant advantages for 3-dimensional miniplate and lag screws. There was no statistically significant difference between locking plates and standard miniplates (P = 0 0.2). The cumulative odds ratio was 0.64, meaning that the use of locking miniplate in the fixation of MFs decreases the risk for postoperative complications by 36% over the use of standard miniplates. Conclusion The results of the three-Dimensional Versus Standard miniplate showed that 3-dimensional miniplate is the best option for mandibular fractures. Regarding Lag Screws Versus Miniplates results of the meta-analysis found that the use of lag screws is superior to using miniplates in reducing the incidence of postoperative complications. And in regards to locking miniplates versus non-locking miniplate, the analysis indicates that the 2.0-mm locking miniplate is a prospective fixation system in the treatment of maxillofacial fractures.
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Mohd YQ, Reddy S, Sinha R, Agarwal A, Fatima U, Abidullah M. Three-Dimensional Miniplate: For the Management of Mandibular Parasymphysis Fractures. Ann Maxillofac Surg 2019; 9:333-339. [PMID: 31909011 PMCID: PMC6933987 DOI: 10.4103/ams.ams_172_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Recently, oral and maxillofacial surgeons are favoring three-dimensional (3D) miniplates to treat mandibular fractures. Aims The aim of the study is to evaluate the efficacy of 3D-miniplates over standard miniplates in the management of mandibular parasymphysis fracture. Materials and Methods Forty patients with mandibular parasymphysis fractures were divided into two groups of 20 patients each. Group I patients underwent osteosynthesis of mandibular fracture by noncompression, unicortical, and stainless steel 3D miniplates, and Group II patients underwent osteosynthesis by noncompression, unicortical, and stainless steel Champy's miniplates. All the patients were followed up 6 months' postoperatively, evaluating occlusion, mobility of fracture segment, pain, wound dehiscence, neurological deficit, and infection. Statistical Analysis Used The data were analyzed by SPSS for windows (version 17) statistical package (SPSS Inc., Chicago, IL, USA). Chi-square test was carried out to determine the statistical difference between the groups. Results Mobility of the fractured site was evaluated postoperatively after 2 weeks, and it was found that mobility was absent in all the cases of Group I and 36 (80%) cases in Group II. There was significant difference in the mean visual analog scale scores among the Group I and II when compared from preoperative to 4-week follow-up. In Group II, two patients showed wound dehiscence. After 2 weeks, infection was seen in two patients of Group II. Conclusion 3D plates in mandibular parasymphysis fractures give dimensional stability and carry low morbidity and infection rates.
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Affiliation(s)
- Yousuf Qureshi Mohd
- Department of Oral and Maxillofacial Surgery, Malla Reddy Institute of Dental Sciences, Hyderabad, Telangana, India
| | - Sreenatha Reddy
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Hyderabad, Telangana, India
| | - Ramen Sinha
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Hyderabad, Telangana, India
| | - Anmol Agarwal
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences and Technologies, Modinagar, Uttar Pradesh, India
| | - Umayra Fatima
- Department of Dental, Princess Esra Hospital, Hyderabad, Telangana, India
| | - Mohammed Abidullah
- Departemnt of Oral Pathology, S. B. Patil Dental College, Bidar, Karnataka, India
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Ferrari R, Lanzer M, Wiedemeier D, Rücker M, Bredell M. Complication rate in mandibular angle fractures-one vs. two plates: a 12-year retrospective analysis. Oral Maxillofac Surg 2018; 22:435-441. [PMID: 30327980 DOI: 10.1007/s10006-018-0728-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 10/09/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE Treatment of mandibular angle fractures using one or two osteosynthesis plates is still a controversial topic. Fracture, treatment, and patient-dependent influencing factors could affect the overall outcome. In the present retrospective study, complication rates of mandibular angle fractures treated by open reduction were assessed according to type of treatment. MATERIALS AND METHODS We analyzed retrospective medical records using the search terms "mandibular angle fracture." We included all patients presenting with a mandibular angle fracture treated by open reduction and internal fixation at our department between 2002 and 2012. RESULTS We included 186 patients treated with open reduction and miniplate fixation (84 one plate; 102 two plates). The early complication rate was significantly higher for the double-plate group (72.5% vs. 47.6%, respectively; p = 0.001). Most common findings in the postoperative period were transient hypoesthesia and tissue swelling. In the two-plate group, a significantly increased operation time of 183 min versus 150 min in the one-plate group was found (p < 0.001). Late complications did not differ significantly between both groups (21.4% single-plate group; 30.4% two-plate fixation group; p = 0.32). CONCLUSION We found a significantly increased early complication rate in the two-plate group. Long-term complications did not differ between both groups.
