3D Miniplate Research Articles

The Use of 3D Titanium Miniplates in Surgical Treatment of Patients with Condylar Fractures.

The aim of this study was to evaluate the effectiveness of open treatment of mandibular condyle fractures using 3D miniplates. A group of 113 patients has been chosen for evaluation, including 100 men and 13 women. After hospitalization, each patient underwent a 6-month postoperative follow-up. The material chosen for the analysis consisted of data collected during the patient’s stay in the hospital as well as the postoperative outpatient care. A single 4-hole Delta Condyle Compression Plate (4-DCCP) was used in 90 out of 113 (79.6%) cases. In 16 out of 113 (14.2%) patients, the Trapezoid Condyle Plate (4-TCP or 9-TCP) was used. The remaining cases required more than one miniplate. No 3D miniplate fractures were found in the study subjects during the analyzed observation period. Loosening of one or more osteosynthesis screws was observed in 4 out of 113 (3.5%) patients. Screw loosening was a complication that did not affect bone healing in any of the patient cases. The conducted research confirms that titanium 3D mini-plates are easy to adjust and take up little space, therefore they can easily be used in cases of mandibular condyle base and lower condyle neck fractures. The stability of the three-dimensional miniplates for osteosynthesis gives very good reliability for the rigid fixation of the fractured mandibular condyle.

Comparative Evaluation of Three Different Techniques for Open Reduction and Fixation of Anterior MandibulComparative Evaluation of Three Different Techniques for Open Reduction and Fixation of Anterior Mandibular Fracturesar Fractures

Aim of the study: To compare the safety and efficacy of three different fixation techniques for anterior mandibular fractures,namely two lag screws, 3D miniplate, and two miniplates.Methods: In randomized, controlled, trial, we enrolled patients with anterior mandibular fractures. Patients were randomlyallocated to one of the following fixation techniques: group (1): two lag screws, group (2): 3D miniplate and group (3): twominiplates. All patients were followed-up for six months.Results: Thirty patients were included. The miniplates group had statistically significant longer time for hardware fixationthan patients in the other two groups (p 0.05). The overall rate of moderate postoperative complications wassignificantly higher in miniplates group than lag screw and 3D plate groups at the 1st postoperative week (p = 0.01). On the1st postoperative months, the overall rate of mild complications was significantly higher in miniplates group than lag screwand 3D plate groups at the 1st postoperative week and month (p < 0.001).Conclusion: Fixation with lag screws and 3D plates lead to less frequency and severity of postoperative complications thanfixation with miniplates for anterior mandibular fractures.

COMPARISON OF BONE HEALING AFTER THE USE OF A THREE DIMENSIONAL MINIPLATE AND A CONVENTIONAL MINIPLATE IN MANDIBULAR BODY OSTEOTOMY (AN EXPERIMENTAL STUDY)

Introduction: Mandibular fractures comprise most of the traumatic injuries treated by an oral and maxillofacial surgeon. The aim of fracture treatment is to restore the architecture and function of bone. Many techniques for treating mandibular fractures have evolved over the years. The design of the three dimensional (3D) plate is conceptually that of 2 linear plates connected by reinforcing vertical struts providing greater resistance against gap opening at the inferior border with biting forces. Objectives: To compare histologically bone healing of mandibular body osteotomy after using either a 3D miniplate or conventional miniplates. Materials and methods: This study was conducted on twelve healthy dogs. An iatrogenic osteotomy defect was performed intra-orally between the mandibular 3rd and 4th premolars using a surgical micro reciprocating saw. The fragments will be reduced bimanually and stabilized: Group A (six dogs): 3D miniplates. Group B (six dogs): conventional miniplates. The dogs were euthanized at 2 and 6 weeks postoperatively and the osteotomy sites were excised, divided into three thirds (Tension Third, TT; Intermediary Third, IT; Compression Third, CT) and prepared for histological analysis. Results:The osteotomy site was completely filled with parallel-fibred bone, with more newly formed Haversian systems in Group A compared with Group B, bone repair did not reach the typical aspects of the parent lamellar bone. The percentages of newly formed bone at 2 weeks in group A according to thirds (TT, IT and CT) that reported have a statistically significant difference in comparison with group B. At 6 weeks, there were no statistically significant differences between the two groups among the TT and CT but there was a statistically significant difference (p4 = 0.039) in the IT. Conclusions: 3-D plates could be a better option than conventional miniplates.

