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Aim: To evaluate the effectiveness of various internal fixation hardware used for treatment of symphyseal and parasymphyseal mandibular fractures based on a single institution`s experience. Materials and Methods: In this retrospective clinical study, one hundred patients with fractures of the anterior region of the mandible involving both the symphysis and parasymphysis areas were included. All cases were selected from the patients` records who were treated in the oral and maxillofacial surgery department in a 4 years period extended from May 2013 to May 2017. Surgical admission notes, x-ray reports, operation records, outpatient notes, and complications were recorded. The patients were followed up periodically until a minimum of 6 weeks. Results: The distribution of fracture pattern was as follows; 53 patients with anterior mandible associated with subcondylar/ condylar fractures, 31 with anterior mandible in association with mandibular angle fractures, and only 16 patients with isolated anterior mandible fracture. The majority of the fractures (40%) were treated by 2 miniplates, followed by the 3-D miniplates (17%), equal use (12% each) of (2 lag screws, 1 lag plus 1 miniplate and 1 reconstruction plate), then 1 lag screw (4%), and the least was the use of only 1 miniplate (3%). Conclusion: Proper selection of the fixation method for anterior mandibular fractures is essential to guarantee a successful treament and early restoration of function. Each method has its own advantages and disadvantages, and each case should be treated individually based on proper diagnosis and planning.

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The aim of this study was to evaluate the rhombic three-dimensional plate in fixation of displaced low subcondylar mandibular fractures clinically and radiographically. MATERIALS AND METHODS: This is a prospective, interventional, single armed case series study that was carried out on twelve patients with displaced low subcondylar mandibular fracture. Open reduction and internal fixation was utilized to treat those fractures using rhombic 3D plate, patients were collected from the department of Oral and Maxillofacial surgery, Faculty of Dentistry, Tanta University. All cases were treated with retromandibular approach. Post-operative evaluation: all patients underwent regular follow up for six months. The following parameters were evaluated: a. Maximal mouth opening, b. Lateral and protrusive mandibular movements, c. Chewing and occlusion, d. Clicking and tenderness of TMJ, e. Vertical height of the ramus, f. Anteroposterior angulation of the condyle. RESULTS: 6 months after the operation, the functional parameters returned to normal, with an average mouth opening of 43.6 mm, protrusion of 9.6 mm, and laterotrusion of 10.5 mm. No clicks or tender TMJ, normal function of facial nerve. Radiographic controls showed good fracture alignment, no plate fracture, bending or loose screws were observed. CONCLUSIONS: The clinical and radiographical data suggested that the rhombic three-dimensional plate is suitable for treatment of condylar fractures and provided stable fixation.

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