scholarly journals The Use of a Novel CAD-CAM Splint to Simplify Open Reduction and Internal Fixation of Mandibular Angle Fracture: A Technical Note

2020 ◽  
pp. 194338752090489
Author(s):  
Mrunalini Ramanathan ◽  
Elavenil Panneerselvam ◽  
Sriraam Kasi Ganesh ◽  
Krishna Kumar Raja
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Technical Note ◽  
Mandibular Angle ◽  
Intermaxillary Fixation ◽  
Mandibular Angle Fracture ◽  
Angle Fracture ◽  
Computer Aided ◽  
Digital Manipulation ◽  
Angle Fractures

Mandibular angle fractures are frequently encountered as they constitute an area of weakness. Complications after open reduction and internal fixation (ORIF) of angle fractures commonly arise due to improper reduction and fixation methods that fail to counteract the dynamic muscle forces present in this region. Conventional reduction methods such as digital manipulation, intermaxillary fixation, towel clip traction, and wiring are associated with various limitations. This technical note highlights the fabrication and use of a computer-aided designing/computer-aided manufacturing–generated splint for ORIF of a superiorly displaced mandibular angle fracture. The splint consisted of 2 components: (1) a distal tooth-borne component to guide the teeth into maximum intercuspation and (2) a proximal bone-borne component to reduce the angle fracture. This composite splint facilitates simultaneous restoration of occlusion as well as reduction of mandibular angle fractures. The advantages of this technique include the following: (1) easy fabrication of splint, (2) easy and precise anatomical reduction of angle fracture, and (3) less operative time.

scholarly journals Redução aberta com fixação interna em fraturas de ângulo mandibular: revisão de literatura / Open reduction with internal fixation in mandibular angle fracture: literature review

2021 ◽  
Vol 4 (3) ◽  
pp. 12166-12177
Author(s):  
Beatriz Nogueira Dos Santos ◽  
Lucas Leverson Lisboa Da Costa ◽  
Alice Christinne de Alencar Lemos ◽  
Amanda Marinho Chaves Costa ◽  
Letícia Sandes de Albuquerque Silva ◽  
...  
Keyword(s):  
Literature Review ◽  
Internal Fixation ◽  
Open Reduction ◽  
Mandibular Angle ◽  
Mandibular Angle Fracture ◽  
Angle Fracture

scholarly journals Comparison of Post-Operative Outcomes of Intermaxillary Fixation and Open Reduction with Internal Fixation of Simple Mandibular Angle Fracture: A Randomized Control Trial

2018 ◽  
Vol 4 (2) ◽  
pp. 108-112
Author(s):  
Uday Kumar Goswami ◽  
Md Rezaul Islam ◽  
Binay Kumar Das ◽  
Pradip Chandra Dash ◽  
Mohammad Hedayet Ali Khan ◽  
...  
Keyword(s):  
Randomized Control Trial ◽  
Open Reduction ◽  
Mandibular Angle ◽  
Intermaxillary Fixation ◽  
Operative Outcomes ◽  
Mandibular Angle Fracture ◽  
Angle Fracture ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Surgical management of simple mandibular angle fracture is a very crucial process.Objective: The purpose of the present study was to compare the post-operative outcomes of intermaxillary fixation and open reduction with internal fixation of simple mandibular angle fracture.Methodology: This randomized control trial was conducted in the Department of Oral and Maxillofacial Surgery at Dhaka Dental College & Hospital, Dhaka and Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2010 to December 2010 for a period of one (01) year. Among all patients admitted/attended to the hospital IPD with fracture of mandibular angle with or without other associated fracture sites were selected as study subjects. After recruitment of the patients, they were assigned either as group A or group B after randomization. In group A the patients of this group were treated by open reduction and internal miniplate fixation with additional placement of intermaxillary fixation; in group B the patients of this group were treated by open reduction and internal miniplate fixation without any additional placement of intermaxillary fixation. During follow up period stability of fracture segments, post reduction alignment and inter-incisal opening were recorded.Result: A total of 30 patients presented with mandibular angle fractures were included in the study. They were allocated in two groups named miniplate osteosynthesis with Inter-maxillary fixation group (n=16) and without inter-maxillary fixation group (n=14) randomly. Time required to accomplish the surgical procedures was significantly high (p=0.000) group A (99.38±15.26 minutes) than group B (55.38±6.34 minutes). Among them 01 patient developed instability after inter-maxillary fixation. And 01 patient developed such in other procedure; however this difference is not statistically significant (p=0.724). In post operative radiography the mean score of post reduction alignment was slightly higher in group A than group B which was 2.50±0.516 and 2.214±0.426 respectively (p=0.107). The inter-incisal opening in baseline was 14.69 and 18.14 in group A and group B respectively. However, in review 3 it was found 36.19 and 37.64 in group A and group B respectively (p=0.0001).Conclusion: In conclusion significantly less operative time was required to accomplish the operative procedure in without IMF group as well as there was also a significant difference of inter-incisal opening between two procedures in subsequent review findingsJournal of National Institute of Neurosciences Bangladesh, 2018;4(2): 108-112

scholarly journals Management of Mandibular Angle Fractures by Two Conventional 2.0-mm Miniplates: A Retrospective Study of 389 Patients