A Comparative Assessment of the Management of Mandibular Angle Fractures using 3D Plates and 2D Mini Plates

The aim of this study was to compare 2D plates with 3D miniplate system in the management of mandibular angle fractures. The study was conducted on 146 patients with mandibular angle fracture, who were equally divided into two groups of 73. Patients in group I were treated with 3D plating and in group II with 2D plating. In all cases, 2.0 mm titanium miniplates were used. The etiology of fracture, amount of mouth opening, and pain and sensory deficit were recorded. Clinical and radiographic assessment was done at 1, 3, and 6 months. The etiology of mandibular angle fracture is roadside accident (RSA) seen in 110 (75.3%) cases, fall in 24 (16.4%), and assault in 12 (2.6%) cases. There was significant (p < 0.05) mouth opening in group I at 1 month postoperatively (32.4 mm) as compared to group II (27.5 mm), at 3 months in group I (33.6 mm) as compared to group II (30.2 mm), and at 6 months in group I (36.4 mm) as compared to group II (31.6 mm). After 1 month, sensory deficit was present in six patients in group I and 10 patients in group II. After 3 months, group I had no patients and three patients in group II. Right angle fracture was found in 71 patients (group I-36, group II-35). Mandibular right angle fracture in 58 patients (group I-28, group II-30). The authors found that the 3D miniplate system is more useful in the management of cases of mandibular angle fracture as compared to 2D miniplates. There has been increase in mandibular fractures in the last few years. Appropriate management with 3D miniplates may be useful in providing better treatment outcomes.

Comparative study of outcomes between locking plates and three-dimensional plates in mandibular fractures.

Objectives:The objective was to compare the efficiency and assess postoperative complications of 2.00 mm unicortical locking plates and three-dimensional (3D) plates in surgical correction of uncomplicated mandibular fracture.Materials and Methods:A prospective cohort study of twenty patients of uncomplicated mandibular fractures, who were operated either by noncompression unicortical 2-mm locking mini-plate or by noncompression unicortical 2-mm 3D mini-plate, were enrolled and followed up for the study outcomes such as operative time, postoperative infection, and postoperative occlusion.Results:Majority of the patients (90%) were male who had road traffic accident. In 80% of cases, mandibular fracture site was parasymphysis. The mean operating time for 3D plates (43.20 min) was significantly lower than that for locking plates (54.82 min), P < 0.001. All cases operated by 3D plates compared to 60% by locking mini-plates did not need intermaxillary fixation, P = 0.025. The 80% of cases operated by 3D plates did not require postoperative occlusion correction compared to 30% in another group, P = 0.01. For other parameters such as postoperative sensory disturbance, postoperative infection, incidence tooth damage, vertical displacement of mandible, feeling of plate after platting, and chewing efficiency after 1 week, there were no statistical significant differences between the two groups.Conclusions:The outcome of 2.0mm 3D mini-plate is better in terms of operating time required, post-operative need of intermaxillary fixation and occlusal correction. While the outcome is similar to the use of non-compression unicortical 2.00mm locking miniplate in parameters like infection rate and incidence of tooth damage etc.

2 mm Conventional Miniplates with Three-Dimensional Strut Plate in Mandibular Fractures.

Aim:The aim of this study was to compare 2 mm conventional miniplates with three-dimensional (3D) strut plates in the treatment of mandibular fractures treated in the Department of Oral and Maxillofacial Surgery of a college in India, during 2012–2015.Materials and Methods:All 20 patients with mandible fracture requiring open reduction and internal fixation of the fracture were reported and reviewed in the Department of Oral and Maxillofacial Surgery of the same dental college in India, during 2012–2015. We classified the data according to the gender, age, etiology, fracture site, and method of treatment of the fractures. Fixation done in 10 patients with 2 mm conventional miniplates kept in Group I, while 10 patients with 3D strut miniplate system considered in Group II.Results:Assessment of patient was done under the following parameters with follow-up at regular intervals at 2nd day postoperatively and at 1st, 3rd, and 6th weeks postoperatively: pain, swelling, infection, interincisal mouth opening in millimeters, paresthesia/anesthesia, mobility between fracture fragments, overall occlusion, need for any supplemental fixation, fate of implant, and complications.Conclusions:3D titanium miniplates showed similar results when compared to standard titanium miniplates with advantages such as reduction in operative time, ease of placement, and cost-effective over the conventional plate system.

