Role of modified three-dimensional miniplate in the mandibular body or parasymphysis fracture involving mental foramen: A prospective clinical study.

Abstract

Background and aim: Three-dimensional (3-D) miniplates have shown better results in the treatment of mandibular fractures but it is difficult in the treatment of mandibular parasymphysis fracture that involves mental foramen or in close proximity. To overcome this, we have modified the 3-D miniplate with a single vertical bar and assessed its efficacy in the mandibular body or parasymphysis fracture.

Methodology: A clinical prospective study was carried out in 20 patients with mandibular body or parasymphysis fractures involving or near mental foramen and treated with a modified 3D miniplate under general anesthesia (GA). The parameters assessed were state of occlusion, neurosensory disturbances, visual analog scale (VAS) score for pain, infection pus, mobility of fracture segment, operating time for adaptation and fixation of the plate, surgeon's opinion on ease of adaptability of the plate, and union of fracture site radiologically. The patients were assessed pre-operatively, first, second, eighth, and 16^th week postoperatively.

Results: The data obtained was analyzed using McNemar's test and paired t-test. Occlusal derangement was corrected and was statistically significant (P < 0.5). The mean operating time for adaptation and fixation was 8.45 min. Temporary paresthesia of the mental nerve was very minimal (P < 0.5). The rate of infection was significantly less. There was no incidence of mobility or fracture of the modified 3D miniplate.

Conclusion: The modified 3D miniplate was efficient in restoring the occlusion, reducing the incidence of temporary paresthesia of mental nerve, and was easy to adapt which aided in bringing down the treatment duration in the management of mandibular body or parasymphysis fracture.