Treatment Of Mandible Fractures Research Articles

Wire Osteosynthesis in the Treatment of Mandible Fractures in Low Resource Settings: A Force Study.

Cadaveric investigation. Rigid internal fixation (RIF) using plates and screws is often not feasible in low and middle-income countries due to limited resources. Interosseous wiring to achieve semi-rigid fixation is often used, but lacks biomechanical force data. Herein we aim to quantitatively compare interosseous wiring to RIF. Cadaveric mandibles were fractured at the parasymphysis and angle. Fixation was achieved using interosseous wiring in both single wire loop and figure-of-eight formations, as well as plate and screw fixation (n = 5 for each fixation type at each fracture site). A force gauge was used to measure the number of Newtons (N) required to achieve diastasis and complete failure at the fixation site. For angle fractures, the mean force required for initial diastasis was 4.1, 5.9, and 10.9N for single wire, figure-of-eight wiring, and plating respectively (P < .001). Complete failure was achieved with 152.9, 168.9, and 237.6N of force for the three methods, respectively (P < .001). Complete failure was achieved for parasymphyseal fractures with 197.7, 263.0, and 262.8N of force for single wire, figure-of-eight wiring, and plating respectively (P = .002). Forces to achieve initial diastasis for parasymphyseal fractures were not statistically significant among the three fixation methods (P = .29). Figure-of-eight interosseous wiring resists comparable forces across mandibular fractures compared to the gold standard of plating. In resource-limited settings when plates and screws are not available, this technique can be considered to achieve semi-rigid fixation of mandibular fractures.

Complicated Mandible Fracture Treatment with Xenogenic Bone Graft

The problem of filling bone cavities remains relevant in maxillofacial and oral surgery. There is a large selection of osteotropic materials, of various natures, for filling bone defects of different etiologies. The aim of our research was to improve the outcome of surgical treatment in a patient with a complicated mandibular fracture, with the use of a collagenic xenograft during osteosynthesis. In this article, we share our experience of the treatment of a patient with a complicated mandibular angle fracture, in combination with a follicular cyst. The obligate steps of treatment included stabilization of the bone fragments, decreasing the risk of fracture line malposition, using titan mini-plates, and shortening the time of bone regeneration, by filling the bone defect with osteotropic material. This approach allowed us to reduce the rehabilitation period and further prosthetic treatment after 4–5 months, without additional bone grafting manipulations. Thus, the use of collagen osteotropic materials, possessing osteoconductive properties, can improve the treatment of patients with mandibular fractures.

Late treatment of mandible fracture after third molar removal

Surgical management of impacted third molars is a treatment performed by dentists and its indicated for various conditions, among the indications has the prevention of mandibular fracture, but this is a factor that has been discussed and is controversial. Fractures caused by a third molar can occur, and on the other hand, the fractures after or during the management of impacted third molar are a possible complication. Surgical planning as the indication to the surgery has to be performed to avoid complications as the fracture. Thus this study aims to report a case about a mandible fracture after third molar extraction, presenting edema, pain, and restriction in mandible mobility in 01-day follow-up. A 27-year-old female was referred to the oral and maxillofacial surgery service of the Santa Casa Hospital of Araçatuba (Araçatuba, Brazil), reporting dental history of third molar removal, with immediately chief complaints. In the assessment, the patient presented edema, pain, malocclusion, and restriction in mandible mobility, and the panoramic X-ray showed a mandible fracture with displacement. The patient underwent surgery under general anesthesia to open reduction with internal fixation (ORIF) through an intraoral approach. On the follow-up, the patient showed an improvement in mouth opening and mandibular mobility without pain or infection signs. The panoramic X-Rays showed us the bone fracture healing.

