Locking v/s non-locking reconstruction plates in mandibular reconstruction

Abstract

Purpose:To compare the efficacy of locking plates to non-locking plates in the osteosynthesis of mandibular fractures on the basis of clinical parameters.Materials and Methods:A prospective randomized clinical trial was conducted at the Faculty of Dental Science, CSMMU (formerly King Georges Medical College), Lucknow, to treat consecutive mandible fractures. The patients were randomly divided into two groups. The patients underwent osteosynthesis—group 1 with 2.4-mm locking titanium plates and group 2 with 2.7 mm non-locking titanium plates. The cause of trauma, the number of days from injury to surgery, average age, gender, and site distribution were all reviewed. The assessment of the patients was done at 1, 3, and 6 weeks and 3 months using the clinical parameters.Results:A total of 12 patients with mandibular fractures met the inclusion criteria. In our study, a statistically significant difference was not found in the clinical parameters such as infection, paraesthesia, hardware failure, and mobility between the fracture segments. A statistically significant difference was found between pain and swelling from the previous follow-up visit in groups 1 and 2. In locking group, pain decreases significantly at 3rd week, 6th week, 12th week from 1st week and pain was absent after 3 week. In non-locking group, pain decreases significantly at 3rd week, 6th week and 12th week from 1st week but pain was present till 12th week. Pre-operative swelling was present only in case of non-locking group. Swelling was present in 66.7% of non-locking group and 0% in locking group. After one week swelling was absent in 100% patients at 3rd, 6th and 12th week. Swelling was considerably decreased in locking group as compared to the non-locking group.Conclusion:These findings show that the use of locking plates in mandibular fracture was efficacious enough to bear the masticatory loads during osteosynthesis of the fracture. The locking plates provide the advantage of a greater stability, with clinical results almost similar to those seen with non-locking plate osteosynthesis.

Sequential treatment from mandibulectomy to reconstruction on mandibular oral cancer - Case review II: mandibular anterior and the floor of the mouth lesion of basaloid squamous cell carcinoma and clear cell odontogenic carcinoma

“…The associated easy application, low risk, short surgical time, stability, aesthetic satisfaction, and low costs postoperatively are some advantages of using pre-bent titanium plates in reconstruction. However, non-union, instability, and infection are known complications in such cases 11 .…”

Mandibular intraosseous squamous cell carcinoma lesion associated with odontogenic keratocyst: a case report

“…The advantages of the pre-bended titanium reconstruction plate include: easy application, stability, minimal damage in the blood supply to the underlying bone, low cost, a short operative time, and postoperative aesthetic satisfaction. However, complications such as instability and delayed union, non-union, and infection due to screw loosening may develop 16 .…”

Procedure for Creating Personalized Geometrical Models of the Human Mandible and Corresponding Implants

“…3). The more detailed level 3 classification system [21] (dentition, atrophy, fracture morphology) is presented in [22]. It is also important to note that each fracture can be simple or complex, as is presented in Fig.…”

“…Reconstruction plates are provided in straight and slightly thicker and stiffer pre-curved lengths. They have oval screw holes, like mentioned compression plates, and they allow potential limited compression [22,23]. To create so-called personalized geometrical models of the plates, which fit anatomy of the traumatized region of the mandible, there is a need to use geometrical model of the patient's mandible as a base model that shape of plate should follow [24].…”