Comparative evaluation of 2D miniplates and 3D miniplates fixation in mandibular angle fracture - A clinical study.

Mandibular angle fracture is common in road traffic accidents. This study was conducted to compare 3D miniplate system with 2D plates for treatment of mandibular angle fractures. The study was conducted on 120 patients with mandibular angle fracture of both genders. After selecting patients, patients were divided into 2 groups of 60 each. In group I, patients were treated with 3D, 2.0-mm titanium plates, and in group II, patients were treated with 2D, 2.0-mm titanium miniplate in mandibular angle fracture. Patients were evaluated regularly after 1, 3, and 6 months for outcome of treatment. In group I, males were 22 and females were 38. In group II, males were 40 and females were 20. Right angle fracture was seen in 32 patients in group I and 26 in group II. Left angle fracture was seen in 24 in group I and 28 in group II. Right angle and left parasymphysis fracture was seen in 3 in group I and 4 in group II. Left angle and right parasymphysis fracture was seen in 1 in group I and 2 in group II. [Table 3], [Graph 1] shows that in group I, after 1 month sensory deficit was present in 5 patients and in group II in 12 patients. After 3 months, there were no patients with sensory deficit in group I and 2 in group II. Preoperatively in group I, mouth opening was 24 mm and in group II patients was 25.80 mm, which increased to 31.20 mm in group I and 28.20 mm in group II at 1 month, 32 mm in group I and 30 mm in group II at 3 months, and 37.20 and 32.12 mm in groups I and II, respectively, at 6 months. The difference was significant (P < 0.05). 3D miniplate system is reliable and effective treatment modality for mandibular angle fractures as compared with traditional 2D miniplates.[INLINE:1].

Evaluation of labial versus labio-inferior lines of osteosynthesis using 3D miniplate for fractures of anterior mandible: A finite element analysis with a pilot clinical trial

PurposeThe fractures of anterior mandible are subject to severe torsional forces due to muscles acting in opposite directions. 3D miniplate has been suggested as a good alternative by some researchers. However, finite element model (FEM) studies indicate that labio-inferior positioning of two miniplates perpendicular to each other offers better stability as compared to labial positioning. This study aims at combining the advantages of a single 3D miniplate and labio-inferior positioning of two conventional miniplates, which was assessed by finite element analysis along with a pilot clinical trial. MethodsTwo FEM models were created using CT data of a 24-year-old patient with Angle class I occlusion: control model with labial plating and study model with labio-inferior plating. The models were processed with MIMICS® (materialise, Leuven, Belgium), CATIA® (Dassault Systemes) and finite element analysis softwares. Parameters adopted for analysis were (1) displacement (mm) of fracture fragments during each screw fixation, (2) lingual splay and post fixation stability of fracture fragments with masticatory load, and (3) stress distribution (MPa) across fracture fragments. Moreover, a pilot clinical trial including five patients with anterior mandible fracture was conducted. The fractures were managed by intraoral open reduction and 3D miniplate fixation in labio-inferior position. Intraoperative interfragmentary gap, post fixation lingual splay and radiographic fracture union and complications were assessed clinically. ResultsLabio-inferior plating demonstrated less displacement (mm) of fracture fragments during screw fixation (0.059 vs. 0.079) as well as after application of masticatory load (1.805 vs. 1.860). Negligible lingual splay and less stress distribution (MPa) across fracture fragments (1.860 vs. 1.847) were appreciated in the study group as compared to control group. Clinical trial support the favorable outcome related to intraoperative and postoperative assessment parameters. ConclusionFEM analysis and clinical trial reveal better results with labio-inferior positioning of 3D miniplate when compared to labial positioning.