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Affiliation(s)
- Raphael Ferrari
- Department of Craniomaxillofacial and Oral Surgery, University Hospital of Zurich, Zurich, Switzerland.
| | - M Lanzer
- Department of Craniomaxillofacial and Oral Surgery, University Hospital of Zurich, Zurich, Switzerland
| | - D Wiedemeier
- Statistical Services, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - M Rücker
- Department of Craniomaxillofacial and Oral Surgery, University Hospital of Zurich, Zurich, Switzerland
| | - M Bredell
- Cantonal Hospital Winterthur, Winterthur, Switzerland
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Comparison of Mechanical Stabilization of the Mandibular Angulus Fracture Fixation, With Titanium Plates and Screws, Resorbable Plates and Screws, and Bone Adhesives. J Craniofac Surg 2018; 29:1780-1787. [DOI: 10.1097/scs.0000000000004866] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Three-Dimensional Finite Element Analysis of Different Plating Techniques for Unfavorable Mandibular Angle Fractures. J Craniofac Surg 2018; 29:603-607. [PMID: 29419593 DOI: 10.1097/scs.0000000000004327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of the current study was to assess the biomechanical behavior of 5 different fixation schemes for unfavorable mandibular angle fractures using the three-dimensional finite element analysis method. Five different miniplate fixation schemes were modeled for the fixation of unfavorable mandibular angle fractures. A double parallel miniplate (M1), which was placed at the halfway point of the mandibular angle height; a 1/3 superior-positioned miniplate (M2); a single miniplate (M3), which was placed at the halfway point of the mandibular angle height (1/2 middle-positioned); a 1/3 inferior-positioned miniplate (M4); and an X-miniplate which was placed at the halfway point of the mandibular angle height (M5). The lowest mechanical stresses were detected in the double miniplate model when compared with the other schemes, whereas 1/3 inferior-positioned miniplate had the highest stress and displacement values. The authors suggest that the double miniplate is an adequate rigid fixation technique, whereas the 1/3 inferior-positioned miniplate configuration should not be used in case of unfavorable mandibular angle fracture.
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Budhraja NJ, Shenoi RS, Badjate SJ, Bang KO, Ingole PD, Kolte VS. Three-dimensional Locking Plate and Conventional Miniplates in the Treatment of Mandibular Anterior Fractures. Ann Maxillofac Surg 2018; 8:73-77. [PMID: 29963428 PMCID: PMC6018293 DOI: 10.4103/ams.ams_175_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context Three-dimensional (3D) locking plates has been designed with the hypothesis that this will overcome the disadvantages of both the systems and also advantages of both systems will be combined for the management of mandibular fractures. Aims The purpose of this study was to evaluate the efficacy of 2-mm 3D locking miniplate in the management of anterior mandibular fracture and to compare it with Champy's miniplate. Settings and Design A prospective, randomized, clinical trial was carried out in thirty patients who were divided equally in two groups. Subjects and Methods Group I and Group II patients were treated with 2-mm 3D locking plates and 2-mm standard miniplates, respectively. They were evaluated according to the outcomes of the study, that is, working time, wound dehiscence, infection, segmental mobility, postoperative occlusion, need for postoperative intermaxillary fixation (IMF), and radiological evaluation of reduction and fixation. Statistical Analysis Used Student's t-test and Mann-Whitney test were used to compare the two systems. The data were analyzed using Statistical Package for the Social Science version 14.0. The P value was taken as significant when <0.05 (confidence interval of 95% was taken). Results The mean duration of procedure for Group I was found to be 49.33 min, whereas for Group II was 59.67 min. There was significantly greater pain on day 1 and at 1 week in Group II patients. 6.7% (n = 1) of both groups showed incidence of infection. Postoperative stability was adequate in most cases except in one patient (n = 1) of 3D locking system, which was revealed as postoperative occlusal disharmony, unsatisfactory radiological reduction of the fracture fragments, and the segmental mobility. There was no incidence of wound dehiscence, tooth damage, and nerve damage in either group. Conclusions The result of the study can conclude that there is no major difference between both systems in terms of treatment outcome.
