Intraoral external oblique ridge compared with transbuccal lateral cortical plate fixation for the treatment of fractures of the mandibular angle: prospective randomised trial

One miniplate compared with two in the fixation of isolated fractures of the mandibular angle

“…3 It was proposed that the threedimensional bends placed in a ridge plate to contour it to the external oblique ridge may reduce its rigidity, but the ridge plate's superficial placement on the ridge may also make it prone to exposure and consequent infection from breakdown of the wound. 28 The limitations of the present study were firstly that only 3 RCT 8,17,19 were included in the meta-analysis together with 3 CCT 6,22,23 and 4 retrospective studies. 9,18,20,21 The results of RCT give the most reliable data for inclusion in a true meta-analysis, but I included retrospective studies because the qualitative analysis of all 10 studies indicated that 3 8,17,19 had only a low risk of bias and 7 6,9,18,[20][21][22][23] had only a moderate risk.…”

Comparison of intraoral and extraoral approaches to mandibular angle fracture repair with cost implications

“…Although common, mandibular angle fractures are corrected with multiple types of surgical approaches. Traditionally absolute rigid fixation was believed to be critical to proper union; however, these beliefs have slowly evolved beginning with Michelet et al and Champy et al Champy described the placement of a single monocortical noncompression miniplate on the superior border of the mandible, either on the external oblique ridge using an intraoral approach or against the outer surface of the mandible using an extraoral approach . This method has been corroborated in the multiple studies, and Ellis in particular has demonstrated that, up to a point, increased rigidity is associated with increased complications …”

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

“…Even when a less experienced surgeon performed the surgery, the time involved to complete ORIF utilizing the 3D strut plate remained comparable to the duration it took an experienced surgeon to perform Champy's technique. In a prospective randomized trial done by Laverick et al comparing the duration of surgeries, no significant difference was found between the transbuccal approach (60 min on average) and Champy's technique (55 min on average) 28 ; however a specialist performed the majority of the cases. In addition, in this study, the duration of the procedure was not increased due to the use of a trocar and the transbuccal plate.…”

“…11 This rate is lower than that reported in more recent articles. 5,28 In addition, Sugar et al found a 20% increase in the rate of infection with the use of Champy's plate during a randomized clinical trial. 29 The low incidence of postoperative infection using the 3D strut plate in the present study may be attributed to the aggressive removal of third molars in the line of fracture.…”