Fixation of subcondylar fractures of the mandible: a randomized clinical trial comparing one trapezoidal plate with two miniplates

Adhikari, Manoj; Bhatt, Krushna; Yadav, Rahul; Mandal, Jeetendra; Bhutia, Ongkila; Roychoudhury, Ajoy

doi:10.1016/j.ijom.2020.10.009

Cited by 12 publications

(9 citation statements)

References 33 publications

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“…The individual shapes of 3D mini-plates are mainly compared in clinical trials to the double straight mini-plates fixation technique. Adhikari et al assessed that the trapezoidal mini-plates can be characterized by a less challenging way of adjustment and greater speed of operation compared to the two straight mini-plates, while maintaining similar clinical treatment results [24]. The same conclusions were reached by Ahuja et al with regard to the delta-shaped 3D miniplates [25].…”

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

“…Commonly, two straight mini-plates are used in fixation of the mandibular condyle base and neck fractures [18,24,25,38]. This technique serves as a reference in the evaluation of the treatment results with 3D mini-plates [7,10,18,24,25,38]. The individual shapes of 3D mini-plates are mainly compared in clinical trials to the double straight mini-plates fixation technique.…”

Section: Discussionmentioning

confidence: 99%

“…Fractures of the mini-plates fixing the mandibular condyles in the technique of 2 straight mini-plates were noted in the material of Adhikari et al and amounted to 16% of cases [24]. In turn, Hirjak et al reported 14% of miniplate fractures using the single straight miniplate technique [40].…”

Section: Discussionmentioning

confidence: 99%

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The Use of Titanium 3D Mini-Plates in the Surgical Treatment of Fractures of the Mandibular Condyle: A Systematic Review and Meta-Analysis of Clinical Trials

Sikora

Chęciński²,

Nowak³

et al. 2021

JCM

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Introduction: Fixing fractures of the base and neck of mandibular condyles is demanding due to the difficulties in surgical access and the various shapes of bone fragments. Classic fixation techniques assume the use of straight mini-plates, utilized for other craniofacial bone fractures. Three dimensional mini-plates may provide a reasonable alternative due to their ease of use and steadily improved mechanical properties. The multitude of different shapes of 3D mini-plates proves the need for their evaluation. Aim: This paper aims to summarize the clinical trials regarding the use of various types of 3D condylar mini-plates in terms of need for reoperation and the incidence of loosening and damage to the osteosynthetic material. Materials and Methods: A systematic review was conducted in accordance with PICOS criteria and PRISMA protocol. The risk of bias was assessed using ROBINS-I and RoB 2 Cochrane protocols. The obtained data series was analyzed for correlations (Pearson’s r) respecting statistical significance (Student’s t-test p > 0.05) and visualized using OriginLab. Results: 13 clinical trials with low overall risk of bias regarding 6 shapes of 3D mini-plates were included in the synthesis. The number of reoperations correlates with the number of fixations (r = 0.53; p = 0.015) and the total number of screw holes in the mini-plate (r = −0.45; p = 0.006). There is a strong correlation between the number of loosened osteosynthetic screws and the total number of fractures treated with 3D mini-plates (r = 0.79; p = 0.001 for each study and r = 0.99; p = 0.015 for each mini-plate shape). A correlation between the percentage of lost screws and the number of distal screw holes is weak regarding individual studies (r = −0.27; p = 0.000) and strong regarding individual mini-plate shape (r = −0.82; p = 0.001). Three cases of 3D mini-plate fractures are noted, which account for 0.7% of all analyzed fixation cases. Discussion: The reasons for reoperations indicated by the authors of the analyzed articles were: mispositioning of the bone fragments, lack of bone fragment union, secondary dislocation, and hematoma. The known screw loosening factors were poor bone quality, bilateral condylar fractures, difficulties in the correct positioning of the osteosynthetic material due to the limitations of the surgical approach, fracture line pattern, including the presence of intermediate fragments, and mechanical overload. Fractures of the straight mini-plates fixing the mandibular condyles amounts for up to 16% of cases in the reference articles. Conclusions: There is no convincing data that the number of reoperations depends on the type of 3D mini-plate used. The frequency of osteosynthetic screw loosening does not seem to depend on the 3D mini-plate’s shape. Clinical fractures of 3D mini-plates are extremely rare.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Use of Titanium 3D Mini-Plates in the Surgical Treatment of Fractures of the Mandibular Condyle: A Systematic Review and Meta-Analysis of Clinical Trials

Sikora

Chęciński²,

Nowak³

et al. 2021

JCM

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“…The application of miniplates fixed with screws is considered the gold standard for ORIF in mandibular surgery [ 4 , 5 ]. Thus, numerous miniplate designs have been introduced during the past decades, and recently, their efficacies have been studied to examine biomechanical stability and surgical simplicity [ 6 , 7 , 8 , 9 ]. Previous biomechanical studies have confirmed the reliability of condyle fixation via two miniplates for subcondylar fractures for withstanding the compression and tension forces within physiological limitations.…”

Section: Introductionmentioning

confidence: 99%

Reliability of a Trapezium Miniplate with Endoscope-Assisted Internal Fixation in Mandibular Subcondylar Fractures: A Three-Dimensional Analysis

Jung

Nam

Fang

et al. 2021

JCM

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This study aimed to evaluate the reliability of a trapezium plate for open reduction and internal fixation (ORIF) of mandibular subcondylar fractures with the simultaneous use of an endoscope. We selected and retrospectively studied 18 patients (12 males and 6 females) with unilateral mandibular subcondylar fractures who visited the Wonju Severance Christian Hospital. The mean age of the patients was 43.43 ± 15.76 years. Patients underwent ORIF with trapezium miniplate application through an intraoral incision under general anesthesia. The clinical and radiographic findings of the fractured side were compared with those of the non-operated side at 6 months follow-up. All occlusions became stable, and transient functional disturbances disappeared within 6 months of periodic follow-up. Functional mandibular movement recovered within the normal range, with an average mouth opening of 41.5 mm, protrusion of 7.5 mm, and lateral excursion of 7 mm at 6 months. Radiographic controls and statistical analysis confirmed a decent anatomical reduction in all 18 cases. In conclusion, the use of a trapezium miniplate with endoscope-assisted ORIF in mandibular subcondylar fractures can be useful for fixation and functional recovery.

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Biomechanical influence of plate configurations on mandible subcondylar fracture fixation: a finite element study

Gupta

Dutta

Dutta³

et al. 2023

Med Biol Eng Comput

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Fixation of subcondylar fractures of the mandible: a randomized clinical trial comparing one trapezoidal plate with two miniplates

Cited by 12 publications

References 33 publications

The Use of Titanium 3D Mini-Plates in the Surgical Treatment of Fractures of the Mandibular Condyle: A Systematic Review and Meta-Analysis of Clinical Trials

The Use of Titanium 3D Mini-Plates in the Surgical Treatment of Fractures of the Mandibular Condyle: A Systematic Review and Meta-Analysis of Clinical Trials

Reliability of a Trapezium Miniplate with Endoscope-Assisted Internal Fixation in Mandibular Subcondylar Fractures: A Three-Dimensional Analysis

Biomechanical influence of plate configurations on mandible subcondylar fracture fixation: a finite element study

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