El Nakeeb, N., El Dibany, M., Shokry, M. (2016). A COMPARATIVE STUDY BETWEEN 3-D PLATES AND CONVENTIONAL MINIPLATES FOR INTERNAL FIXATION OF ANTERIOR MANDIBULAR FRACTURES. Alexandria Dental Journal, 41(3), 253-260. doi: 10.21608/adjalexu.2016.58036
Norhan A. El Nakeeb; Mostafa M. El Dibany; Mohamed M. Shokry. "A COMPARATIVE STUDY BETWEEN 3-D PLATES AND CONVENTIONAL MINIPLATES FOR INTERNAL FIXATION OF ANTERIOR MANDIBULAR FRACTURES". Alexandria Dental Journal, 41, 3, 2016, 253-260. doi: 10.21608/adjalexu.2016.58036
El Nakeeb, N., El Dibany, M., Shokry, M. (2016). 'A COMPARATIVE STUDY BETWEEN 3-D PLATES AND CONVENTIONAL MINIPLATES FOR INTERNAL FIXATION OF ANTERIOR MANDIBULAR FRACTURES', Alexandria Dental Journal, 41(3), pp. 253-260. doi: 10.21608/adjalexu.2016.58036
El Nakeeb, N., El Dibany, M., Shokry, M. A COMPARATIVE STUDY BETWEEN 3-D PLATES AND CONVENTIONAL MINIPLATES FOR INTERNAL FIXATION OF ANTERIOR MANDIBULAR FRACTURES. Alexandria Dental Journal, 2016; 41(3): 253-260. doi: 10.21608/adjalexu.2016.58036
A COMPARATIVE STUDY BETWEEN 3-D PLATES AND CONVENTIONAL MINIPLATES FOR INTERNAL FIXATION OF ANTERIOR MANDIBULAR FRACTURES
1B.D.S. Faculty of Dentistry, Alexandria University, Alexandria, Egypt
2Professor of Oral & Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
3Oral Surgical Sciences Department, Faculty of Dentistry, Beirut Arab University & Lecturer of Oral & Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
Abstract
INTRODUCTION: The management of facial trauma is one of the most demanding aspects of oral and maxillofacial surgery. Being the most prominent mobile bone of the facial skeleton, mandible fracture occurs more frequently than any other facial fracture. OBJECTIVES: To compare between the effect of three dimensional (3D) plates and conventional miniplates for internal fixation of anterior mandibular fractures. MATERIALS AND METHODS: This was a controlled and randomized clinical trial. A total of 20 patients; aged between 21-50 years, who had symphyseal or parasymphseal mandibular fracture were randomly selected for this study from the outpatient clinic of Oral and Maxillofacial Surgery Department, Faculty of dentistry, Alexandria University. In this study, open reduction and internal fixation were performed for mandibular symphyseal and parasymphyseal region fractures using one three dimensional (3D) plate in 10 patients as study group and using two miniplates in 10 patients as control group. Clinical and radiographical evaluation were made. Each patient was evaluated: 1- clinically for infection, pain, swelling, malocclusion, wound healing, sensory disturbance, primary stability of the fracture segment, maximum mouth opening and masticatory efficiency using pressure indicating film. 2- Radiological: cone beam computed tomography (CBCT) images were taken to evaluate reduction of the fractured segment, malunion/non-union and bone density within the fracture line. The data collected was subjected to statistical analysis. RESULTS: There was an improvement in wound healing, oedema, occlusion and sensory disturbance in both groups. There was no statistical significant difference between the two groups regarding pain, maximum mouth opening, bite force or bone density. CONCLUSIONS: Three dimensional plate is effective in the treatment of anterior mandibular fractures as well as conventional miniplates. Ease of application and shorter working time are its advantages over conventional miniplates.