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Affiliation(s)
- Nilima J Budhraja
- Department of Oral and Maxillofacial Surgery, VSPM's Dental College and Research Center, Nagpur, Maharashtra, India
| | - Ramakrishna S Shenoi
- Department of Oral and Maxillofacial Surgery, VSPM's Dental College and Research Center, Nagpur, Maharashtra, India
| | - Samprati J Badjate
- Department of Oral and Maxillofacial Surgery, VSPM's Dental College and Research Center, Nagpur, Maharashtra, India
| | - Kshitij O Bang
- Department of Oral and Maxillofacial Surgery, VSPM's Dental College and Research Center, Nagpur, Maharashtra, India
| | - Pranav D Ingole
- Department of Oral and Maxillofacial Surgery, VSPM's Dental College and Research Center, Nagpur, Maharashtra, India
| | - Vrinda S Kolte
- Department of Oral and Maxillofacial Surgery, VSPM's Dental College and Research Center, Nagpur, Maharashtra, India
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Khiabani K, Keyhan SO, Razmdideh R, Chaleh Chaleh Z, Amirzade-Iranaq MH. Effect of different miniplate osteosynthesis in different mandibular angle fracture patterns on bite force: A 3D finite element analysis. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2018. [DOI: 10.1016/j.ajoms.2018.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Mondal S, Singh G, Mishra M, Gaur A, Srivastava A. Comparative Evaluation between Single Noncompression Miniplate and Two Noncompression Miniplates in the Treatment of Mandibular Angle Fractures. Craniomaxillofac Trauma Reconstr 2018; 12:122-127. [PMID: 31073361 DOI: 10.1055/s-0038-1629907] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 10/03/2017] [Indexed: 10/17/2022] Open
Abstract
This study was conducted to compare the outcome of single noncompression miniplate versus two noncompression miniplates in the treatment of mandibular angle fracture. A total of 40 patients were divided into two groups: Group I ( n = 20), patients were treated by single miniplate at superior border of mandible by intraoral approach; Group II ( n = 20), patients were treated by one miniplate at superior border of mandible, intraorally, and another at the lateral aspect of angle, transbuccally by trocar and cannula. Comparative evaluation was done at 1, 2, 4, 6, and 12 weeks and 6 months. The findings of this study suggest that there was no significant difference in postoperative complications (malocclusion, pain, swelling, infection, facial nerve injury, wound dehiscence, plate exposure) and bite force between the two groups.
