Titanium Lag Screw Versus Miniplate Fixation in the Treatment of Anterior Mandibular Fractures

Abstract

The use of plates for open reduction and internal fixation of mandibular fractures has become a widely accepted method in the past 3decades. However, the anterior mandible is well suited to lag screw fixation owing to the thickness of its bony cortices. Hence, the purpose of the present study was to comparatively evaluate clinical outcomes of fixation using lag screws and miniplates in anterior mandibular fractures. Fifty patients reporting to the department of oral and maxillofacial surgery with noncomminuted anterior mandibular fractures were randomly divided into 2 groups of 25 patients each. Patients in group A were treated with 2.5-mm lag screws 22 to 26mm in length and those in group B were treated with 2.0-mm 4-hole miniplates with a gap using monocortical screws. Subsequent follow-up was performed at 3, 6, 12, and 24weeks postoperatively. The primary determinants included radiographic analysis of the fracture gap and biting efficiency of the patients in groups A and B. The secondary determinants included evaluation of duration of surgery, occlusion before and after injury, and postoperative complications. Results were evaluated using χ2 and unpaired t tests. The mean age of the patients in this study was 29.1±8.32years (range, 18 to 67yr). The mean postoperative fracture gap was considerably larger in group B. The mean duration of surgery (minutes) was 37.60±9.30 for group A and 47±6.55 for group B. The difference was statistically significant (P=.001). The lag screw group showed faster improvement in biting efficiency compared with the miniplate group. Lag screw fixation was found to have good stability and rigidity, was inexpensive, and was less time consuming in treating anterior mandibular fractures compared with miniplates.