Efficacy of different fixation techniques in repair of anterior mandibular fractures

Objective: To compare between double straight miniplates, double inverted L- shaped miniplates ,and three dimensional ( 3 D) rectangular miniplate in fixation of anterior mandibular (symphyseal / parasymphyseal area) fractures .Patients and methods: Thirty adult patients with anterior mandibular fractures were included in this study. The patients were divided randomly into three equal groups, group I was treated by superior and inferior straight miniplate while group II was treated by double L- shaped miniplates fixation technique and group III was treated by 3D rectangular miniplate. Postoperative clinical, radiographic evaluation and quantitative measurements were performed.Results: Wound healing was optimal in all cases except two cases in group I and one case in group II. Satisfactory occlusion was obtained in all cases except three cases in group I where it had mild to moderate occlusal derangement. Other parameters including maximal mouth opening, sensory nerve function, and patient's tolerance to the plate were comparable. There were the similarity between the density changes for the three groups as there was highly significant difference in G(I) compared to G(II) at six months, and G(I) compared to G(III) at three and six months also between G (II) compared to G(III) at six months. .Conclusion: Both double L-shaped miniplates and 3D rectangular miniplate provided enough stability for proper bone healing, establishment of optimal occlusion and early return to normal function more than with double straight miniplates. Additionally, there is superiority of 3 D rectangular miniplate over double inverted L- shaped miniplates in these parameters.

Management of mandibular angle fractures using 3- dimensional or standard miniplates: A systematic review and meta-analysis

PurposeThis study proposed to compare clinical outcomes between three-dimensional (3D) plate and standard miniplate fixation systems for the management of mandibular angle fractures (MAFs). MethodsA systematic review search of several databases, including MEDLINE-Ovid, Embase, Springer Link, and PubMed, for relevant articles in English and without date restrictions was performed in February 2018. The quality of studies was assessed, and the relative risk (RR) with its corresponding 95% confidence interval (CI) was assessed to measure postoperative complications. ResultsEleven publications were enrolled in the analysis. The results showed that there were significant differences in overall complications (RR, 0.453; 95% CI, 0.311–0.660; P = 0.007). The incidence of hardware failure showed a statistically significant difference in the outcome, favoring 3D miniplates (fixed: RR 0.156; 95% CI, 0.042–0.581; P = 0.0006). Subgroup analyses indicated that the 3D miniplate caused a lower incidence rate of malunion and hardware failure than the standard miniplate with 8 or 10 holes (P = 0.006, P = 0.03, respectively). In addition, the use of standard miniplates had a shorter operation time than the use of 3D miniplates (P = 0.002). ConclusionThe present study demonstrates that the three-dimensional miniplate was a better fixation system than the standard miniplate technique in reducing postoperative complications in the management of mandibular angle fracture (P = 0.007).

Three-Dimensional Miniplate: For the Management of Mandibular Parasymphysis Fractures.

Background:Recently, oral and maxillofacial surgeons are favoring three-dimensional (3D) miniplates to treat mandibular fractures.Aims:The aim of the study is to evaluate the efficacy of 3D-miniplates over standard miniplates in the management of mandibular parasymphysis fracture.Materials and Methods:Forty patients with mandibular parasymphysis fractures were divided into two groups of 20 patients each. Group I patients underwent osteosynthesis of mandibular fracture by noncompression, unicortical, and stainless steel 3D miniplates, and Group II patients underwent osteosynthesis by noncompression, unicortical, and stainless steel Champy's miniplates. All the patients were followed up 6 months’ postoperatively, evaluating occlusion, mobility of fracture segment, pain, wound dehiscence, neurological deficit, and infection.Statistical Analysis Used:The data were analyzed by SPSS for windows (version 17) statistical package (SPSS Inc., Chicago, IL, USA). Chi-square test was carried out to determine the statistical difference between the groups.Results:Mobility of the fractured site was evaluated postoperatively after 2 weeks, and it was found that mobility was absent in all the cases of Group I and 36 (80%) cases in Group II. There was significant difference in the mean visual analog scale scores among the Group I and II when compared from preoperative to 4-week follow-up. In Group II, two patients showed wound dehiscence. After 2 weeks, infection was seen in two patients of Group II.Conclusion:3D plates in mandibular parasymphysis fractures give dimensional stability and carry low morbidity and infection rates.

