A Comparison of Post-Operative Occlusion with 3-D vs. 2-D Miniplate Fixation in the Management of Isolated Mandibular Angle Fractures

Abstract

Mandibular angle fractures (MAFs) are treated in a variety of ways; however, the standard therapy is still up for debate. Despite the fact that many studies have generated evidence for the appropriate biomechanical stability of 3-D miniplates, there is an insufficient amount of data on the treatment of mandibular angle fractures with these plates. A comparative study was conducted at The Department of Oral and Maxillofacial Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad. Patients were randomly divided into two groups of 52 patients each. Patients in group A were treated with 3-D miniplate placement on the lateral cortex following the principle of 3-D fixation proposed by Farmand and Dupoirieux, whereas patients included in group B were treated using 2-D conventional miniplate, placed according to Champy’s line of ideal osteosynthesis. A single surgical team performed the procedure. On the first and seventh post-operative days, the first month, and then the third month after surgery, regular evaluations were conducted. Assessment regarding Post Open Reduction and Internal Fixation (ORIF) occlusion was performed with the help of measuring tools. On the first day post-operative follow-up, 41 (78.8%) patients in group A and 31 (59.6%) patients in group B had satisfactory occlusion. The seventh day post-operative follow-up showed that 43 (82.7%) patients in group A and 41 (78.8%) patients in group B had satisfactory occlusion (p > 0.05). In both treatment groups, the first and third month follow-up evaluations revealed optimal occlusion. In comparison to conventional 2-D miniplate, the 3-D miniplate system produced better results and can be recommended as a better option for the management of mandibular angle fractures.