Comparison of Bite Force with Locking Plates versus Non-Locking Plates in the Treatment of Mandibular Fractures: A Meta-Analysis

Is "Bite force" a reliable parameter to compare masticatory efficiency restoration following ORIF of anterior mandibular fractures?

Objectives

Mandible is an integral part of masticatory system, and it is expected that it's fracture will have a significant impact on occlusal forces, range of motion, muscle activity levels, and occlusion. The main objective of this study was to compare the efficacy of 3-dimensional (3D) miniplate and conventional miniplates for fixation of anterior mandibular fractures on the basis of bite force as a main parameter.

Methods

66 patients having isolated anterior mandibular fractures were randomized into two groups equally: Conventional miniplates and 3D miniplates. The bite force at incisor, canine, and molar regions was measured preoperatively and postoperatively at weekly intervals until the sixth week, and the mean bite force as well as changes in mean bite force were compared between two groups.

Results

An increase in bite force was noted at each subsequent follow up in both the groups across all sites. Statistically significant difference was found in mean bite force values between both the groups during mid-follow up period. The difference in changes in the mean bite force too was observed to be statistically significant during the mid to late follow up period.

Interpretation & conclusion

Bite force is a reliable parameter to assess restoration of masticatory efficiency following open reduction and internal fixation (ORIF). 3D miniplates when used in anterior mandibular fractures management are efficient enough to withstand masticatory forces throughout the healing process, providing better stability of fractured segments against torsional forces during immediate post-operative period.

The effect of two phosphodiesterase inhibitors on bone healing in mandibular fractures (animal study in rats)

OBJECTIVES

Despite advances in maxillofacial surgery, impaired bone healing remains a concern for surgical teams. Many studies have evaluated the effects of sildenafil and pentoxifylline on bone healing. However, their effects on healing of bone fractures have not been well investigated. This study aimed to assess the effects of the phosphodiesterase inhibitors sildenafil and pentoxifylline on healing of mandibular fractures in rats.

MATERIALS AND METHODS

A total of 60 rats were randomly divided into six groups of 10. Mandibular fracture was induced in all rats. After the surgical procedure, group C1 received saline, group S1 received 10 mg/kg sildenafil and group P1 received 50 mg/kg pentoxifylline. The rats were sacrificed after 1 week. Groups C4, S4, and P4 received pharmaceutical therapy as in groups C1, S1, and P1 but were sacrificed after 4 weeks. The samples then underwent histological analysis.

RESULTS

The mean rate of bone healing of mandibular fractures in groups S1 and P1 was significantly higher than in group C1 at 1 week (P<0.001). The mean rate of bone healing of mandibular fractures in group P1 was higher than in group S1 at 1 week (P=0.04). The mean rate of bone healing of mandibular fractures in groups S4 (P=0.001) and P4 (P=0.004) was significantly higher than in group C4 at 4 weeks, but no significant difference was noted in the rate of healing between groups P4 and S4 (P=0.53).

CONCLUSION

Sildenafil and pentoxifylline can be used as adjuncts to enhance bone healing in rats.