COMPARISON BETWEEN PERPENDICULAR AND CONVENTIONAL FIXATION IN SYMPHYSEAL AND PARA SYMPHYSEAL MANDIBULAR FRACTURES (RANDOMIZED CONTROLLED TRIAL)

Document Type : Original Article

Authors

1 oral and maxillofacial surgery

2 Department of Oral and Maxillofacial Surgery Faculty of Dentistry, Alexandria University, Alexandria, Egypt

3 department of Oral and Maxillofacial Surgery Faculty of Dentistry , Alexandria University , Alexandria ,Egypt

Abstract

Introduction: Mandible fractures are among the most common facial fractures to occur. The conventional internal fixation technique, uses two parallel mini-plates. The perpendicular fixation was introduced to neutralize the compression, shear and tension forces, which its done by moving the inferior mini-plate to be placed at the inferior border of the mandible perpendicularly to the sub apical mini-plate to allow for 3 dimensional fixation.
Objectives: To clinically and radiographically evaluate the use of perpendicular plating protocol compared to the conventional Champy's protocol in mandibular symphyseal and para-symphyseal fractures.
Materials and methods: The study was conducted on twenty patients diagnosed with symphyseal and /or para-symphyseal fractures indicated for open reduction and internal fixation. Fracture line was exposed through standard intra-oral vestibular incision to gain access to the fractures. Perpendicular plating was done in group A while conventional plating was done in group B.
Results: Insignificant statistical difference was reported in pain, edema, and maximum mouth opening during the followup period when comparing both groups. One case had malocclusion In group A, while the rest of the patients in both groups showed normal occlusion. Two patients one in each group showed postoperative wound infection. By comparing postoperative 12 weeks to immediate values, average bone density had shown significant difference . Moreover, group A (p=.005 ) had a higher mean bone density than group B (p=.093 ).
Conclusion: The perpendicular mini-plates fixation is suitable for the treatment of anterior mandibular fractures.

Keywords

Main Subjects