Fracture Fixation Using Three-dimensional Plate versus Two-dimensional Plate in Mandibular Angle Fractures - A Comparative Study.

Abstract

Introduction: Management of mandibular fractures has changed over time, yet controversy still exists regarding the optimal treatment. Presently, open reduction and internal fixation is the mainstay of treatment and is achievable with different plating systems.

Materials and methods: This is a clinical comparative study to compare the treatment outcomes using three-dimensional (3D) plate versus two-dimensional plate for management of mandibular angle fractures. Thirty cases of mandibular angle fractures were randomly divided into two groups. Routine follow-up was done post-operatively at the intervals of 1 week, 3 months and 6 months. Surgical time, pre- and post-operative occlusion and mouth opening were recorded. Patients were assessed for post-operative complications. Radiographic tracing pre- and post-operatively was done on the pre-operative panoramic to evaluate the gap between the bony segments.

Results: Mouth opening improved significantly in both the groups. There was no statistically significant difference in surgical time between both the groups. The fracture line tracings used to evaluate the gap between the bony segments showed that the gap between the bony segments measured at point A was significantly lesser compared to that in Group II (P = 0.04; statistically significant). However, we noted no difference at the other points. There was no statistically significant difference in post-operative mobility, occlusion and post-operative complications between the groups.

Discussion: 3D plates offered better occlusal stability, thereby avoiding the need for inter-maxillary fixation and ensuring early restoration of mandibular function. It is an easy alternative to conventional titanium miniplates and has low morbidity and infection rates.