Trauma to the facial skeleton frequently results in injuries to the soft tissues, teeth, and major skeletal component of the face, including mandible, maxilla, zygoma, naso-orbito-ethmoid complex, and supra orbital fractures.
1Proper anatomical reduction, restoration of the premorbid occlusion, and proper fixation until stable osseointegration are considered as the basic principles in treating mandibular fractures. Miniplates and reconstruction plates are commonly used to treat simple and comminuted fractures of mandible. However, thick fixation plates are bulky and palpable through the thin skin and the gingiva. A large miniplate placement in the interforaminal region in upper half of the mandible can result in complications such as infection, wound healing problems, tooth-root injuries, or mass-effect problems due to limited space available.
2In the mandible, because of thick compact bone, the difficulty in identifying the course of the dental roots leads to the probability of injury to the teeth which is three times higher than in the maxilla. It is desirable to minimize the size and amount of osteosynthesis material used, as there are Keywords ► bite force ► mandible fracture ► microplate ► miniplate ► open reduction and internal fixation
AbstractThe purpose of this study was to compare the mechanical behavior of combination of microplate and miniplate with two standard miniplates for fixation of mandibular fractures in the interforaminal region on the basis of bite force and other clinical parameters. A prospective randomized study was conducted on 20 patients with mandibular fracture requiring open reduction and internal fixation (ORIF) who were randomly categorized into Group A and Group B with 10 patients in each group. Ten healthy persons whose age and gender matched with study groups were included in control Group C. Pre-and postoperative bite force was measured at specified intervals in both the study groups and was compared with the control group. The bite force values were comparatively less in Group A than Group B, although there was no statistically significant difference. Also, bite force values were less in both the study groups when compared with the control group. No statistically significant difference was found in other clinical parameters such as infection, fracture mobility, and hardware failure. The results were suggestive that the use of microplate and miniplate combination in management of minimally displaced mandibular fractures in the interforaminal region provides stable fixation comparable to two miniplate combination.
Dental implants with their increasing success rates and predictability of final outcome are fast becoming the treatment of choice for replacing missing teeth. Considering the success of immediate implant placement in reducing tissue loss and achieving good esthetic results, is making it a more popular treatment modality in implant dentistry. Understanding the management of gingival tissues in relation to implants to obtain maximum esthetics is of utmost importance. The use of provisional abutments and immediate temporization has a proven track record of their ability to produce optimal esthetics and to guide the tissue response during the healing phase. With careful patient selection and execution, customized healing abutments can provide an effective method to enhance the esthetic and emergence profile for anterior implant restorations.
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