2016 ◽  
Vol 9 (3) ◽  
pp. 206-210 ◽  
Author(s):  
Giuseppe Spinelli ◽  
Davide Lazzeri ◽  
Francesco Arcuri ◽  
Domenico Valente ◽  
Tommaso Agostini
Keyword(s):  
Postoperative Complications ◽  
Internal Fixation ◽  
Complication Rate ◽  
Wound Dehiscence ◽  
Mandibular Angle ◽  
Outer Cortex ◽  
Mandibular Angle Fracture ◽  
Angle Fracture ◽  
Significant Difference ◽  
Angle Fractures

Fractures of the mandibular angle account for 23 to 42% of all facial fractures with a high complication rate (0–32%). Although the ideal treatment remains debatable, two main procedures are commonly used to manage the majority of mandibular angle fractures that are open reduction and internal fixation by a noncompression miniplate placed on the external oblique ridge with or without a second miniplate on the outer cortex. The purpose of this study was to describe our management of mandibular angle fractures by two noncompression miniplates placed on the outer cortex via a transbuccal approach. Medical records and radiographic examination of 389 patients (258 males [66.3%] and 131 females [33.7%]) operated from January 2000 to December 2012 were retrospectively reviewed. Postoperative complications including malocclusion, infection, wound dehiscence, nonunion, and reoperative surgery were recorded and analyzed. Fifty-three patients developed postoperative complications (overall complication rate: 13.6%). No significant difference was found in the complication rate by age and gender variables and regarding the interval between the trauma and the operation and the presence of the teeth in the line of fracture. A higher rate of complications was found among patients with alcohol/drug addiction and in patients with multiple-site involvement. The findings of this study suggest that the use of two transbuccal miniplates placed on the outer cortex for the internal fixation of mandibular angle fracture provided a low rate of complications. The global incidence of screw loosening, wound dehiscence, plate exposure, infection, reoperation, and plate removal were similar with the data reported in the literature with improved health outcomes, lower postoperative morbidity, and a faster return to normal life.

scholarly journals Who Can Treat Mandibular Trauma Better?

2019 ◽  
pp. 16-23
Author(s):  
Savina Gupta ◽  
Hemant Yadav ◽  
Hirkani Attarde ◽  
Jai Singh Narula
Keyword(s):  
Treatment Plan ◽  
Maxillofacial Surgery ◽  
Clinical Situation ◽  
Oral And Maxillofacial Surgery ◽  
Mandibular Angle ◽  
Intermaxillary Fixation ◽  
Mandibular Angle Fracture ◽  
Operative Care ◽  
Angle Fracture ◽  
Angle Fractures

Oral and maxillofacial surgery, a specialty responsible for the diagnosis, treatment of trauma, congenital, developmental and iatrogenic lesions in the maxillofacial complex. Despite all the progress that has occurred in the specialty of this fraternity, many people are still unaware of the specialty. Even today, difficulties are experienced owing to the lack of knowledge of the general public and health professionals concerning the scope of oral and maxillofacial surgery. To investigate recognition of the scope of oral and maxillofacial surgery; 50 questionnaires about mandible angle fracture were sent to the oral & maxillofacial surgeons and plastic surgeons, in 2 equal groups. The questionnaire covered 9 questions regarding peri-operative care of mandible angle fracture. Each interviewee had to answer the clinical situation with their own perspective and knowledge. On the basis of questionnaire responses, a good knowledge of treatment plan in terms of function and aesthetics were evaluated, which were instituted by oral and maxillofacial surgeons and plastic surgeons gave little consideration on functional outcome. Results obtained from this questionnaire signified that less number of plastic surgeons operated on mandibular angle fractures as compared to oral surgeons, with not much a discrepancy in the choice of radiographs. The plastic surgeons usually prefer an extraoral approach over an intraoral, with the main aim to re-establish esthetics whereas oral surgeons preferred functional establishment. Both the surgeons treat these fractures with the help of rigid osteosynthesis and intermaxillary fixation. Not many plastic surgeons opt for Champ’s technique of osteosynthesis. Both the surgeons do not prefer to remove plates postoperatively. Moreover, the plastic surgeons do not wish to extract tooth in line of fracture majorly. Thus, we conclude that oral and maxillofacial surgeons are better proficient than plastic surgeons in handling mandibular angle fracture and the specialty needs to broaden its horizons in order to ensure the correct referral of all patients.