Management of anterior mandibular fractures using four fixation methods: A clinical comparative study

Purpose: To compare the surgical outcomes of three-dimensional (3D) mini-plates for fixationof anterior mandibular fractures (AMFs) and those of bone plates and lag screws.Materials and methods: Patients with AMFs, who met the inclusion criteria, were equallydistributed into 4 groups. Those in Group I were treated with double 2.0 mm mini-plates, patientsin Group II were treated with double lag screws, 2.3mm locking plates were used in group III,while in Group IV 2.0 mm 3D mini-plates were used. Prior to the surgical intervention, MMF wasperformed to verify the centric occlusion in all patients. After hardware fixation, the MMF wasintraoperatively released, and the adequacy of fixation and occlusion was verified. The operationtime and postoperative outcomes were also analyzed.Results: Sixty patients (41 males and 19 females) were included in this prospective study.There were no significant differences in demographic data. The clinical examination showed stablefixation with no mobility in all cases. None of the patients in the 3D mini-plates group showedclinical manifestations of infection or dehiscence. The incidence of malocclusion was the highestin the mini-plates group. There was no statistically significant difference among the groups in allparameters, except for infection and paresthesia. They were significantly greater in double miniplatesand 2.3 mm locking plate groups respectively.Conclusion: The use of 3D mini-plates is a viable option for fixation of AMFs. It has advantagesof both lag screws and bone plates. A 3D mini-plate provided sufficient inter-fragmentary stabilitywith a relatively low rate of complications when compared with other conventional fixationtechniques.

Surgical Management of Mandibular Angle Fractures.

The study proposed to determine the superiority between different fixation methods in the mandibular angle fractures (MAFs) and to evaluate best option for surgeon and patient. A systematic review was conducted according to PRISMA guidelines, examining Medline-Ovid, Embase, and Pubmed databases. The quality of studies was assessed, and the odds risk (OR) with its corresponding 95% confidence interval (CI) was assessed to measure the effect size. Subgroup analyses by different fracture regions and different miniplate sizes were performed. Publication bias was measured by a funnel plot. Twenty-one articles were enrolled in this review: 8 randomized controlled trials , 2 controlled clinical trials, and 11 retrospective studies. There were significant advantages for 3-dimensional (3D) miniplate (OR = 0.48, P = 0.003, 95% CI, 0.35-0.67) and 1 miniplate (OR 0.38, 95% CI 0.25-0.58, P < 0.00001). The cumulative OR for locking miniplate was 0.45, showing that the utilizing of locking mini-plate in management of MAFs decreases postoperative complications risk by 55% over the use of nonlocking mini-plate. The results of this review indicated that the use of 3D miniplate, locking plate, and 1 plate were more advanced to 2 miniplates technique in low incidence of postoperative complications in the treatment of MAFs.

Comparative evaluation of different fixation techniques of the sagittal split ramus osteotomy in 10 mm advancements: Mechanical testing and screw insertion torque

PurposeTo compare the mechanical characteristics of five techniques for the functionally stable fixation of simulated sagittal split ramus osteotomy with 10 mm of advancement and to evaluate the screw insertion torque. Materials and methodsFifty polyurethane hemimandibles with sagittal split ramus osteotomy and containing an advancement of 10 mm fixed and distributed as follows: Customized 3D Plate Group: 1 customized 3D miniplate; 4-Hole Plate Group: 2 miniplates with 4 holes; 6-Hole Plate Group: 2 miniplates with 6 holes; Hybrid Group: 1 flat miniplate with 4 holes and 1 bicortical screw; and Bicortical Screw Group: 3 bicortical screws. We conducted a mechanical test using vertical linear loading with a displacement velocity of 1 mm/min on a universal testing machine and assessed the screw insertion torque using a digital torque wrench. ResultsThe means of strength for the 1-, 3- and 5-mm displacements were determined by a one-way analysis of variance (ANOVA) followed by the post hoc Tukey test. Statistically significant differences were observed only for the 5-mm displacement (F = 3.36; p = 0.01). There was a difference between the 4-H2P and HG groups (p = 0.04). ConclusionThe customized miniplate, the fixation methods with three bicortical screws, or with two straight miniplates with either 4 or 6 holes, all offer a similar mechanical resistance suitable for fixation.

