Evaluation of osteosynthesis of miniplate versus lag screw in management of mandibular angle fracture - A comparative study

Abstract

The aim of the study was to compare lag screw and standard (Champy’s) miniplate fixation in the management of mandibular angle fractures and to analyze advantages and disadvantages of one over the other. A total of 30 patients involving mandibular angle fracture reporting to the Department of Oral, Maxillofacial and Reconstructive Surgery, Bapuji Dental College and Hospital, Davangere, were included in the study. Patients were divided into two groups randomly. The procedure was carried out under general anesthesia. Following strict aseptic precautions, an appropriate intraoral/extra-oral incision was selected; fracture site identified, reduced, and after obtaining satisfactory occlusion, temporary maxillo-mandibular fixation was placed using either Erich’s arch bar or Ivy loop eyelet wiring. Fixation was done using either standard miniplate (Group 1) or lag screw (Group 2). The patients were followed up for a period of 2 months at the interval of 1 week, 2 weeks, 4 weeks, and 8 weeks by a blinded experienced oral surgeon for infection, segmental mobility, postoperative occlusion and radiological evaluation of reduction and fixation. Duration of fixation was found to be less in lag screw group than in miniplate group. Radiological evaluation of reduction and fixation was significant in both the groups. No significant difference was found between both the groups in clinical parameters such as infection, segmental mobility and postoperative occlusion. The clinical outcomes of both the lag screw system and standard miniplate systems in the present study were similar. However, the following advantages with the use of lag screw can be highlighted: Relatively lesser fixation time, Superior fracture fragment stability, fewer complications, Stable occlusion & less hardware, less cost required.