Treatment of a Mandibular Fracture by Two Perpendicular Mini-Plates

Document Type : Original

Authors

1 Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Dental Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction:
In open reduction and internal fixation for the treatment of mandibular fracture, the fixation technique used is very important in reducing post-operative complications and promoting the healing process. This study assessed the results of fixation of the mandible using two mini-plates perpendicular to each other in the lower border of the mandible for fracture treatment. 
 
Materials and Methods:
Access to the fractures was via an extraoral approach (through existing scars or incisions). After reductions of mandibular fractures, the fracture line fixation was accomplished using two mini-plates perpendicular to each other. One-week intermaxillary fixation (IMF) was applied and 3 weeks of soft diet was recommended in the post-operative period. All patients were followed up for at least 1 year regarding infection and malocclusion.
 
Results:
Twenty-five patients (28 fracture lines) underwent this technique. Most (81.8%) patients were male and the mean age was 41.3±7.59 years (range, 17–73 years). Symphyseal fracture (frequency, 52%) was the most prevalent followed by angle (32%) and body (16%) fractures. Among the patients who underwent surgery, only one malocclusion and no cases of infection were observed. No cases [Rachel1] of facial nerve weakness or damage were observed in this study.
 
Conclusion: 
This method can be used in specific cases to replace treatment with one mini-plate, which necessitates a more intensive fixation or reconstruction plate therapy.    
 [Rachel1]Please confirm

Keywords

References

1. Holmes PJ, Koehler J, McGwin G Jr, Frequency of maxillofacial injuries in all-terrain vehicle collisions. J Oral Maxillofac Surg 2004; 62(6): 697–701.
2. Muhonen J, Leikomaa H. Treatment of mandibular fracture. Duodecim 2010; 126(6): 712–6.
3. van den Bergh B, Heymans MW, Duvekot F, Forouzanfar T. Treatment and complications of mandibular fractures: A 10-year analysis. J Craniomaxillofac Surg 2012; 40(4): e108–11.
4. Uglesić V, Virag M, Aljinović N, Macan D. Evaluation of mandibular fracture treatment. J Craniomaxillofac Surg 1993; 21(6): 251–7.
5. Bell RB, Wilson DM. Is the use of arch bars or interdental wire fixation necessary for successful outcomes in the open reduction and internal fixation of mandibular angle fractures? J Oral Maxillofac Surg 2008; 66(10): 2116–22.
6. Terris DJ, Lalakea ML, Tuffo KM, Shinn JB. Mandible fracture repair: specific indications for newer techniques. Otolaryngol Head Neck Surg 1994; 111(6): 751–7.
7. Blitz M, Notarnicola K. Closed reduction of the mandibular fracture. Atlas Oral Maxillofac Surg Clin North Am 2009; 17(1): 1–13.
8. Renton TF, Wiesenfeld D. Mandibular fracture osteosynthesis: a comparison of three techniques. Br J Oral Maxillofac Surg 1996; 34(2): 166–73.
9. Bolourian R, Lazow S, Berger J. Transoral 2.0-mm miniplate fixation of mandibular fractures plus 2 weeks' maxillomandibular fixation: a prospective study. J Oral Maxillofac Surg 2002; 60(2): 167–70.
10. Chritah A, Lazow SK, Berger JR. Transoral 2.0-mm locking miniplate fixation of mandibular fractures plus 1 week of maxillomandibular fixation: a prospective study. J Oral Maxillofac Surg 2005; 63(12): 1737–41.
11. Rudderman RH, Mullen RL, Phillips JH. The biophysics of mandibular fractures: an evolution toward understanding. Plast Reconstr Surg 2008; 121(2): 596–607.
12. Michelet FX, Deymes J, Dessus B. Osteosynthesis with miniaturized screwed plates in maxillo-facial surgery. J Maxillofac Surg 1973; 1(2): 79–84.
13. Rajchel J, Ellis E, Fonseca RJ. The anatomical location of the mandibular canal: its relationship to the sagittal ramus osteotomy. Int J Adult Orthodon Orthognath Surg 1986; 1(1): 37–47.
14. Nakamura S, Takenoshita Y, Oka M. Complications of miniplate osteosynthesis for mandibular fractures. J Oral Maxillofac Surg 1994; 52(3): 233–8.
15. Zachariades N, Papademetriou I. Complications of treatment of mandibular fractures with compression plates. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995; 79(2): 150–3.
16. Williams MD, Pearson MH, Milner SM. Complications in the use of compression plates in the treatment of mandibular fractures. Oral Surg Oral Med Oral Pathol 1991; 72(2): 159–61.
17. Zachariades N, Mezitis M, Mourouzis C, Papadakis D, Spanou A. Fractures of the mandibular condyle: a review of 466 cases. Literature review, reflections on treatment and proposals. J Craniomaxillofac Surg 2006; 34(7): 421–32.
18. Wagner A, Krach W, Schicho K, Undt G, Ploder O, Ewers R. A 3-dimensional finite-element analysis investigating the biomechanical behavior of the mandible and plate osteosynthesis in cases of fractures of the condylar process. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 94(6): 678–86.
19. Fonseca RJ,Waker RV,Betts NJ,Barber HD,Powers MP. Oral and maxillofacial trauma. 3th ed. Louis: Saunders Elsevier;2005. p. 1139.
20. Ellis E 3rd, Dechow PC, Carlson DS. A comparison of stimulated bite force after mandibular advancement using rigid and nonrigid fixation. J Oral Maxillofac Surg 1988;46(1):26–32.
21. Rosenquist BE. Nerve transpositioning to facilitate implant placement. Dent Econ 1995; 85(10): 92–3.
22. Dharmar S. Locating the mandibular canal in panoramic radiographs. Int J Oral Maxillofac Implants1997; 12(1): 113–7. 
 
Iranian Journal of Otorhinolaryngology
Volume 26, Issue 1 - Serial Number 1
January and February 2014
Pages 31-36

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