Retrospective study of mandibular angle fractures treated with three different fixation systems

Abstract

Aim:To evaluate the outcomes of mandibular angle fractures treated with metal 2.0 mm locking, metal 2.0 mm nonlocking, and 2.5 mm resorbable systems.Study Design:Retrospective cohort study.Materials and Methods:Trauma records were screened for linear angle fractures treated with open-reduction and internal semi-rigid fixation with single metal/bioresorbable plates, and baseline variables were tabulated. The outcome variable was the presence or absence of any complication.Statistical Analysis Used:The Fisher's exact test and analysis of covariance (ANCOVA) using STATA 11.Results:A total of 60 case records of over four years were included. The mean age of the patients was 27.4 (SD 9.7) years. Fifty-five were male and five female. There were 20 nonlocking and 16 locking metal miniplates and 24 bioresorbable plates. In 55 (91.6%) cases there was a third molar in the fracture line. In 51/55 (92.7%) cases the third molar was retained. In seven patients postoperative complications were seen. There was no difference between the complication rates of the three treatment groups. Infection was the most common complication followed by delayed union and hardware failure.Conclusions:This retrospective study found no difference in the complication rate when fractures of the mandibular angle were treated with locking or nonlocking miniplates or bioresorbable plates.

Biodegradable versus titanium osteosynthesis in maxillofacial traumatology: a systematic review with meta-analysis and trial sequential analysis

“…The included studies consisted of 7 publications of RCTs 2,14,33-37 , of which 4 were publications of a single RCT, each with a different FU 2,33,35,36 , 4 prospective cohort studies 11,13,38,39 , and 13 retrospective cohort studies 8,40,[49][50][51][41][42][43][44][45][46][47][48] . Low risk of bias was observed in the 'random sequence generation' domain in all but one of the included RCTs (Table 1).…”

“…The most common types of fractures were mandibular, zygomatic and maxillary fractures. Ten studies solely included patients with mandibular fractures 8,11,13,14,34,38,42,46,47,49 , while six studies included patients with only zygomatic fractures 37,39,41,43,44,50 . The remaining studies included various types of fractures (e.g., Le Fort or orbital fractures) 2,33,35,36,40,45,48,51 .…”

“…The remaining studies included various types of fractures (e.g., Le Fort or orbital fractures) 2,33,35,36,40,45,48,51 . Comminuted fractures were excluded in 16 studies 13,14,43,44,46,47,50,[33][34][35][36]38,39,41,42 , while two studies did not exclude these type of fractures 8,45 . The remaining six studies did not report specific in-or exclusion criteria regarding comminuted fractures 11,37,40,48,49,51 .…”

“…The most commonly used titanium osteosynthesis systems were manufactured by KLS Martin 2,11,33,35,36,41 , Synthes 14,37,40,42,47 , and Stryker 13,43 . Twelve studies reported details regarding the size of the titanium plates and the screws 2,8,40,43,47,11,13,14,33,[35][36][37][38] . The screw diameter ranged from 1.3 to 2.0 mm with corresponding plates, depending on the location of the fracture.…”

“…The most frequently used biodegradable osteosynthesis systems were the Inion CPS (79/15/6 poly-L-lactic acid (PLLA)/poly-DL-lactic acid (PDLLA)/trimethylene carbonate) 2,11,14,33,35,36,44,46,47 and the BioSorb FX (self-reinforced 70/30 PLLA/PDLLA) 38,41,42,46,51 (Table S4). The screw diameters ranged from 1.5 to 2.5 mm, being generally larger compared to the titanium systems for similar fracture types.…”