Three-dimensional v/s standard titanium miniplate fixation in the management of mandibular fractures--a randomized clinical study

Abstract

Purpose: The aim of this study was to compare treatment outcomes using three-dimensional and standard titanium miniplates in the management of mandibular fractures.

Material and methods: A prospective study of 30 patients with mandibular fractures. Patients were randomly categorized into 2 groups with 15 patients in each group; patients in Group I were treated with 2.0 mm 3-dimensional titanium miniplate and screws and patients in Group II were treated with 2.0 mm standard plates and screws. Clinical parameters evaluated were: intra-operative assessment of reduction, intra-operative and post-operative assessment of stability of occlusion, mobility of fracture fragments and need for intermaxillary fixation. Radiographic parameters included pre-operative evaluation of displacement of fracture fragments and post-operative evaluation of bone union and plate fracture at different time intervals.

Results: In Group I, 3 patients (20%) and in Group II, 8 patients (53%) had gap between fracture fragments during reduction. Six patients (40%) in Group I and 8 patients (53%) in Group II had mildly deranged occlusion on the 7th post-operative day. Two patients (13%) in Group I and 6 patients (40%) in Group II needed IMF till the end of the 1st month. No patients showed tissue dehiscence at the end of 1st and 3rd month post-operatively. Infection was not observed in any patient post-operatively. Five patients (33%) from Group I had displaced fracture fragments and 10 patients (67%) had severely displaced fracture fragments pre-operatively. Seven (47%) patients from Group II had displaced fracture fragments and 8 (53%) had severely displaced fracture fragments pre-operatively. Nine patients (60%) in Group I and 6 patients (40%) in Group II showed radiographic evidence of bone union after the 3rd month post-operatively.

Conclusion: The use of 3D miniplate is a viable option for fixation of mandibular fractures routinely. 3D titanium miniplates showed comparable results compared to standard titanium miniplates.

Keywords: 3D plate; Mandibular fracture; Strut plate; Titanium miniplates.