Despite many advances in internal fixation, angle fracture remains among the most difficult and unpredictable fracture to treat compared with those of other areas of the mandible. Large number of studies on mandibular angle fracture treatment attests to the fact that no single approach has been shown to be ideal, and that treatment of mandibular angle fractures remains conceptually controversial, with a bothersome complication rate. During the past decade, significant attention has been placed on variety of plate fixations for mandibular angle fractures.1-14 Fixation using miniplates has been shown to simplify surgery and reduce surgical morbidity, but failed to surpass the predictability of rigid fixation.
15-18Although there have been several studies on linear and curvilinear plates for mandibular fracture fixation, only a few reports on the use of low profile three-dimensional (3D) strut or mesh plates are reported in the literature. 1,6 In fact, majority of studies on 3D strut plates are in vitro biomechanical studies. The geometry of 3D strut plate conceptually allows for an increased number of screws, stability in 3D, and resistance against torque forces while maintaining a low profile and malleability. The 2.0-mm titanium 3D curved angle strut plate allows for almost no movement at the superior and inferior borders with manual torsional and bending forces, as opposed to when a single linear plate is applied to the superior border area. When only one linear plate is placed at the superior border, torsional and bending forces usually cause movement along the axis of the plate with buccal-lingual splaying and gap formation at the inferior border, respectively. Because the Keywords ► angle fracture ► mandibular angle ► rigid fixation ► 3D plates ► curved strut plate
AbstractThe aim of the study was to evaluate the efficacy and complication rate with use of 2.0-mm titanium three-dimensional (3D) curved angle strut plate for mandibular angle fractures. Twenty cases requiring internal fixation of the mandibular angle by 2.0-mm titanium 3D curved angle strut plates were evaluated. Postoperative clinical and radiological analyses were done on 1st, 2nd, 4th, and 6th weeks, which included wound healing, transmitted movements, difficulty in function and occlusion, and neurosensory changes, if any. Reasonable level of success in terms of immediate jaw function was noted in all cases. Transient inferior alveolar nerve dysfunction was observed in three cases, which recovered gradually in 2 months, and surgical site infection was observed in two cases, which resolved with appropriate course of antibiotics and wound care. Fixation of mandibular angle fractures with a 2.0-mm titanium 3D curved angle strut plate is predictable, expeditious, and has less complication rate.