Comparison of 3-dimensional and standard miniplate fixation in the management of mandibular fractures.

PURPOSE: The aim of this follow-up study was to compare 3-dimensional (3D) and standard (Champy's) miniplate fixation in the management of mandibular fractures, and to analyze advantages and disadvantages of one over the other.

PATIENTS AND

METHODS

A prospective randomized clinical trial was carried out in patients with well-defined inclusion and exclusion criteria. Patients were followed for 2 months for wound dehiscence, infection, segmental mobility, postoperative occlusion, significant period of postoperative complications, and radiological evaluation of reduction and fixation.

RESULTS

Twenty patients were enrolled in both the groups with no case of wound dehiscence. In group 1, 2 patients had mild segmental mobility (P = .07), 2 patients had surgical site infection (P = .07), and 2 patients involving mental nerve had involved roots of teeth (P = .07). Radiological evaluation did not show any statistically significant difference in reduction (P = 1.4), but showed a significant difference (P = .03) in fixation between the 2 groups, especially in cases involving the mental nerve (ie, fracture near or involving the mental foramen) and oblique fractures.

CONCLUSION

Champy's miniplate system is a better and easier method than the 3D miniplate system for fixation of mandibular fractures. In comparison, the 3D miniplate system is unfavorable for use in cases of oblique fractures and those involving the mental nerve, and is also difficult to adapt. In most cases, it provides good stability but with excessive implant material because of extra vertical bars incorporated for countering the torque forces. However, operative time is less because of simultaneous stabilization at both superior and inferior borders.