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Affiliation(s)
- Shubhamoy Mondal
- Department of Oral and Maxillofacial Surgery, Sardar Patel Postgraduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Gaurav Singh
- Department of Oral and Maxillofacial Surgery, Sardar Patel Postgraduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Madan Mishra
- Department of Oral and Maxillofacial Surgery, Sardar Patel Postgraduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Amit Gaur
- Department of Oral and Maxillofacial Surgery, Sardar Patel Postgraduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Abhinav Srivastava
- Department of Oral and Maxillofacial Surgery, Sardar Patel Postgraduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
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Jain MK, Kerur P. Bite Force as a Parameter for Comparison Between Three-Dimensional and Standard Titanium Miniplates for the Management of Anterior Mandibular Fractures: A Prospective Randomized Double-Blinded Clinical Trial. J Maxillofac Oral Surg 2018; 18:249-255. [PMID: 30996547 DOI: 10.1007/s12663-018-1091-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 02/05/2018] [Indexed: 11/25/2022] Open
Abstract
Background and Objectives To compare the efficacy of three-dimensional (3D) miniplates with standard miniplates in the osteosynthesis of anterior mandibular fractures on the basis of bite force recordings and other clinical parameters. Methods A prospective randomized double-blinded clinical trial was carried out for the treatment of anterior mandibular fractures. In total, 20 patients were randomly divided into two groups of 2-mm 3D and standard titanium miniplates. The assessment of patients was done at weekly intervals for 6 weeks using bite force recordings and other clinical parameters. Results A statistically significant difference was found in the duration of surgery which was less in group A as compared to group B (p = 0.03). No significant difference was found in other clinical parameters. Interpretation and Conclusion The clinical outcome of both the 3D and standard miniplate systems in the present study was similar; however, the following advantages with the use of 3D miniplates can be highlighted:Relatively lesser operating time.Three-dimensional stability of the fracture site and simultaneous stabilization at superior and inferior borders in the fixation of mandibular fractures.
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Affiliation(s)
- Manoj Kumar Jain
- 1Department of Oral and Maxillofacial Surgery, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka 573201 India
- Nuface/Sumukha Clinic, Benaka Complex 1st Floor, Sankar Matt Road 5th Cross, KR Puram, Hassan, Karnataka 573201 India
| | - Priyadarshini Kerur
- Department of Oral and Maxillofacial Surgery, Inderprastha Dental College and Hospital, Sahibabad, Ghaziabad, Uttar Pradesh 201010 India
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Zimmermann C, Henningsen A, Henkel KO, Klatt J, Jürgens C, Seide K, Kienast B. Biomechanical comparison of a multidirectional locking plate and conventional plates for the osteosynthesis of mandibular angle fractures—A preliminary study. J Craniomaxillofac Surg 2017; 45:1913-1920. [DOI: 10.1016/j.jcms.2017.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 05/02/2017] [Accepted: 05/29/2017] [Indexed: 10/19/2022] Open
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García Carricondo AR, Quesada Bravo FJ, Espín Gálvez F, Parrón Carreño T, Alarcón Rodriguez R. A comparative study between traditional fixation with miniplates and modified lag screws for the treatment of mandibular fractures. Clin Oral Investig 2017; 22:1503-1511. [PMID: 29038962 DOI: 10.1007/s00784-017-2243-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/09/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The objective of this study is to investigate two internal fixation surgical techniques for mandibular fractures in order to compare modified lag screw techniques with standard miniplates. MATERIALS AND METHODS This is an observational prospective study. Three hundred eighteen patients were operated on for mandibular fractures. The patients were divided into two groups according to the type of surgical technique used: modified lag screws (155 patients) and traditional miniplates (163 patients). Analyses were made of sociodemographic and preoperative variables, the parameters related to the fracture type and postoperative data. RESULTS There were no differences between the two groups regarding their sociodemographic characteristics. The modified lag screws were primarily used with double fractures, while conventional miniplates were more often used with simple fractures. The number of complications was higher with the miniplate technique. The unfavorable fractures had an OR of 5.75 due to postoperative complications; double fractures had an OR of 8.87 and simple fractures an OR of 19.53, which, in both cases, were lower with conventional miniplates than with modified lag screws. CONCLUSION Modified lag screws provide a rigid fixation system that is as secure as miniplates, but with greater compression between the fragments, less postsurgical gap, faster ossification, and fewer postoperative complications. CLINICAL RELEVANCE The modified screw technique is a safe tool that does not require any specific osteosynthesis materials not found in a basic traumatology kit and has a lower cost, due to the reduced amount of material used.