1. MansonPN.FacialInjuries.In:McCarthyJG(ed).Plastic Surgery Vol. 2. Philadelphia: WB Saunders, 1990: 916- 78. 2. Anwar M, Iqbal T, Malik SA. A Study on the Surgical Management of Mandibular Fractures by Different Treatment Modalities. Pak J Plast Surg 2013; 2: 1-36. 3. KhanM.ManagementofMaxillofacialTrauma.AFIDDent Jr 1998; 10: 18-21. 4. Amanat N. Ananalysis of maxillofacial fractures in Aga Khan University Hospital. Pakistan J Surg 1993; 9: 128-32. 5. MezitisM,ZachariadesN,RallisG.Anauditofmandibular fractures treated by intermaxillary fixation, intraosseous wiring and compression plating. Br J Oral Maxillofac Surg 1996; 34: 293-7.
6. Jaques B, Richter M, Arza A. Treatment of mandibular fractures with rigid osteosynthesis using AO system. J Oral Maxillofac Surg 1997; 55: 1402-7. 7. Sadhwani BS, Anchlia S. Conventional 2.0 mm miniplates versus 3-D plates in mandibular fractures. Ann Maxillofac Surg 2013; 3: 154-9. 8. Luhr HG. Vitallium Luhr systems for reconstructive surgery of the facial skeleton. Otolaryngol Clin North AM 1987; 20: 573-606. 9. Farmand M, Dupoirieux L. The value of 3-dimensional plates in maxillofacial surgery. Rev Stomatol Chir Maxillofac 1992; 93: 353-7. 10. Harada K, Watanabe M, Ohkura K, Enomoto S. Measure of bite force and occlusal contact area before and after bilateral sagittal split ramus osteotomy of the mandible using a new pressure-sensitive device: a preliminary report. J Oral Maxillofac Surg 2000; 58: 370-3. 11.SPI: Sensor Product Inc. [Internet] New Jersey. 2008. Available at: www.sensorprod.com/pressurex.php. 12. Shaaban AA. Clinical assessment of the bite force recovery in mandibular fracture patients following treatment with the two common treatment modalities. Master thesis, Faculty of Dentistry, Alexandria University 2002. 39-43. 13. Al-Bishri A, Barghash Z, Rosenquist J, Sunzel B. Neurosensory disturbance after sagittal split and intraoral vertical ramus osteotomy: as reported in questionnaires and patient’s records. Int J Oral Maxillofac Surg 2005; 34: 247- 51. 14.Chang JD, Bird SR, Bohidar NR, King T. Analgesic efficacy of rofecoxib compared with codeine/acetaminophen using a model of acute dental pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 100: E74-80. 15. Jain MK, Manjunath KS, Bhagwan BK, Shah DK. Comparison of 3-Dimensional and Standard Miniplate Fixation in the Management of Mandibular Fractures. J Oral Maxillofac Surg 2010; 68: 1568-72. 16.Kotz S, Balakrishnan N, Read CB, Vidakovic B. Encyclopedia of statistical sciences. 2nd ed. Hoboken, N.J.: Wiley-Interscience, 2006. 17. Kirkpatrick LA, Feeney BC. A simple guide to IBM SPSS statistics for version 20.0. Student ed. Belmont, Calif.: Wadsworth, Cengage Learning, 2013. 18. Champy M, Loddè JP, Schmitt R, Jaeqer JH, Muster D. Mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg 1978; 6: 14-21. 19. Kumar BP, Kumar J, Mohan AP, Venkatesh V, Kumar HR. Three Dimensional Stainless Steel Plate versus Stainless Steel Miniplate in Mandibular Parasymphysis Fracture. J Bio Innov 2012; 1: 19-32. 20. Khalifa ME, El Hawary HE, Hussein MM. Titanium Three Dimensional Miniplate versus Conventional Titanium Miniplate in Anterior Mandibular Fracture. Life Science J. 2012; 9: 1006-10. 21.Yadav S, Agarwal A, Singh S, Kumar S, Anand KR, Chhabra V. 3-D locking titanium miniplates in management of mandibular fracture; A prospective 64-67 clinical study. J Dent Specialities 2015; 3: 64-7. 22. Farmand M. The 3D plating in maxillofacial surgery. J Oral Maxillofac Surg 1993; 51: 166-7. 23.Wittenberg JM, Smith BR, Trigg DD. Treatment of mandibular angle fractures with 3-D titanium miniplates. J Oral Maxillofac Surg 1994; 52: 106. 24.Hughes PJ. 3D plate versus the lag screw technique for treatment of fractures of anterior mandible. J Oral Maxillofac Surg 2000; 58: 23.
