Hardware Removal Rates for Mandibular Angle Fractures

Moore, Evan; Bayrak, Sinehan; Moody, Marcus W.; Key, J. Michael; Vural, Emre

doi:10.1097/scs.0b013e31826468f5

Cited by 22 publications

(6 citation statements)

References 5 publications

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“…There were 9 RCTs [ 9 , 10 , 14 – 20 ] and 4 CCTs (3 retrospective studies [ 21 – 23 ] and 1 prospective study [ 8 ]) in this meta-analysis, consisting of 593 participants (339 in 3D miniplate group and 254 in standard miniplate group). The characteristics of the 13 included studies are summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…According to the Champy technique, the standard miniplate needs to be placed on the external oblique line, which leads to the proximity to incision, whereas the 3D miniplate could easily avoid this situation as it is covered by the masseter along the buccal cortex, well away from the incision [ 15 , 21 ], and this might be the reason for differences between the two miniplates in the incidence of wound dehiscence. The pooled results integrating 6 studies in this meta-analysis indicated a dramatic reduction (64%) in the incidence of wound dehiscence using 3D miniplate than the standard, however, without significant difference ( P = 0.07), which might be due to the small sample size.…”

Section: Discussionmentioning

confidence: 99%

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The 3-dimensional miniplate is more effective than the standard miniplate for the management of mandibular fractures: a meta-analysis

Liu

Wei

et al. 2017

Eur J Med Res

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PurposeThe study aimed to determine the superiority between 3-dimensional (3D) miniplate and standard miniplate for mandibular fractures (MFs) treatment.BackgroundControversial results on the use of standard miniplate and 3D miniplate have remained for management of MFs.MethodsSeveral electronic databases were retrieved up to September 2014 to identify eligible studies. The quality of studies was assessed, and the relative risk (RR) with its corresponding 95% confidence interval (CI) was assessed to measure the effect size. Subgroup analyses by different fracture regions and different 3D miniplate sizes were performed. Publication bias was measured by a funnel plot.ResultsThere were 13 studies included for the meta-analysis, consisting of 593 participants. The 3D miniplate achieved significant lower incidences of malocclusion (RR 0.43, 95% CI 0.24–0.77, P = 0.004) and hardware failure (RR 0.31, 95% CI 0.13–0.74, P = 0.008) than the standard miniplate. There were no significant differences between the two miniplates on the incidence of the remaining outcomes: wound dehiscence, infection, paresthesia, and nonunion/malunion. Subgroup analyses indicated that 3D miniplate caused a lower hardware failure than standard with the size of 8 or 10 holes (RR 0.23, 95% CI 0.08–0.66, P = 0.006). Besides, publication bias was not detected.ConclusionThe 3D miniplate is superior to the standard miniplate on the reduction of postoperative complication rates for the management of MFs. More holes in the 3D miniplate might contribute to a successful treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The 3-dimensional miniplate is more effective than the standard miniplate for the management of mandibular fractures: a meta-analysis

Liu

Wei

et al. 2017

Eur J Med Res

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“…9,19,20 Although the 3D strut plate is a relatively recent development in the treatment of mandibular angle fractures, the current literature documents successful clinical and biomechanical outcomes. 1,5,17,[20][21][22][23][24] A study done using sheep mandibles and a class III cantilever model found that the degree of displacement and gap formation of the 3D strut plate is comparable to that of a reconstruction Plate. 13 The design of the strut plates confers a significant advantage over single plate and two-plate fixation methods on the lateral surface of the mandible.…”

Section: Discussionmentioning

confidence: 93%

“…The primary reason for plate removal in that study was attributed to loose fixation screws and Plates. 21 Only 10 patients (4.5%) developed postoperative infections and required surgical incision and drainage with removal of the fixation plates due to the infection. The angle fracture in all of these cases was displaced more than 3 mm.…”

Section: Discussionmentioning

confidence: 99%

The use of three-dimensional strut plates for the management of mandibular angle fractures: a retrospective analysis of 222 patients

Sawatari

Alotaibi

Christensen

et al. 2016

International Journal of Oral and Maxillofacial Surgery

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“…There have been several studies as to the removal of the plates after healing of the mandibular fractures. [ 2 3 32 33 34 35 36 37 38 39 ] Most of these studies have concluded that routine removal of the plates is not necessary because complication rates are relatively low. These studies have suggested the removal of symptomatic plates only.…”

Section: Discussionmentioning

confidence: 99%

Routine removal of the plate after surgical treatment for mandibular angle fracture with a third molar in relation to the fracture line

Yamamoto

Matsusue

Horita

et al. 2015

Ann Maxillofac Surg

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Purpose:The purpose was to analyze the clinical course of surgically treated mandibular angle fractures from the viewpoint of routine removal of the plate because these fractures are associated with high rates of complications and plate removal.Subjects and Methods:The subjects were 40 patients with unilateral mandibular angle fracture, which was intraorally reduced and principally fixed with a single miniplate on the external oblique ridge. The third molar in relation to the fracture line was extracted in seven patients during the surgery. Clinical course was evaluated in terms of removal of the plate, preservation of the third molar and complications.Results:One patient showed a wound infection postoperatively, and two patients developed pericoronitis during the follow-up. These were managed with medication and local irrigation. One patient with a preserved third molar did not make a required visit and was lost from the follow-up. Removal of the plates was performed in 39 patients after confirmation of good fracture healing, mostly within a year. Twenty-four of 32 preserved third molars were simultaneously extracted. These procedures were generally performed under local anesthesia on an outpatient basis, and they did not cause any complications.Conclusions:Routine removal of the plate after surgical treatment for mandibular angle fractures, simultaneously with extraction of the third molar if indicated, may be beneficial to avoid complications related to the plate and the third molar later in life.

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Hardware Removal Rates for Mandibular Angle Fractures

Abstract: Overall, removal rates between Champy line and 8-hole strut plates are not different in treating mandibular angle fractures, although the 8-hole strut plate has a lower rate of loose hardware-related plate removal compared with the Champy line plate.

Cited by 22 publications

References 5 publications

The 3-dimensional miniplate is more effective than the standard miniplate for the management of mandibular fractures: a meta-analysis

The 3-dimensional miniplate is more effective than the standard miniplate for the management of mandibular fractures: a meta-analysis

The use of three-dimensional strut plates for the management of mandibular angle fractures: a retrospective analysis of 222 patients

Routine removal of the plate after surgical treatment for mandibular angle fracture with a third molar in relation to the fracture line

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