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Affiliation(s)
- Ana Rocío García Carricondo
- Department of Oral and Maxillofacial Surgery, Torrecardenas Hospital Complex, Avd. Torrecardenas No. 80, 04009, Almeria, Spain.
| | - Francisco Javier Quesada Bravo
- Department of Oral and Maxillofacial Surgery, Torrecardenas Hospital Complex, Avd. Torrecardenas No. 80, 04009, Almeria, Spain
| | - Fernando Espín Gálvez
- Department of Oral and Maxillofacial Surgery, Torrecardenas Hospital Complex, Avd. Torrecardenas No. 80, 04009, Almeria, Spain
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Dougherty WM, Christophel JJ, Park SS. Evidence-Based Medicine in Facial Trauma. Facial Plast Surg Clin North Am 2017; 25:629-643. [PMID: 28941514 DOI: 10.1016/j.fsc.2017.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This article provides the reader with a comprehensive review of high-level evidence-based medicine in facial trauma and highlights areas devoid of high-level evidence. The article is organized in the order one might approach a clinical problem: starting with the workup, followed by treatment considerations, operative decisions, and postoperative treatments. Individual injuries are discussed within each section, with an overview of the available high-level clinical evidence. This article not only provides a quick reference for the facial traumatologist, but also allows the reader to identify areas that lack high-level evidence, perhaps motivating future endeavors.
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Affiliation(s)
- William M Dougherty
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Virginia, 1215 Lee Street, Charlottesville, VA 22903, USA
| | - John Jared Christophel
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Virginia, 1215 Lee Street, Charlottesville, VA 22903, USA
| | - Stephen S Park
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Virginia, 1215 Lee Street, Charlottesville, VA 22903, USA.
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Dreizin D, Nam AJ, Tirada N, Levin MD, Stein DM, Bodanapally UK, Mirvis SE, Munera F. Multidetector CT of Mandibular Fractures, Reductions, and Complications: A Clinically Relevant Primer for the Radiologist. Radiographics 2017; 36:1539-64. [PMID: 27618328 DOI: 10.1148/rg.2016150218] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
After the nasal bones, the mandible is the second most common site of facial fractures, and mandibular fractures frequently require open reduction. In the trauma injury setting, multidetector computed tomography (CT) has become the cornerstone imaging modality for determining the most appropriate treatment management, fixation method, and surgical approach. Multidetector CT is also used to assess the adequacy of the reduction and evaluate potential complications in the postoperative period. For successful restoration of the mandible's form and function, as well as management of posttraumatic and postoperative complications, reconstructive surgeons are required to have a detailed understanding of mandibular biomechanics, occlusion, and anatomy. To provide added value in the diagnosis, treatment planning, and follow-up of mandibular fractures, radiologists should be aware of these concepts. Knowledge of the techniques commonly used to achieve occlusal and anatomic reduction and of the rationale behind the range of available treatment options for different injury patterns-from isolated and nondisplaced fractures to multisite and comminuted fractures-also is essential. This article focuses on the use of multidetector CT for pre- and postoperative evaluation of mandibular fractures and outlines fundamental concepts of diagnosis and management-beginning with an explanation of common fracture patterns and their biomechanical underpinnings, and followed by a review of the common postoperative appearances of these fractures after semirigid and rigid fixation procedures. Specific considerations regarding fractures in different regions of the tooth-bearing and non-tooth-bearing mandible and the unique issues pertaining to the edentulous atrophic mandible are reviewed, and key features that distinguish major from minor complications are described. (©)RSNA, 2016.