Potentially modifiable patient factors in mandible fracture complications: a systematic review and meta-analysis

Introduction: The mandible is the most common bone to develop complications following treatment of facial fractures. This is due to a complex interaction of both fracture specific and patient factors. Our aim was to identify those patient factors, with a specific focus on those that may be potentially modifiable to reduce the incidence of complications. Methods: A systematic review of the literature was undertaken using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology to identify patient factors ascribed to an increased risk of complications following mandible fracture treatment. These were divided non- modifiable and potentially modifiable factors. A meta-analysis was performed to weight those factors for which statistical analysis had been performed. Results: 22 pertinent papers were identified, of which 8 described non-modifiable and 7 potentially modifiable factors. The most common potentially modifiable factor identified was smoking. Meta-analysis established that tobacco smoking demonstrated an increased risk of complications in three studies (OR: 4.04 – 8.09). Conclusions: Division of patient factors into those that are potentially modifiable and those that are not will enable clinicians to focus on those in which change within the immediate post-operative period can be instigated. This includes smoking cessation assistance, education as to the need for a soft diet and facilitating post- operative clinic attendance. It also enables stratification of risk in terms of consent, and choice of treatment. Further research should use standardised terminology, particularly in stopping the use of generalizable terms such as patient compliance and instead describing its individual components. Introduction: The mandible is the most common bone to develop complications following treatment of facial fractures. This is due to a complex interaction of both fracture specific and patient factors. Our aim was to identify those patient factors, with a specific focus on those that may be potentially modifiable to reduce the incidence of complications. Methods: A systematic review of the literature was undertaken using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology to identify patient factors ascribed to an increased risk of complications following mandible fracture treatment. These were divided non- modifiable and potentially modifiable factors. A meta-analysis was performed to weight those factors for which statistical analysis had been performed. Results: 22 pertinent papers were identified, of which 8 described non-modifiable and 7 potentially modifiable factors. The most common potentially modifiable factor identified was smoking. Meta-analysis established that tobacco smoking demonstrated an increased risk of complications in three studies (OR: 4.04 – 8.09). Conclusions: Division of patient factors into those that are potentially modifiable and those that are not will enable clinicians to focus on those in which change within the immediate post-operative period can be instigated. This includes smoking cessation assistance, education as to the need for a soft diet and facilitating post- operative clinic attendance. It also enables stratification of risk in terms of consent, and choice of treatment. Further research should use standardised terminology, particularly in stopping the use of generalizable terms such as patient compliance and instead describing its individual components.

Comparative evaluation of biting force in 2mm locking plates with 2mm miniplates in the treatment of mandible fractures: A clinical study

1. To compare efficacy of 2mm locking plates with 2mm miniplates in the fixation of mandible fractures and 2. To evaluate and compare the biomechanical function by measuring the bite force at 1st week, 3rd week, 6th week and 3rd month postoperatively in 20 patients divided equally into two study groups.A prospective randomized study was carried out at Department of Oral and Maxillofacial Surgery, Meghna Institute of Dental Sciences, Nizamabad from 2019 to 2021 to treat consecutive mandibular fractures where patients were randomly divided into two groups each composed of 10 patients where Group A were treated with single 4 holed stainless-steel locking miniplates and Group B with two 4 holed stainless steel conventional mini plates both maintaining a gap of 2.0 mm system. Later assessment was done using bite force recording postoperatively at 1st week, 3rd week, 6th week and 3rd month and with the associated complications like Swelling, Infection, Paresthesia, Mobility between fracture fragments and Hardware failure.When the mean bite force values in right molar region of group A and group B were compared at 1st week, 3rd week, 6th week and 3rd month, there was statistically significant increase in bite force noted in group A when compared to group B at 1st week and 3rd week (P&amp;#60;0.05). But no statistically significant differences were observed at 6th week and 3rd month (P&amp;#62;0.05).When the mean bite force values in the central incisor region of group A and group B were compared at 1st week, 3rd week, 6th week and 3rd month, there was statistically significant increase in bite force noted in group A compared to group B at 1st week and 3rd week (P&amp;#60;0.05). But no statistically significant differences were observed at 6th week and 3rd month (P&amp;#62;0.05).When the mean bite force values in left molar region of group A and group B were compared at 1st week, 3rd week, 6th week and 3rd month, there was statistically significant increase in bite force noted in group A when compared group B at 3rd week (P&amp;#60;0.05). But no statistically significant differences were observed at 1st week, 6th week and 3rd month (P&amp;#62;0.05).The study signifies that both the fixation systems were able to provide stability to fracture segments, but locking plate system has provided better stability when compared to miniplates system, hence recommending for more elaborative studies to arrive at definitive conclusion.

