Comparative Evaluation of Clinical Outcomes Using Delta Plates and Conventional Miniplates for Internal Fixation of Mandibular Condylar Fractures in Adults

Ahuja, Suraj Arjun; Galinde, Jyotsna; Asnani, Usha; Mistry, Yusuf Abbas

doi:10.1016/j.joms.2017.12.018

Cited by 23 publications

(25 citation statements)

References 36 publications

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“… 4 , 20 , 21 , 36 Three-dimensional plates combine the ease of applying one plate with the additional fracture stability similar to a 2-plate system. 27 , 37 There were no cases of plate fracturing in our patient population. The ultimate goal of fixation is to obtain anatomic reduction of the condylar base fracture using the appropriate plating system (Fig.…”

Section: Discussionmentioning

confidence: 76%

Algorithm for Management of Mandibular Condylar Base Fractures

Peterson

Nguyen

Baughman

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: Increasing evidence suggests that open reduction and internal fixation of condylar base fractures in adults results in improved outcomes in regard to interincisal opening, jaw movement, pain, and malocclusion. However, most of the condylar fractures are managed by maxillomandibular fixation alone due to the need for specialized training and equipment. Our aim was to present an algorithm for condylar base fractures to simplify surgical management. Methods: A retrospective review was performed of patients (n = 22) with condylar base fractures treated from 2016 to 2020. Patients who presented with operative fractures that require open treatment underwent 1 of 2 different techniques depending on the fracture type: a preauricular approach with a transoral approach if the condyle was dislocated (n = 2) or a transoral only approach (n = 20) in nondislocated cases. Operative time, occlusion, range of motion, and postoperative complications were assessed. Results: Condylar base fractures were combined with other mandibular fractures in 16 of 22 patients. Patients with condylar dislocation were managed with a preauricular approach with a secondary transoral incision (n = 2, median 147 minutes). Those without dislocation were treated with a transoral approach (n = 20, median 159 minutes). Most patients were restored to their preoperative occlusion without long-term complications. Conclusions: We present a simplified algorithm for treating condylar base fractures. Our case series suggests that reduction in operative time and clinical success can be achieved with open reduction and internal fixation using a transoral approach alone or in combination with a preauricular approach for dislocated fractures.

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Section: Discussionmentioning

confidence: 76%

Algorithm for Management of Mandibular Condylar Base Fractures

Peterson

Nguyen

Baughman

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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“…An exceptionally extensive study was conducted by Louvrier et al on a group of 434 patients in the years 2006–2018 and published in 2020 [ 31 ]. The remaining similar studies from the last 10 years were conducted on 10 to 42 patients in the study group [ 7 , 15 , 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…We did not use the single straight or L-shaped plate technique knowing convincing arguments about the poor quality of such fixation [ 14 , 15 ]. According to clinical studies, the use of two miniplates gives good results, but it has a serious disadvantage of having to insert a minimum of 3–4 screws in the proximal bone fragment [ 14 , 15 ]. The use of a TCP allows insertion of 2 or more screws in a smaller fraction.…”

Section: Discussionmentioning

confidence: 99%

“…The most common types are straight plates with linear arrangement of holes, L-shaped plates and multidimensional plates (3D plates) [ 7 , 14 ]. It has been proved that use of a single straight or L-shaped plate presents less satisfactory mechanical properties than using of two plates (double plate technique) or a single 3D plate [ 14 , 15 ]. These include Strut, Rhombic, Trapezoid (TCP), Delta (DCCP), Lambda, A-shape (ACP) and X-shape (XCP) patterns [ 7 , 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

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The Use of 3D Titanium Miniplates in Surgical Treatment of Patients with Condylar Fractures

Sikora

Chęciński²,

Sielski³

et al. 2020

JCM

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The aim of this study was to evaluate the effectiveness of open treatment of mandibular condyle fractures using 3D miniplates. A group of 113 patients has been chosen for evaluation, including 100 men and 13 women. After hospitalization, each patient underwent a 6-month postoperative follow-up. The material chosen for the analysis consisted of data collected during the patient’s stay in the hospital as well as the postoperative outpatient care. A single 4-hole Delta Condyle Compression Plate (4-DCCP) was used in 90 out of 113 (79.6%) cases. In 16 out of 113 (14.2%) patients, the Trapezoid Condyle Plate (4-TCP or 9-TCP) was used. The remaining cases required more than one miniplate. No 3D miniplate fractures were found in the study subjects during the analyzed observation period. Loosening of one or more osteosynthesis screws was observed in 4 out of 113 (3.5%) patients. Screw loosening was a complication that did not affect bone healing in any of the patient cases. The conducted research confirms that titanium 3D mini-plates are easy to adjust and take up little space, therefore they can easily be used in cases of mandibular condyle base and lower condyle neck fractures. The stability of the three-dimensional miniplates for osteosynthesis gives very good reliability for the rigid fixation of the fractured mandibular condyle.

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“…Locking plates are also made from titanium but they are thicker (1.2 to 1.5 mm) than standard plates. Some authors decided to compare standard (non-locking) plates and screws with locking plates and screws [82,83,84,85]. Glória et al in their meta-analysis in the field of locking and non-locking plates and screws argue that although a better bite force result with the locking plates, there is still no sufficient evidence to support this information safely [85].…”

Section: Techniques and Materials Used For The Fixation Of Condylar Fmentioning

confidence: 99%

Aktualne poglądy na temat leczenia złamań wyrostka kłykciowego żuchwy

Sikora

Olszowski

Chlubek

2018

Pomeranian J of Life Sci

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The aim of this review was to present and discuss current views on the treatment of condylar fractures (CFs). The authors addressed the following issues: the etiology, epidemiology and mechanisms of CFs; strategies and methods for the treatment of CFs. Moreover, the choice of surgical approach for the open treatment of CFs as well as techniques and materials used for fixation of CF are discussed.The PubMed database was used to search for relevant articles published between 2000 and 2018. The analysis referred to both original and review papers (including meta-analyses) that concerned adult patients. There are still differences in opinions among researchers regarding the choice of appropriate treatment – closed or open. There is no consensus among open treatment supporters in choosing the right surgical approach. The important question is which material to choose for osteosynthesis of the condylar fracture.Recent studies show satisfactory results in terms of stability of condylar osteosynthesis with the use of 3D plates. Further discussion is required on the choice of material for fixation of the condylar fracture and, in particular, on the possibility of using resorbable materials.

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Comparative Evaluation of Clinical Outcomes Using Delta Plates and Conventional Miniplates for Internal Fixation of Mandibular Condylar Fractures in Adults

Cited by 23 publications

References 36 publications

Algorithm for Management of Mandibular Condylar Base Fractures

Algorithm for Management of Mandibular Condylar Base Fractures

The Use of 3D Titanium Miniplates in Surgical Treatment of Patients with Condylar Fractures

Aktualne poglądy na temat leczenia złamań wyrostka kłykciowego żuchwy

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