MANDIBULAR SYMPHYSIS FRACTURES

Introduction: Mandible is one of the most commonly fractured bones inmaxillofacial trauma. Mandibular symphysis is a common site of mandibular fractures. Compareto conventional miniplates, three dimentional plates were found more effective in terms of postoperative occlusion, post operative mobility of reduced fractured segments and the degree ofanatomic reduction. Objectives: Compare the conventional 2.0mm mini plates versus 3D miniplates in the fixation of isolated mandibular symphysis fractures. Study Design: Interventionalstudy. Setting: Oral &amp; Maxillofacial Surgery Department, Abbasi Shaheed Hospital Karachi.Period: Two years from 1st January 2013 to 2nd January 2015. Material &amp; Methods: Onehundred and fifty four patients were randomly selected and allocated into two groups. Group‘I’in which patients were treated with conventional mini plates and group‘II’ where patients weretreated with 3D mini plates. Results: Mean (+SD) age of patients was 29.53 (±7.88) years.Among 154 patients in this study, majority (75.3%) of cases had age 20 - 35 years. Majority,124 (81.2)were males and 29 (18.8%) were females. In Group I, anatomic reduction at 3 monthpost-operative was observed in 30 (39%). In Group II (3D Plates) at 3 months post-operatively,ideal molar relationship was higher (89.6% Vs. 98.7%; p-value = 0.016), fracture mobility waslower (14.3% Vs. 2.6%; p-value = 0.009) and higher anatomic reduction. Conclusion: Threedimensional miniplates are more effective compared to conventional miniplates.

Novel Use of Orbita Plates in Mandibular Body Fractures.

Isolated fractures of the mandibular body separate the dentate border and compress lower border when subjected to masticatory forces. This study aims at evaluating the efficacy of two Orbita plates in Champy's osteosynthesis lines along with achieving 3D configuration and preventing trauma to mental foramen. (1) To achieve a near 3D configuration by fixing the terminal parts of both plates in contact with each other; (2) to preserve the mental nerve within the ellipse created by two Orbita plates; and (3) to prevent damage to the root apices from the upper plate. This study was performed on 20 patients with mandible body fracture through the mental foramina. With the intraoral vestibular approach, two Orbita miniplates were fixed in Champy's osteosynthesis lines. A geometrically closed quadrangular relationship was achieved in the shape of an ellipse, with the mental nerve emerging from it. Fracture healing was optimum in all the cases along with satisfactory occlusion. Postoperative intermaxillary fixation was not required. Mental nerve function impairment was insignificant. This served to achieve satisfactory functional outcomes in patients with mandible body fracture without injury to roots and along with achieving a geometrically close quadrangular relationship even where 3D miniplates cannot be placed.

Bite Force as a Parameter for Comparison Between Three-Dimensional and Standard Titanium Miniplates for the Management of Anterior Mandibular Fractures: A Prospective Randomized Double-Blinded Clinical Trial.

To compare the efficacy of three-dimensional (3D) miniplates with standard miniplates in the osteosynthesis of anterior mandibular fractures on the basis of bite force recordings and other clinical parameters. A prospective randomized double-blinded clinical trial was carried out for the treatment of anterior mandibular fractures. In total, 20 patients were randomly divided into two groups of 2-mm 3D and standard titanium miniplates. The assessment of patients was done at weekly intervals for 6weeks using bite force recordings and other clinical parameters. A statistically significant difference was found in the duration of surgery which was less in group A as compared to group B (p=0.03). No significant difference was found in other clinical parameters. The clinical outcome of both the 3D and standard miniplate systems in the present study was similar; however, the following advantages with the use of 3D miniplates can be highlighted:Relatively lesser operating time.Three-dimensional stability of the fracture site and simultaneous stabilization at superior and inferior borders in the fixation of mandibular fractures.

