Transoral Miniplate Fixation of Mandibular Angle Fracture with and without 2 Weeks of Maxillomandibular Fixation: A Clinical Trial Study

Abstract

Background and Objectives The ideal line of osteosynthesis in mandibular angle fractures indicates that a plate might be placed either along or just below the external oblique ridge. Some authors believe that using one miniplate at this line at the mandibular angle region provides sufficient strength to stabilize the fracture but others imply a second plate is required. Such controversies exist in the use of maxillomandibular fixation (MMF). The intention of the present study was to compare efficiency and complications of using one miniplate with and without MMF in mandibular angle fractures. Methods and Materials Forty patients with facial trauma with mandibular angle fractures including displaced and unfavorable fractures were categorized into two groups of 20 persons. In all patients, one miniplate was placed on the external oblique ridge. In the first group, patients had light maxillomandibular elastic bands just after surgery but no rigid MMF. In the second group, patients had rigid MMF for 2 weeks after surgery. Patients were followed to evaluate complications and treatment efficiency. Conclusions Our study showed that use of a single miniplate in the external oblique ridge is a functionally stable treatment for all types of angle fractures (including displaced and unfavorable fractures) except comminuted and long oblique fractures, which were not included in our study. Use of postoperative MMF did not improve the results.

Routine removal of the plate after surgical treatment for mandibular angle fracture with a third molar in relation to the fracture line

“…There have been many studies concerned with the fixation method used for mandibular angle fractures. [ 8 9 10 11 12 13 14 15 16 17 18 19 ] Some researchers have advocated the use of two miniplates, one on the external oblique ridge and the other on the lower border of the mandible, to obtain stable fixation based on biomechanical studies. [ 20 21 22 ] However, Ellis and Walker reported high complication rates in cases intraorally fixed with two miniplates.…”

Update on ladder plates for mandibular angle fractures

“…In contemporary practice, the Champy technique is often employed via a transoral approach and accompanied by maxillomandibular fixation (MMF) to maximize fracture stability. However, the use of MMF postoperatively is not standardized because of decreased patient functionality and satisfaction [39].…”