scholarly journals Surgical Management of Unusual Biangular Mandibular Fractures

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Stefan Cocis ◽  
Umberto Autorino ◽  
Fabio Roccia ◽  
Chiara Corio
Keyword(s):  
Internal Fixation ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Mandibular Fractures ◽  
Mandibular Angle ◽  
Mandibular Angle Fracture ◽  
Angle Fracture ◽  
Angle Fractures ◽  
Inferior Border ◽  
Surgery Department

Bilateral mandibular angle fractures, while representing a rarity among mandibular fractures, are a huge challenge of complex management for the maxillofacial surgeon. There are still many open questions regarding the ideal management of such fractures, including the following: the removal of the third molar in the fracture line, the best surgical approach, and the fixation methods. In this report the authors present the case of 40-year-old man presenting with a bilateral mandibular angle fracture referred to the Maxillofacial Surgery Department of Turin. Open reduction and internal fixation has been made for both sides. The left side third molar was removed and the internal fixation was achieved through internal fixation with one miniplate according to Champy’s technique and transbuccal access for a 4-hole miniplate at the inferior border of the mandible. Right side third molar was not removed and fixation was achieved through intraoral access and positioning of a 4-hole miniplate along the external ridge according to Champy. An optimal reduction was achieved and a correct occlusion has been restored.

scholarly journals A Prospective Study of Strut versus Miniplate for Fractures of Mandibular Angle

2013 ◽  
Vol 6 (3) ◽  
pp. 191-196 ◽  
Author(s):  
Amy S. Xue ◽  
John C. Koshy ◽  
Erik M. Wolfswinkel ◽  
William M. Weathers ◽  
Kristina P. Marsack ◽  
...  
Keyword(s):  
Mandibular Angle ◽  
Patient Demographics ◽  
Mandibular Angle Fracture ◽  
Plate Group ◽  
Angle Fracture ◽  
Significant Difference ◽  
Comminuted Fractures ◽  
Angle Fractures ◽  
A Prospective Study ◽  
To Receive

This prospective randomized clinical trial compared the treatment outcomes of strut plate and Champy miniplate in fixation of mandibular angle fractures. Patients with mandibular angle fracture were consented and enrolled into this study. Exclusion criteria include patients with severely comminuted fractures. The patients were randomly assigned to receive the strut plate or Champy miniplate for angle fracture fixation. Patient demographics, fracture characteristics, operative and postoperative outcomes were collected prospectively. Statistical analysis was performed to evaluate the significance of the outcome. A total of 18 patients were included in this study and randomly assigned to receive either the strut plate or Champy miniplate. Out of which five patients were excluded postoperatively due to complex fracture resulting in postoperative maxillomandibular fixation. The final enrollment was 13 patients, N = 6 (strut) and N = 7 (Champy). There was no statistically significant difference in the pretreatment variables. Nine of these patients had other associated facial fractures, including parasymphyseal and subcondylar fractures. Most of the (11) patients had sufficient follow-up after surgery. Both groups exhibited successful clinical unions of the mandibular angle fractures. The complications associated with the mandibular angle were 20% in the strut plate group and 16.7% in the Champy group. One patient in the strut plate group had a parasymphyseal infection, requiring hardware removal. The strut plate demonstrated comparable surgical outcome as the Champy miniplate. It is a safe and effective alternative for management of mandibular angle fracture.

scholarly journals Qualitative and quantitative assessment of relationship between mandibular third molar and angle fracture on North Indian population: A clinico-radiographic study

2013 ◽  
Vol 07 (02) ◽  
pp. 212-217 ◽  
Author(s):  
Suresh Yadav ◽  
Shallu Tyagi ◽  
Naveen Puri ◽  
Prince Kumar ◽  
Puneet Kumar
Keyword(s):  
Third Molar ◽  
Indian Territory ◽  
Mandibular Angle ◽  
The North ◽  
Mandibular Angle Fracture ◽  
Mandibular Third Molar ◽  
Angle Fracture ◽  
Angle Fractures ◽  
Inferior Border ◽  
The Relationship

ABSTRACT Objective: To assess the relationship between impacted mandibular third molar presence and the risk for mandibular angle fracture with the effect of various positions of mandibular third molar and the risk of mandibular angle fracture. Materials and Methods: In the North Indian territory, a total of 289 patients with mandibular angle fractures were studied and evaluated for the possible relationship with impacted third molar on the basis of clinical and panoramic radiographical findings. Results: Results that confirmed the highest risk for mandibular angle fracture was associated with mesioangular angulations (45.42%) followed by vertical (26.34%), distoangular in sequence and least risk was found with bucco-version angulations (2.67%) according to Winter′s classification. Additionally, the highest risk of mandibular angle fracture was reported with partially erupted third molar (47.75%), followed by erupted (23.53%) and unerupted third molar (19.38%). Conclusion: The risk for mandibular angle fracture is not only affected by status of eruption, angulations, position, number of roots present in third molar but also by the distance of mandibular third molar from inferior border of mandible and the percentage of remaining amount of bone at the mandibular angle region.

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