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Affiliation(s)
- David Dreizin
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
| | - Arthur J Nam
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
| | - Nikki Tirada
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
| | - Martin D Levin
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
| | - Deborah M Stein
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
| | - Uttam K Bodanapally
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
| | - Stuart E Mirvis
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
| | - Felipe Munera
- From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B., S.E.M.), Division of Plastic Surgery (A.J.N.), and Department of Surgery (D.M.S.), University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, The George Washington Hospital, Washington, DC (N.T.); School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa (M.D.L.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine and Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
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Silajiding K, Wusiman P, Yusufu B, Moming A. Three dimensional versus standard miniplate fixation in the management of mandibular fractures: A meta-analysis of randomized controlled trials. Kaohsiung J Med Sci 2017; 33:464-472. [PMID: 28865605 DOI: 10.1016/j.kjms.2017.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 03/07/2017] [Accepted: 03/21/2017] [Indexed: 11/28/2022] Open
Abstract
The aim of this meta-analysis is to evaluate the efficacy of the 3-dimensional miniplate system in comparison with the standard miniplate system for the treatment of mandibular fractures (MFs). A systematic review was conducted according to PRISMA guidelines, examining Medline-Ovid, Embase, and PubMed databases. The primary search objective was to identify all papers reporting the results of randomized control trials (RCTs) for the treatment of adults with mandibular fractures, with the aim of comparing the different techniques. The incidence of complications was evaluated; nine studies including 283 patients with different fracture sites were enrolled in the analysis. The results showed no significant differences in overall complications (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.552-1.542; P = 0.81), postoperative infections (OR, 0.99; 95% CI, 0.40-2.48; P = 0.89), wound dehiscence (OR, 0.96; 95% CI, 0.13-7.37; P = 0.96), paresthesia (OR, 0.47; 95% CI, 0.20-1.07; P = 0.11), or malocclusion (OR, 1.8; 95% CI, 0.39-8.32; P = 0.47) between standard miniplates and 3-dimensional miniplates for treating mandibular fractures. Mandibular fractures treated with 3-dimensional miniplates and standard miniplates presented similar short-term complication rates, and the low postoperative maxillomandibular fixation rate of using standard miniplates also indicated that the standard miniplate has a promising application in the treatment of mandibular fractures.
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Affiliation(s)
- Kubila Silajiding
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China; Stomatological Research Institute of Xinjiang Uyghur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Patiguli Wusiman
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China; Stomatological Research Institute of Xinjiang Uyghur Autonomous Region, Urumqi, Xinjiang, People's Republic of China
| | - Bilikezi Yusufu
- Department of Oral and Maxillofacial Surgery, The First People's Hospital in Kashgar Region, Kashgar, Xinjiang, People's Republic of China
| | - Adili Moming
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China; Stomatological Research Institute of Xinjiang Uyghur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.
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Lee JH. Treatment of Mandibular Angle Fractures. Arch Craniofac Surg 2017; 18:73-75. [PMID: 28913310 PMCID: PMC5556899 DOI: 10.7181/acfs.2017.18.2.73] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 04/13/2017] [Accepted: 04/16/2017] [Indexed: 11/11/2022] Open
Abstract
The management of mandibular angle fractures is often challenging and results in the highest complication rate among fractures of the mandible. In addition, the optimal treatment modality for angle fractures remains controversial. Traditional treatment protocols for angle fractures have involved rigid fixation with intraoperative maxillomandibular fixation (MMF) to ensure absolute stability. However, more recently, non-compression miniplates have gained in popularity and the use of absolute intraoperative MMF as an adjunct to internal fixation has become controversial. In this article, the history of, and current trends in, the treatment of mandibular angle fractures will be briefly reviewed. In addition, issues regarding the management of the third molar tooth will be discussed.
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Affiliation(s)
- Jung-Ho Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Simple Percutaneous Transbuccal Approach for Management of Mandibular Angular Fracture. J Craniofac Surg 2017; 28:1035-1037. [DOI: 10.1097/scs.0000000000003539] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Osteosynthesis using cannulated headless Herbert screws in mandibular angle fracture treatment: A new approach? J Craniomaxillofac Surg 2017; 45:526-539. [PMID: 28256384 DOI: 10.1016/j.jcms.2017.01.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 12/18/2016] [Accepted: 01/20/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Fractures of the mandibular angle are a common type of facial skull fracture. Although operative treatment includes a wide range of fixation techniques, a definite gold standard method has yet to be established. Headless, cannulated Herbert screws, often used in many forms of minimally invasive trauma surgery, provide functional and stable fracture fixation. MATERIALS AND METHODS In a prospective, double-randomised, controlled, parallel-group - designed, in vitro trial, the biomechanical behaviour of the Herbert bone screw system was compared to that of a conventional locking plate system in 40 mandibular angle fractures of human mandible cadaver phantoms. RESULTS The mean stress values were 250 (±68.0) N in the plate subgroup and 200 (±61.0) N in the screw subgroup. The respective mean strain values were 7.90 (±2.7) mm and 6.90 (±2.2) mm, and the respective mean stiffness were values 1.10 (±0.61) N/m and 0.78 (±0.40) N/m. The differences in the results obtained using the two treatments were not significant (p = 0.55). CONCLUSIONS The biomechanical behaviour of the two fixation systems within the tested loads did not significantly differ with respect to postoperative parameters clinically relevant in osteosynthesis. Both systems met the mandibular angle assessment criterion, which is considered to be sufficient for clinical use. The results indicate the potential clinical utility of these two systems, and recommend further testing.