A comparative evaluation of bite force as a parameter for the stability in conventional and three-dimensional mini plates

Introduction: Maxillofacial skeleton fractures can be treated by open (surgical) and closed (non-surgical) techniques. Fracture sites are immobilized either with intermaxillary fixation or external or internal devices (i.e. plates and screws) to allow bone healing. Aim: The study was primarily aimed at investigating the comparison between three-dimensional (3D) mini plates versus conventional mini plates in mandibular fractures under functional load. Methodology: This study was carried out in twenty patients for treatment of mandibular fractures. Bite force readings were made using indigenous bite force recorder in kilograms. Bite forces were recorded at the operated site and contralateral site of the same region. Bite force recordings were done preoperatively before fixing Erich arch bar and postoperatively at each follow-up (7th, 14th, 21st, 28th, and 90th day). Observations: Data show postoperatively in operated sites of the molar that patients in Group A generate more biting force on day 28 and day 90 when compared to Group B. The difference in mean bite force over control group on fractured sites of molars and incisors when comparison was done between postoperative days interval was significant. Conclusion: It was concluded that the 3D mini plates in mandibular fractures are efficacious enough to bear masticatory loads during the osteosynthesis of fracture. It gives the advantage of reduced implant material and 3D stability with almost similar results as seen in two conventional mini plates osteosynthesis.

Are three-dimensional plates as effective as superior border plating in mandibular angle fractures? A comparative evaluation of effectiveness

Purpose: The purpose of this study is to evaluate the effectiveness of three-dimensional (3D) miniplates over standard miniplates in the management of mandibular angle fracture. Materials and Methods: This study included 40 individuals who were diagnosed clinically and radiographically to have sustained mandibular angle fracture and subsequently underwent open reduction and internal fixation (ORIF). All participants were divided randomly in to two groups. Group I included 20 patients who underwent ORIF for angle fracture with superior border plating using 2 mm 4 hole with gap miniplate while Group II included 20 patients who underwent ORIF with rectangular 3D miniplate placed through an intraoral incision in conjunction with the use of a trocar through percutaneous route for fixation of plate. Results: Patients who were treated using 3D plates had more pain on visual analog scale score and reduced mouth opening in the immediate postoperative phase. However, the stability at the facture site was superior to that of those treated by superior border plating. Conclusion: 3D plate was found to be standard in profile, strong yet malleable, facilitating reduction, and stabilization at both the superior and inferior borders, thereby giving a 3D stability at the fracture site and early return to normal function.

A Comparative Prospective Study of Three different Bone Plating Methods for treatment of Mandibular Symphysis and Parasymphysis Fractures

Background Recently, various modifications in placing miniplates for direct fixation of the mandibular fracture are gaining popularity. The modifications have various advantages like more rigidity, less foreign material, less time in application, etc. Thus the purpose of this prospective study was to evaluate outcomes for three bone plating techniques used in the treatment of mandibular symphysis/ parasymphysis fractures.Methods A prospective study was conducted on 45 patients with mandibular symphysis/parasymphysis fractures and the patients were divided into 3 groups (A, B and C). Patients were followed for 3 months. Outcome parameters like occlusion, distraction of lower border radiologically, parasthesia, infection, failure of bone plate (plate fracture) and screw loosening, postoperative segmental stability and radiological evaluation of fixation were recorded.Results Distraction of lower border was seen in all the groups which were noticed radiographically at all follow ups. There was no occlusal discrepancy present in all the groups after three months post operatively. The fracture segments were stable in all groups at all times. Parasthesia was noticed in all the groups, which gradually decreased in one month and resolved completely by third month follow up. The degree of parasthesia, distraction of lower border, occlusal discrepancy was not statistically significant between the three groups. Hardware failure was not found in all the groups.Conclusion It can be concluded that conventional miniplate system is a better and easier method than the 3D miniplate system for fixation of mandibular fractures. In comparison, the 3D miniplate system is unfavorable for use in cases of oblique fractures and those involving the mental nerve, and is also difficult to adapt.