Major clinical considerations and treatment of mandible fracture: a concise systematic review

Introduction: In the scenario of mandible fractures, traumas are the main reasons for these events. In this context, the rates of mandible fracture complications vary from 7 to 29% and were correlated with the severity of the fracture. Motor vehicle assaults and collisions significantly outperformed all other causes of mandibular injury. Most consultations for mandible fractures begin with a diagnosis of computed tomography imaging (CT). CT scans were 100 percent sensitive for fractures of the mandible compared to 86 percent for panoramic radiographs. Despite this, radiographic images are not a substitute for a complete history and clinical examination. Objective: To carry out a narrative and systematic review of the literature, to explore the main literary findings and clinical results on fractures of the mandibles. Methods: It followed a systematic literature review model on the main clinical findings of mandible fractures, according to the rules of PRISMA. The research was carried out from January 2021 to May 2021 and developed based on Google Scholar, Scopus, PubMed, Scielo, and Cochrane Library. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 170 studies were analyzed, with only 34 studies of medium and high quality being selected, according to GRADE standards, and with risks of bias that do not compromise scientific development. Most mandible fractures require stabilization for proper treatment and to restore pre-injury occlusion. Although mandible fractures with good dentition on both sides of the fracture line can be treated in some cases by a period of intermaxillary fixation, most surgeons and patients prefer open reduction and internal fixation, as the process is faster. The use of two mini-plates results in better results with minimal complications. The treatment of mandibular fractures should aim to restore functional occlusion and mandibular continuity with the lowest possible risk. Open treatment of unilateral mandibular condyle fractures results in better functional results, especially in terms of mandible mobility. Finally, the application of low-intensity pulsed ultrasound can reduce postoperative pain and facilitated fracture healing in patients with impaired healing potential.

Treatment of Mandible Fractures Using a Miniplate System: A Retrospective Analysis.

Three-dimensional (3D) mini plate systems are used in the treatment of mandibular fractures. The system is advantageous in comparison to conventional plates due to the stabilization of tension and compression areas, improved initial stability, and biomechanical behavior. The aim of this retrospective study was to evaluate the use of a 3D miniplate system for the treatment of patients with mandibular fractures. Patients with mandibular fractures treated with a 3D plate system at the Department of Oral and Maxillofacial Surgery, University Hospital Münster, during a period of 5 years, were included in this study. Mandibular fracture conditions and minor and major post-operative complications were reported. In total, 336 patients and 391 mandibular fractures were assessed. The most common fracture site was anterior mandible, and 155 cases involved a tooth-bearing area. Minor complications were seen in 8.03% of cases, whereas only 1.49% of patients suffered from major complications. The treatment of mandible fractures using 3D miniplates resulted in fracture reduction with a low complication rate.

Comparison of Operating Room Time Length With the Use of Virtual Surgical Planning Versus Conventional Treatment of Mandible Fractures

Comparison of Operating Room Time Length With the Use of Virtual Surgical Planning Versus Conventional Treatment of Mandible Fractures

Facial injury management undertaken at US and UK medical treatment facilities during the Iraq and Afghanistan conflicts: a retrospective cohort study

ObjectivesTo perform the first direct comparison of the facial injuries sustained and treatment performed at USA and UK deployed medical treatment facilities (MTFs) in support of the military campaigns in...

Risk Factors Associated With Complications After Treatment of Mandible Fractures.

Complications that arise after treatment of mandible fractures can result in significant morbidity. Identifying modifiable risk factors associated with these complications is valuable in guiding clinical practice for improved patient outcomes. To describe the risk factors associated with complications in patients undergoing treatment for mandible fracture. A retrospective review was conducted of 137 patients presenting to a tertiary care, level 1 trauma center with mandible fractures between January 1, 2014, and January 1, 2017. Outcomes and demographic characteristics for patients with at least 3 weeks of follow-up were compared using multivariate logistic regression analysis. Of the 137 patients meeting inclusion criteria, there were 113 males (82.5%) and 24 females (17.5%), with a mean (SD) age at presentation of 32.3 (15.7) years. Median follow-up was 71 days (range, 22-1189 days). Postoperative complications were identified in 29 patients (21.2%); complications included wound dehiscence or surgical site infection (n = 17), bony nonunion (n = 5), and hardware exposure (n = 13). Complications were managed surgically in 19 patients and nonsurgically in 10 patients. On univariate analysis, the initial surgery was completed later (mean [SD], 5.9 [6.6] days after injury) in patients who developed complications than in those who did not (mean [SD], 3.8 [4.0] days). On multivariate analysis, complications were associated with increased time from injury to treatment (odds ratio [OR], 1.60; 95% CI, 1.02-2.53; P = .04), tobacco use (OR, 8.10; 95% CI, 1.26-52.00; P = .03), and dental extraction (OR, 93.00; 95% CI, 1.19 to >999.00; P = .04). Residence in the same city as the medical center was associated with fewer complications (OR, 0.08; 95% CI, 0.01-0.69; P = .02). In a 3-year review of mandible fractures managed at a single academic center, complications were associated with an increased time to treatment, tobacco use, dental extraction, and living farther from the treatment facility. On a systems level, the results of this study suggest that expediting intervention for mandible fractures may improve outcomes. 3.