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Liu Y, Wei B, Li Y, Gu D, Yin G, Wang B, Xu D, Zhang X, Kong D. The 3-dimensional miniplate is more effective than the standard miniplate for the management of mandibular fractures: a meta-analysis. Eur J Med Res 2017; 22:5. [PMID: 28196543 PMCID: PMC5322783 DOI: 10.1186/s40001-017-0244-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 02/02/2017] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The study aimed to determine the superiority between 3-dimensional (3D) miniplate and standard miniplate for mandibular fractures (MFs) treatment. BACKGROUND Controversial results on the use of standard miniplate and 3D miniplate have remained for management of MFs. METHODS Several electronic databases were retrieved up to September 2014 to identify eligible studies. The quality of studies was assessed, and the relative risk (RR) with its corresponding 95% confidence interval (CI) was assessed to measure the effect size. Subgroup analyses by different fracture regions and different 3D miniplate sizes were performed. Publication bias was measured by a funnel plot. RESULTS There were 13 studies included for the meta-analysis, consisting of 593 participants. The 3D miniplate achieved significant lower incidences of malocclusion (RR 0.43, 95% CI 0.24-0.77, P = 0.004) and hardware failure (RR 0.31, 95% CI 0.13-0.74, P = 0.008) than the standard miniplate. There were no significant differences between the two miniplates on the incidence of the remaining outcomes: wound dehiscence, infection, paresthesia, and nonunion/malunion. Subgroup analyses indicated that 3D miniplate caused a lower hardware failure than standard with the size of 8 or 10 holes (RR 0.23, 95% CI 0.08-0.66, P = 0.006). Besides, publication bias was not detected. CONCLUSION The 3D miniplate is superior to the standard miniplate on the reduction of postoperative complication rates for the management of MFs. More holes in the 3D miniplate might contribute to a successful treatment.
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Affiliation(s)
- Yong Liu
- Departments of Orthopaedics, Jilin Oilfield General Hospital, Songyuan, 131200, China
| | - Bo Wei
- Departments of Neurosurgery, China-Japan Union Hospital of Jilin University, Changchun, 130033, Jilin, China
| | - Yuxiang Li
- Departments of Orthopaedics, Jilin Oilfield General Hospital, Songyuan, 131200, China
| | - Dawei Gu
- Departments of Orthopaedics, Jilin Oilfield General Hospital, Songyuan, 131200, China
| | - Guochao Yin
- Departments of Orthopaedics, Jilin Oilfield General Hospital, Songyuan, 131200, China
| | - Bo Wang
- Departments of Orthopaedics, Jilin Oilfield General Hospital, Songyuan, 131200, China
| | - Dehui Xu
- Departments of Orthopaedics, Jilin Oilfield General Hospital, Songyuan, 131200, China
| | - Xuebing Zhang
- Departments of Orthopaedics, Jilin Oilfield General Hospital, Songyuan, 131200, China
| | - Daliang Kong
- Departments of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, 130033, Jilin, China.
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Yadav S, Mittal HC, Dhupar V, Akkara F, Sachdeva A. Transoral approach alone in single miniplate osteosynthesis of angle fracture - our experience. Natl J Maxillofac Surg 2017; 7:71-75. [PMID: 28163483 PMCID: PMC5242079 DOI: 10.4103/0975-5950.196136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Aim: The aim of this study was to determine the outcome of transoral approach alone to treat the mandibular angle fracture using single 2.0 mm miniplate. Materials and Methods: In this study, 28 patients were included and treated with 2.0 mm single miniplate osteosynthesis at upper border along Champy's line of osteosynthesis using transoral approach alone. Results: All the cases were treated successfully with 2.0 mm single miniplate with common complications such as infection (two cases) and plate exposure (one case) in a total of two cases. Conclusion: Use of single miniplates by transoral approach alone for superior border osteosynthesis is effective and simple approach without need of extra armamentarium.
