Background: Loss of masticatory function is one of the important effects of mandibular fractures. Therefore the therapeutic goal of management is to restore original anatomic form and function. Considering this, maximal bite force could be a major factor for evaluating the success of treatment. Objective: The purpose of this study was to compare the efficiency of 2.0mm 3-Dimensional plates and two standard 2.0 mm Miniplates in the fixation of anterior mandibular fractures i.e, the parasymphysis and symphysis fractures on the basis of bite force and other clinical parameters. Materials and Methods: The study was conducted on 30 patients with isolated fractures of anterior mandible region. The patients were categorized into two groups with 15 patients in each group. In group A patients were treated with 3-Dimensional miniplate and in group B patients were treated with two conventional Miniplates and these patients were evaluated pre-operatively, immediate post-op, 1 st week, 4 th week, 3 rd month and 6 th post-op months using bite force and other clinical parameters. Results:The study results revealed no statistically significant difference between the study groups with respect to root damage and mal-union. There was occlusal discrepancy, mobility of fracture segments, and post-op infection observed in Conventional plate group which was absent in 3D plate group. One patient in Conventional plates group had to undergo implant retrieval due to persistent infection and experienced neurosensory deficit even after 6 th post-op month. The bite force measurement between the study groups showed statistical significant increase of bite force in the right premolar and right molar regions at 4 th post-op month, 3 rd post-op month and 6 th post op-month. In 3D plate group, patients showed increased bite force values in comparison to Conventional plates group throughout the follow up intervals. Conclusion:This study concluded that the use of 3D miniplates in anterior mandibular fractures is efficacious enough to bear masticatory loads during the healing of fractures. It gives the advantage of greater stability, increased bite force, reduced implant material and 3D stability. It was also found that 3D miniplate was superior to two-dimensional miniplate with respect to stability, increased bite force, economy and surgical technique achieving early function with stable occlusion.
Mandibular condylar process is the third most commonly fractured bone. Various surgical approaches to fix this condyle are described hitherto testify to the advantages and disadvantages of various surgical techniques used for approaching the condyle in such fracture cases. Here we have compared three such surgical techniques. Aim: The aim of this study was to compare the outcome of various surgical approaches for the treatment of condylar fractures. Materials and Methods: A retrospective study of 60 patients who were diagnosed with condylar fracture and required open reduction and internal fixation were considered. 59 cases were unilateral and 1 was bilateral. 60 patients were categorized into three groups of 20 each according to the surgical approach performed. All data were evaluated using the patient's records including the radiological imaging. Parameters like post-op IMF, facial nerve injury, scar, wound infection, malocclusion and plate retrieval were noted. Results: The submandibular approach showed the worst outcome in terms of facial nerve injury, unfavorable scar, and wound infection. No significant differences between the pre-auricular and trans parotid approaches were detected in the above mentioned parameters. Post op infection was high in the pre auricular group. 10% of the cases in the pre auricular group had to undergo plate retrieval. Conclusion:Inferior neck condylar fractures benefit from submandibular approach, high neck fractures from trans parotid approach and condylar head fractures via preauricular approach.
The aim of this study was to compare the outcomes of external oblique ridge platting and lateral cortical plating for mandibular angle fractures. Materials and Methods: A retrospective study was performed of patient's data, who underwent open reduction and internal fixation of mandibular angle fractures. Inpatient and outpatient records were reviewed for pertinent data including age, gender, presence of other fractures, type of plating, operative time, and post-operative complications. Results: 40 patients with angle fracture were included in the study, 60% of them were treated with external oblique ridge plating and the rest 40% with lateral cortical plating. The mean age of the patients were 32.40 years. Main etiology of injury was road traffic accident (RTA). Post-op infection and wound dehiscence was observed in 12.5% and 10% of cases respectively in the external oblique plating group and 2.5% and 5% cases respectively in the lateral cortical plating group. Nonunion was not seen in any of the cases. Implant retrieval was performed in 5% of the external oblique ridge plating group and none in the other group. (p value 0.21). Conclusion: Lateral cortical plate fixation for angle fracture is a better and simple method when compared to external oblique ridge fixation. It is safe and reliable with minimal complications. Hence this technique is recommended for the fixation of mandibular angle fractures for better stability and outcome.
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