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For fractures in symphysis and parasymphysis region, severely displaced angle fractures and for comminuted fractures 3-D locking plate could be a better option. In the angle and body region a single miniplate fixed according to Champy's technique is easy to place with less surgical time, less surgical trauma, is more economical and has similar clinical results.

In the last three decades, polyetheretherketone (PEEK) has been increasingly employed as a biomaterial for orthopedic and spinal implants. PEEK dental implants have shown equal promise and are currently being used and investigated in many parts of the world. While their osseointegration capacity has been established beyond doubt, it is not clear whether these implants are suitable for specific situations with low functional and high esthetic demands or as completely viable alternatives to titanium in all situations. We present a brief introduction to the PEEK implants, a representative system and kit and the advantages and disadvantages as compared to titanium implants.It is our observation that PEEK implants function well in anterior as well as posterior regions and when loaded immediately (one week after placement). Their use in the esthetic zone can be of significant advantage to the surgeon as well as patient. However, diminished radiopacity and limitation of available sizes may be causes for concern.

Objective To compare the efficacy and surgical outcome of treatment of anterior mandibular fracture using either 2.0 mm titanium miniplate or 2.4 mm titanium lag screw technique. Materials and Methods A total of 30 patients were managed by open reduction and internal fixation utilizing the miniplate and lag screw technique for fractures of anterior mandible. The patients were randomly divided into two groups. Group I: (15 patients) were treated with Leibinger, 2.0 mm titanium mini plates system with self-tapping screws and Group II: (15 patients) were treated with 2.4 mm cortical lag screw (Synthes). Intraoperatively duration of surgery was measured from the time incision was placed till the closure of wound. Subsequent follow up was done at 3, 6, 12, 24 weeks, postoperatively. During every follow up, patients were assessed clinically for malocclusion, neurosensory deficit, biting efficiency, implant failure, mal-union/ non-union. Pre and postoperative radiographs were taken to assess the gap between fracture segments. Results were evaluated using Chi square and the unpaired t test. Results In our study, the mean duration of surgery (hours) was 1.97 ± 0.52 for group I and 1.26 ± 0.55 for group II. The difference was found to be statistically significant (p value 0.001). i.e. more time was taken in case of surgery with mini-plates when compared to the lag screw. Short surgical procedure reduces the incidence of infectious complications, which significantly lowers the financial burden. The mean post-operative radiographic distance between all measuring points were considerably more in case of mini-plate group as compared to lag screw group. Lag screw group showed faster improvement in terms of biting efficiency as compared to mini-plate group which showed a tendency to masticate only medium hard food items by 24 weeks. In both groups, no postoperative malocclusion was noted. In initial weeks, neurosensory deficit was seen more in mini-plate group as compared to lag screw group but after six weeks all patients showed improvement in neurosensory function without any permanent nerve damage. Conclusion According to this prospective study, rigid internal fixation provided by lag screw technique for anterior mandibular fracture offers several advantages over conventional bone plating. It is an excellent means of achieving rapid and safe fixation which is followed by primary bone healing in anterior mandibular fractures, without any major complications.

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