Comparison of Three-Dimensional Plates Versus Conventional Two Miniplates For Open Reduction and Internal Fixation of Mandibular Symphysis and Parasymphysis Fractures

Abstract

Objectives: To compare the efficacy of single 3-D miniplates over conventional 2 miniplates for open reduction and internal fixation of mandibular symphysis and parasymphysis fractures. Study Design: A prospective randomized clinical study. Settings: Department of Oral and Maxillofacial Surgery, Faisalabad Medical University/ Allied Hospital Faisalabad. Duration: April 2017 to April 2018. Methodology: A total of 32 patients with mandibular symphysis and parasymphysis fractures were included in the study. Patients were randomly divided into 2 groups. In Group A single 3-D plates were placed while in Group B 2 miniplates were placed. All patients were followed up for 3 months postoperatively. The efficacy of 3-D miniplates over conventional miniplates was measured regarding following parameters: Infection, wound dehisce, postoperative malocclusion, segmental mobility and nerve deficit. Results: The mean operating time for Group A was 8.469 minutes (+SD of 1.9102) and for Group B mean operating time was 14.688 minutes with (+SD of 1.4245). Out of 16 patients treated by conventional 2 miniplates, 5 patients (31.2%) developed infection, 1 patient had wound dehiscence (6.25%), 4 patients developed occlusal discrepancy (25.0%), another 4 (25.0%) had postoperative segmental mobility and 1 patient (6.25%) developed neurological deficit. Whereas out of 16 patients treated by 3-D plate 2 patients (12.5%) developed infection, 1 patient (6.25%) each presented with wound dehiscence and occlusal discrepancy, whereas no patients (0.00%) had postoperative segmental mobility and neurological deficit. Conclusion: The results of this study confirmed that single 3-D plate osteosynthesis was comparable to conventional 2 miniplate osteosynthesis in fixation of mandibular symphysis and parasymphysis fractures. Both systems provided enough stability for proper bone healing, and there was no pronounced difference between the two groups with regard to the outcomes of infection, wound dehiscence, postoperative malocclusion, segmental mobility and neurological deficit. The only statically significant result was of mean operating time for group A that was less compared to group B.

Key Words: Mandibular fracture, Infection, Wound dehiscence.