One miniplate compared with two in the fixation of isolated fractures of the mandibular angle

Al‐Moraissi, Essam Ahmed

doi:10.1016/j.bjoms.2015.05.006

Cited by 20 publications

(8 citation statements)

References 29 publications

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“…This result suggests proximity to the oral cavity is a major risk factor for plate removal. When comparing double plating to a single upper border plate, the literature does state double plating is more prone to complications 16 …”

Section: Discussionmentioning

confidence: 99%

Is Open Reduction Internal Fixation Using Titanium Plates in the Mandible as Successful as We Think?

Capucha

Shilo

Abdalla‐Aslan

et al. 2021

Journal of Craniofacial Surgery

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Titanium plats are the gold-standard for fracture fixation. Titanium is considered biocompatible, corrosion resistant with an elasticity-modulus closest to bone. Nonetheless, titanium plates are not always as inherent as hoped. The authors investigated morbidity associated with titanium plates in mandibular fractures. A retrospective study of mandibular fractures treated between 2000 and 2018 using internal-fixation was conducted. Data included age, gender, complications, and location. Predictor-variable was location. Outcome-variable was plate removal. A total of 571 patients were included, 107 resulted in plate removal (18.7%). Body was the most prevalent location of fracture (29.3%). Symphysis/para-symphysis showed the highest removal rate (24.1%), followed by body and angle (21.3/19.8%). A total of 23.4% of double-plating cases resulted in plate removal, upper-border in 15% and lower-border in 8.8%, all reconstruction-plates. Exposure was the most frequent complication leading to removal. Although titanium plates are the gold standard, almost every fifth patient returns for plate removal. Agedistribution emphasizing 41 to 50 with decrease towards extremities may imply better healing in the young and soft-tissue elasticity and less complaints in the elderly. Significantly more complications in doubleplating compared to lower border suggests proximity to the oral-cavity as a risk-factor for removal. Complication rates and patterns are not negligible and perhaps should encourage clinicians to consider using biodegradable-systems for upper-border plates.

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Section: Discussionmentioning

confidence: 99%

Is Open Reduction Internal Fixation Using Titanium Plates in the Mandible as Successful as We Think?

Capucha

Shilo

Abdalla‐Aslan

et al. 2021

Journal of Craniofacial Surgery

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show abstract

“…Segmental arch bar with single large and stronger bone plate ©Association of Oral and Maxillofacial Surgeons of India [19] in a meta-analysis showed that the incidence of wound infection, dehiscence, hardware failure, and overall complications were less in patients treated with one miniplate on external oblique ridge in comparison to two.…”

Section: Impact Of Presence or Absence Of Impacted Mandibular Third Molar (Im3m) On Angle And Condylar Fracturementioning

confidence: 99%

Fractures of the Mandible

Rai

2021

Oral and Maxillofacial Surgery for the Clinician

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Fracture of Mandible is the most common occurrence in comparison to any other bone of the maxillofacial region. Various classifications are put forward which are helpful in diagnosing the mandible fracture. This chapter focuses on the general and clinical examination of the maxillofacial region which helps in clinical diagnosis, different radiographic techniques, various approaches, emergency as well as surgical management and outcome with various modalities of treatment.

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“…Less rigid fixation allows some motion at the fracture line and typically involves the transoral placement of one miniplate (Champy method, figure 1.3) at the external oblique ridge of the mandible [2][3][4][5]. The alternate more rigid treatment augments the Champy method with an additional plate placed trans-buccally on the lateral inferior border of the mandible (biplanar fixation, figure 1.3) [5][6][7][8]. While biplanar fixation is theorized to be more stable, it is often less preferred surgically because it is more invasive and requires an extraoral scar and reflection or splitting of the masseter muscle [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Macaca mulattais a good model for human mandibular fixation research

et al. 2022

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Biomechanical and clinical studies have yet to converge on the optimal fixation technique for angle fractures, one of the most common and controversial fractures in terms of fixation approach. Prior pre-clinical studies have used a variety of animal models and shown abnormal strain environments exacerbated by less rigid (single-plate) Champy fixation and chewing on the side opposite the fracture (contralateral chewing). However, morphological differences between species warrant further investigation to ensure that these findings are translational. Here we present the first study to use realistically loaded finite-element models to compare the biomechanical behaviour of human and macaque mandibles pre- and post-fracture and fixation. Our results reveal only small differences in deformation and strain regimes between human and macaque mandibles. In the human model, more rigid biplanar fixation better approximated physiologically healthy global bone strains and moments around the mandible, and also resulted in less interfragmentary strain than less rigid Champy fixation. Contralateral chewing exacerbated deviations in strain, moments and interfragmentary strain, especially under Champy fixation. Our pre- and post-fracture fixation findings are congruent with those from macaques, confirming that rhesus macaques are excellent animal models for biomedical research into mandibular fixation. Furthermore, these findings strengthen the case for rigid biplanar fixation over less rigid one-plate fixation in the treatment of isolated mandibular angle fractures.

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One miniplate compared with two in the fixation of isolated fractures of the mandibular angle

Cited by 20 publications

References 29 publications

Is Open Reduction Internal Fixation Using Titanium Plates in the Mandible as Successful as We Think?

Is Open Reduction Internal Fixation Using Titanium Plates in the Mandible as Successful as We Think?

Fractures of the Mandible

Macaca mulattais a good model for human mandibular fixation research

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