25.Zix J, Lieger O, Lizuka T. Use of straight and curved 3- Dimensional titanium miniplates for fracture fixation at the mandibular angle. J Oral Maxillofacial Surg 2007; 65: 1758-63.
26.Guimond C, Johnson JV, Marchena JM. Fixation of mandibular angle fractures with a 2.0 mm 3-dimensional curved angle strut plate. J Oral Maxillofac Surg 2005; 63: 209- 14. 27.Agarwal M, Meena B, Gupta DK, Tiwari AD, Jakhar SK. A Prospective Randomized Clinical Trial Comparing 3D and Standard Miniplates in Treatment of Mandibular Symphysis and Parasymphysis Fractures. J Maxillofac Oral Surg 2014; 13: 79-83. 28.Al-Moraissi EA, Ellis E. Surgical management of anterior mandibular fractures: a systematic review and meta- analysis. J Oral Maxillofac Surg 2014; 72: 2507. 29.Feledy J, Caterson EJ, Steger S, Stal S, Hollier L. Treatment of mandibular angle fractures with a matrix miniplate. A preliminary report. Plast Reconstr Surg 2004; 114: 1711.
30.Kawai T, Murakami S, Hiranuma H, Sakuda M. Radiographic changes during bone healing after mandibular fractures. Br. J Oral Maxillofac Surg 1997; 35: 312-8.
31.Smith WP. Delayed miniplate osteosynthesis for mandibular fractures. Br J Oral Maxillofac Surg 1991; 29: 73-6. 32.Regalo SC, Santos CM, Vitti M, Regalo CA, de Vasconcelos PB, Mesteiner W Jr, et al. Evaluation of molar and incisor bite force in indigenous compared with white population in Brazil. Arch Oral Biol 2008; 53: 282-6. 33. Van Spronsen PH, Weijs WA, Valk J, Prahl-Andersen B, van Ginkel FC. Comparison of jaw-muscle bite-force cross- sections obtained by means of magnetic resonance imaging and high-resolution CT scanning. J Dent Res 1989; 68: 1765-70. 34.Shinogaya T, Bakke M, Thomsen CE, Vilmann A, Sodeyama A, Matsumoto M. Effects of ethnicity, gender and age on clenching force and load distribution. Clin Oral Investig 2001; 5: 63-8. 35.Ikebe K, Nokubi T, Morii K, Kashiwagi J, Furuya M. Association of bite force with aging and occlusal support in older adults. J Dent 2005; 33: 131-7. 36. Melek LN, El Mahallawy AS, Sharara AA, Ezz El Din A, Nour El-Din AHM. Evaluation of the 3-Dimensional Threadlock plate in the management of mandibular angle fractures. Ph.D. Thesis. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University. 2014. 37.Parmar S, Meanat S, Raghani M, Kapadia T. Three dimensional miniplates rigid fi xation in fracture mandible. J Maxillofac Oral Surg 2007; 6: 14. 38. Pepato AO, Palinkas M, Regalo SC, de Medeiros EH, de Vasconcelos PB, Sverzut CE, et al. Effect of surgical treatment of mandibular fracture: electromyographic analysis, bite force, and mandibular mobility. J Craniofac Surg 2014; 25: 1714-20.