Evaluation of the epidemiological profile and oral rehabilitation of patients with buccomaxillofacial trauma

Objective: To obtain the epidemiological profile and follow the rehabilitation of patients with buccomaxillofacial trauma attended at a hospital emergency service. Material and Methods: The study consisted of the analysis of medical charts, evaluation and follow-up of adult patients, over 18 years of age, in the preoperative and postoperative period from August 2015 to July 2016. Of the 114 charts examined, all had their epidemiological profile evaluated, but only 45 patients underwent a maxillofacial surgical procedure. During the clinical evaluation, post-trauma conditions were recorded before treatment (T1) and 48 hours after surgical treatment (T2). Results: The age group most affected by buccomaxillofacial trauma was between 20 and 31 years, especially in the male gender. The mandible and nasal bones were the most affected by trauma. The limitation of mouth opening was the main consequence and the levels of buccal opening before and after treatment of mandible fractures were significantly different. Conclusions: The profile of patients with facial trauma was composed of men, aged between 21 and 30 years, motorcycle traffic accidents and physical aggression being the predominant causal factors. The facial bones most affected by the trauma were the jaw and the nasal bones. The limitation of mouth opening was a consequence of the trauma of the mandibular region. Immediate treatment of fractures that affected the mandible provided the restoration of the maximum opening, occlusion and homeostasis of the stomatognathic system in the postoperative patients.KEYWORDS Trauma of head; Traumatology; Fracture fixation.

3-D Miniplates Versus Conventional Miniplates in Treatment of Mandible Fractures.

To study whether the use of 3-D miniplate, when compared with conventional miniplate, gives better clinical outcomes with fewer complications in patients with fracture mandible. A prospective study was conducted in the Department of Oral and Maxillofacial Surgery, Trauma Care Centre, on 40 patients. They were randomly divided into Group-I and Group-II with 20 patients in each group. In Group-I, 3-D miniplate was used and in Group-II, conventional miniplate was used. Parameters such as fracture stability, occlusal status, mouth opening, nerve paresthesia, infection, pain, swelling, and complications were evaluated on 1st, 7th postoperative day, 1st month and 3rd month. Fracture stability and occlusion were clinically better in Group-I than in Group-II on each follow-up; however, it was not statistically significant. Infection rate was lesser in Group-I than in Group-II (p=0.003). Mouth opening was more in Group-II than in Group-I on immediate (p=0.001) and 7th post-op day (p=0.002). Overall complications were lesser in Group-I than in Group-II (p>0.005). There is no major difference observed in clinical outcomes between 3-D miniplate and conventional miniplate. Either method of fixation can be used successfully in treatment of mandible fractures with comparable rates of complications.

Locking Plate System Versus Standard Plate Fixation in the Management of Mandibular Fractures: Meta-Analysis of Randomized Controlled Trials.