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Affiliation(s)
- Sunil Yadav
- Department of Dentistry, BPS Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India
| | - Hitesh Chander Mittal
- Department of Dentistry, BPS Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India
| | - Vikas Dhupar
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Francis Akkara
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Akash Sachdeva
- Department of Oral and Maxillofacial Surgery, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
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A New Method of Fixation With the Yang's Keyhole Plate System for the Treatment of Mandible Fractures. J Craniofac Surg 2016; 28:508-512. [PMID: 28027189 DOI: 10.1097/scs.0000000000003312] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study was designed to assess the clinical outcomes and surgical convenience of a newly designed Yang's Keyhole plate (YK plate) system for treatment of subcondyle and angle fractures of the mandible. To evaluate the system's clinical outcomes and surgical convenience, chart review and surgical simulation using a mandible replica model were performed. METHODS The YK plate system, which is a slightly modified sliding plate, has 0.8-mm thick titanium and a widened hole in the anterior region to permit a screw head to be inserted. The clinical results and clinical convenience of the newly developed YK plate system and the existing 4-hole miniplate fixation technique were compared using a surgical simulation. Moreover, the clinical results of the patients who underwent mandibular surgery were compared during the follow-up examination periods (ie, weeks 1, 2, 4, 8, and 16). RESULTS No critical complications in any of the 22 patients were reported during the 4-month follow-up period. The results of the assessment of clinical convenience using the surgical simulation showed that using the YK plate system was more convenient and saved time compared to using the 4-hole miniplate. CONCLUSION The newly developed YK plate system can be applied to subcondyle and angle fractures of the mandible and can provide reliable and convenient application and use.
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Yamaji MAK, Oliveira Neto PJD, Ribeiro MDC, Pereira LC, Morais MD, Sverzut CE, Trivellato AE. Evaluation of in vitro resistance of different 2.0-mm titanium plates on the mandibular angle sectioning. Oral Maxillofac Surg 2016; 19:65-70. [PMID: 25015878 DOI: 10.1007/s10006-014-0456-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 07/01/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to compare, by mechanical in vitro testing, a regular 5-hole plate and a long 4-hole plate with a regular 4-hole plate, applied to stabilize a simulated mandibular angle fracture. STUDY DESIGN The plates from the 2.0-mm titanium-based system were adapted and stabilized passively in the same site in both groups using four screws, 6 mm long. During the resistance-to-load test, the force was applied perpendicular to the occlusal plane at three different points: first molar at the plated side, first molar at the contralateral side, and between the central incisors. RESULTS The regular 5-hole plates and longer 4-hole plates were superior to the regular 4-hole plates. Furthermore, no statistically significant difference was found between the regular 5-hole plates and long 4-hole plate. CONCLUSIONS The length and shape of plates did not interfere with the effectiveness to stabilize the fragments. OBJECTIVE The purpose of this study was to compare, by mechanical in vitro testing, a regular 5-hole plate and a long 4-hole plate with a regular 4-hole plate, applied to stabilize a simulated mandibular angle fracture.Study design The plates from the 2.0-mm titanium-based system were adapted and stabilized passively in the same site in both groups using four screws, 6 mm long. During the resistance-to-load test, the force was applied perpendicular to the occlusal plane at three different points: first molar at the plated side, first molar at the contralateral side, and between the central incisors. RESULTS The regular 5-hole plates and longer 4-hole plates were superior to the regular 4-hole plates. Furthermore, no statistically significant difference was found between the regular 5-hole plates and long 4-hole plate.Conclusions The length and shape of plates did not interfere with the effectiveness to stabilize the fragments.
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