The aim of this meta-analysis was to evaluate the efficacy of the 2.0-mm locking miniplate system in comparison with the standard miniplate system in treatment of mandible fractures. A systematic review was conducted according to PRISMA guidelines, examining Medline-Ovid, Embase, and PubMed databases, eligible studies were restricted to comparative controlled trials. Inclusion criteria were based on humans randomized controlled trials, controlled clinical trials, with the aim of comparing 2 fixation techniques, namely locking miniplate and standard miniplate (nonlocking miniplate) techniques. In addition, the incidence of complications was evaluated. Nine studies with 380 patients and 551 fracture sites were enrolled into the analysis. The results showed that there were no significant differences in overall complications (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.34-1.22; P = 0.2), postoperative infection (OR, 0.53; 95% CI, 0.23-1.23, P = 0.15), and occlusion discrepancy (P > 0.05) when comparing 2.0-mm locking miniplates with 2.0-mm nonlocking miniplates in treating mandible fractures. However, the use of 2.0-mm locking miniplates had a lower postoperative maxillomandibular fixation rate than the use of 2.0-mm nonlocking miniplates (OR, 0.43; 95% CI, 0.22-0.83; P < 0.0001). Mandible fractures treated with 2.0-mm locking miniplates and standard 2.0-mm miniplates present similar short-term complication rates, and the low postoperative maxillomandibular fixation rate of using 2.0-mm locking miniplates also indicates that the 2.0-mm locking miniplate has a promising application in treatment of mandibular fractures.

RISK FACTORS FOR MAJOR COMPLICATIONS OF OPERATIVE MANDIBULAR FRACTURES

The primary goals in the treatment of mandible fractures are to 1) restore proper form and function of the injured bone and associated structures and 2) achieve osseous union of the bone segments. Implicit in these goals is the avoidance of complications which jeopardize successful outcomes, add time to the healing process, and increase cost of providing care. Some risk factors for complications in mandibular trauma have been described, such as: poor compliance, substance abuse, and certain plating techniques. However, few of the existing studies controlled for confounding variables and no studies have attempted to stratify the risk factors. The purpose of the study is to determine and quantify the risk factors for developing serious complications in the operative treatment of mandibular fractures.

The Cost and Inpatient Burden of Treating Mandible Fractures: A Nationwide Inpatient Sample Database Analysis

Objectives: At the conclusion of this presentation, the participants should be able to discuss the patient demographics, hospitalization characteristics, and costs associated with the treatment of mandible fractures. Study design: Cross-sectional study. Methods: A cross-sectional analysis using the 2009 Nationwide Inpatient Sample Database to identify patients hospitalized for isolated mandible fractures. Results: 1481 patients were identified with isolated mandible fractures. The average age of patients was 31, and 93.5% were male. Forty-six percent were White, 30% African-American, 14% Hispanic, 9% other, and 1% Asian. Twelve percent of patients presented with a history of alcohol abuse, 7.2% drug abuse, and 7.7% mental illness. Forty percent were from the lowest median household income quartile, and 75% were uninsured or had Medicaid. Thirty-nine percent of patients underwent surgery within 24 hours of admission, the average length of stay (LOS) was 2.95 days, and average cost of hospitalization was $35,804. Increased LOS was associated with alcohol abuse (3.7 vs. 2.9 days, p&lt;0.001), drug use (4.7 vs. 2.8 days, p&lt;0.001), mental illness (3.9 vs. 2.9 days, p=0.001), and age greater than 40 years (3.8 vs. 2.7 days, p&lt;0.001). Increased total cost was associated with drug use ($56,600 vs. $34,391, p&lt;0.001) and alcohol abuse ($42,343 vs. $34,943, p=0.011). Conclusions: Males, persons of low socioeconomic status, and African-Americans comprise a disproportionately high percentage of mandible fracture patients treated nationally. Healthcare expenditures associated with the treatment of mandible fractures are higher for older patients, those with mental illness, and those with a history of substance abuse.

Comparison of Complication Rates with and without Arch Bar Use in Treatment of Mandible Fractures

Objectives: 1) Explain the pros and cons of using arch bars for mandible fracture stabilization. 2) Compare and contrast the outcomes of mandible fractures treated with and without arch bars. Methods: A retrospective review was performed of mandible fractures treated at a Level 1 trauma center between 2001 and 2011. Two-hundred forty-two patients met inclusion criteria. Patients were categorized into those treated with or without arch bars. Major complications were malocclusion, infection, and malunion. Independent variables of age, sex, trauma, and dental status were collected. Exclusion criteria included lack of follow-up, greenstick fractures, mid-facial fractures, and subcondylar fractures. Data were analyzed using Fisher’s exact test. Results: Eighty-four patients had one mandible fracture, and 158 patients had two fractures. Overall, patients treated with arch bars had a complication rate of 13%, and those treated without arch bars had a rate of 16%. This was statistically insignificant ( P = 0.58). When separated by number of fractures, the differences remained insignificant (12% and 10% complication rates with and without arch bars in single fracture cases ( P = 0.74); 14% and 19% in two fracture cases ( P = 0.37)). Conclusions: The use of arch bars did not have a significant effect on major complications in this series. This trend was consistent for cases of one and two mandible fractures. These data suggest that many patients with mandible fractures may be safely treated without arch bars.

Effectiveness of 2.0 mm Standard and 2.0 mm Locking Miniplates in Management of Mandibular Fractures: A Clinical Comparative Study

To compare and evaluate the effectiveness of 2.0mm locking miniplates versus 2.0mm standard miniplates in treatment of mandible fractures. Sixty randomly selected patients who sustained mandibular fractures were selected for this study. The fractured fragments were stabilized using 2.0mm locking miniplates in 30 cases and in the remaining 30 cases the fractured fragments were fixed with conventional 2.0mm miniplates. Post-operative stability was assessed with radiographs at 7thday, 1st, and 3rdmonths. The stability of the reduced fracture was assessed clinically and both the types of plates were assessed with an OPG or conventional radiographs. This study shows favorable results on use of locking miniplates in mandibular fractures. The results show that there were no significant differences in the post-operative complications between the conventional and the locking plate/screw mandibular systems. The locking plate/screw system was more rigid than conventional plate/screw system, thereby reducing the need and duration of intermaxillary fixation (IMF).

Use of Antibiotics in the Treatment of Mandible Fractures: A Systematic Review

The use of prophylactic antibiotics in the treatment of mandible fractures is common practice. The evidence supporting this practice has not been formally assessed for quality. The purpose of this study was to evaluate this empirically. Randomized and nonrandomized trials evaluating the possible impact of the prophylactic use of antibiotics in patients with mandible fractures were identified. Data were extracted on characteristics of studies and patients, including treatment, fracture location, time from injury to treatment, antibiotics used (type, route, dosage, duration), and complications (infection, malunion, reoperation). Randomized controlled trials (RCTs) were further evaluated for issues of reported methodological quality. There were 31 eligible studies (5,437 patients). Of these, 9 were prospective RCTs; the remaining 22 were retrospective case series. Information about the time between injury and definite treatment was provided by 10 studies (31%). The type of antibiotic used was not defined in 13 of 31 studies (42%). Half of the studies (15 of 31 [48%]) did not describe the route of administration and did not comment on the duration of the antibiotic course. The vast majority (23 of 31 [74%]) did not describe the dosage of the antibiotics used. Most of the RCTs were small, had not adequately described the mode of randomization, and did not present intention-to-treat analyses. None of them presented power calculations or ensured allocation concealment. There was not a single mention about number needed to treat. The amount and quality of the available data precluded formal quantitative synthesis, despite scattered signals that prophylactic antibiotics may be better than nothing in preventing infection. The overall evidence to support the use of prophylactic antibiotics in mandible fractures is of poor quality. Large RCTs are needed to guide clinical practice.

The Biophysics of Mandibular Fractures: An Evolution toward Understanding

Predicting outcomes based on a variety of fixation techniques remains problematic in the treatment of mandible fractures. There is inherent difficulty in comparing the hundreds of published articles on the subject because of the large number of variables, including injury patterns, assessment techniques, treatment approach, device selection and application, and definition of outcome. The authors review the behavior of the human mandible. Behavior of the intact mandible, multiple fracture scenarios, and small and large (single and multiple) plating applications are reviewed. Several misconceptions in the literature are clarified. Factors that will resolve the dichotomy between clinical results and current biomechanical theories are presented such that a more logical biomechanical model may be used to approach fixation of the mandibular fracture being treated. Current mandibular biomechanics theory must be expanded to reflect the complex nature of the system and to more accurately describe conditions that exist in the physical world. Otherwise, further analysis in advancements in outcome and treatment will be relegated to chance.

Poster 260: Comparing 2.5 mm Resorbable Plates and Screws to 2.0 mm Titanium Plates and Monocortical Screws in the Treatment of Mandible Fractures

Poster 260: Comparing 2.5 mm Resorbable Plates and Screws to 2.0 mm Titanium Plates and Monocortical Screws in the Treatment of Mandible Fractures