scholarly journals Effect of plate configuration on resistance in mandibular angle fractures

2020 ◽  
Vol 10 (1) ◽  
pp. 6-11
Author(s):  
Mehmet Emrah Polat ◽  
Hojjat Ghahramanzadeh Asl ◽  
Saim Yanık

Aim:  This in-vitro experimental study compared the biomechanical behaviors of three single-miniplate osteosynthesis configurations used in the treatment of mandibular angle fractures. Methodology: Twenty-one synthetic polyurethane hemimandible replicas including the medullar and cortical portions were used in this study. The replicas were divided randomly into three groups (n = 5/group). Data from the three groups were compared using analysis of variance and the Tamhane T2 test. P values < 0.05 were considered to indicate significance. The replicas in all groups were fixed with 7-mm-long self-tapping screws and 2.0-mm four-hole miniplates in three different configurations external oblique, lateral angulus superior and lateral angulus inferior configuration. Results: The replicas were tested on a servohydraulic apparatus, and the data were transmitted to a computer for analysis of peak displacement and peak force. Peak load and peak displacement did no differ significantly among the three groups.. Conclusion: This experimental study showed that the torsional forces resulting from the fixation of miniplates for the treatment of mandibular angle fracture did not differ among the three configurations tested.   How to cite this article: Polat ME, Ghahramanzadeh asl H, Yanık S. Effect of plate configuration on resistance in mandibular angle fractures. Int Dent Res 2020;10(1):6-11. https://doi.org/10.5577/intdentres.2020.vol10.no1.2   Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

2013 ◽  
Vol 6 (3) ◽  
pp. 191-196 ◽  
Author(s):  
Amy S. Xue ◽  
John C. Koshy ◽  
Erik M. Wolfswinkel ◽  
William M. Weathers ◽  
Kristina P. Marsack ◽  
...  

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.


2013 ◽  
Vol 07 (02) ◽  
pp. 212-217 ◽  
Author(s):  
Suresh Yadav ◽  
Shallu Tyagi ◽  
Naveen Puri ◽  
Prince Kumar ◽  
Puneet Kumar

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.


2013 ◽  
Vol 6 (2) ◽  
pp. 107-113 ◽  
Author(s):  
Kazem S. Khiabani ◽  
Meghdad Khanian Mehmandoost

Background and Objectives The ideal line of osteosynthesis in mandibular angle fractures indicates that a plate might be placed either along or just below the external oblique ridge. Some authors believe that using one miniplate at this line at the mandibular angle region provides sufficient strength to stabilize the fracture but others imply a second plate is required. Such controversies exist in the use of maxillomandibular fixation (MMF). The intention of the present study was to compare efficiency and complications of using one miniplate with and without MMF in mandibular angle fractures. Methods and Materials Forty patients with facial trauma with mandibular angle fractures including displaced and unfavorable fractures were categorized into two groups of 20 persons. In all patients, one miniplate was placed on the external oblique ridge. In the first group, patients had light maxillomandibular elastic bands just after surgery but no rigid MMF. In the second group, patients had rigid MMF for 2 weeks after surgery. Patients were followed to evaluate complications and treatment efficiency. Conclusions Our study showed that use of a single miniplate in the external oblique ridge is a functionally stable treatment for all types of angle fractures (including displaced and unfavorable fractures) except comminuted and long oblique fractures, which were not included in our study. Use of postoperative MMF did not improve the results.


2021 ◽  
Vol 4 (1) ◽  
pp. 01-14
Author(s):  
Fernando P.S. Guastaldi

Mandible fractures correspond to 19-40% of all facial fractures. Among all mandible fractures, 12-30% are fractures of the mandibular angle. These fractures are mainly caused by sports activities, interpersonal violence and car accidents. The presence of the third molar and the thin transverse bone area seem to be responsible for the frequent involvement of the mandibular angle in facial fractures. Before the advent of antibiotics, a high frequency of infection was always associated after an open reduction in mandibular angle fractures. Wired osteosynthesis and maxillomandibular fixation (MMF) were traditional methods for fixing mandibular angle fractures. The limitation of both methods has influenced the development of new approaches for the treatment of mandibular angle fractures. Currently, osteosynthesis of mandibular angle fractures with plates and screws has become an effective treatment option. Several forms are described in the literature as: fixation of bone segments with a miniplate on the upper edge of the mandible, fixation with two miniplates, lag screw or by a single rigid plate on the lower edge of the mandible. The purpose of this study was to summarize the main characteristics of biomechanical studies such as the type of mandible source used, the plating techniques employed, the plate material, and the loading protocols used to evaluate the stability of the fixation methods. The Medline (PubMed) database was searched combining relevant terms and pertinent articles in English were included. Articles had to meet the following inclusion criteria: be in vitro biomechanical studies evaluating fixation methods for mandibular angle fractures. A total of 27 articles fulfilled the inclusion criteria. Synthetic mandibles (n=12), animal mandibles (n=9), and human cadaveric mandibles (n=5) were used as the sample source to perform the biomechanical analysis. One article used both synthetic and human cadaveric mandibles. Also, a variety of fixation techniques was described such as mini-plates, lag-screws, reconstruction plates, and three-dimensional plates. The materials of the bone plates used were: stainless steel, commercially pure titanium, titanium alloy or bioresorbable. However, there was inconsistency in reporting the materials and not all studies clearly stated the material of the bone plates. For the biomechanical analysis, there was a high variation among all studies regarding the loading protocols used. The same side of fixation, the anterior part of the mandible (central incisors) or the contralateral side were reported as the dentate regions in which the force was applied. For more than 2 decades, in vitro biomechanical studies have been used to help researchers and clinicians in the field of Oral and Maxillofacial Surgery to properly evaluate and compare the different devices and techniques available for the treatment of mandibular angle fractures. Also, biomechanical studies are important to answer questions on fatigue performance and fracture strength on the gross level.


2019 ◽  
pp. 93-100
Author(s):  
Minh Phuong Hoang ◽  
Tan Tai Tran ◽  
Hong Loi Nguyen ◽  
Van Minh Nguyen ◽  
Thi Phuong Dung Le

Background: Angle mandibular fractures are among the most common traumatic injuries of the maxillofacial region. The optimal treatment modality for angle fractures remains controversial. The present study was designed to describe the clinical and radiographic features of patients who had suffered mandibular angle fractures and evaluate the postoperative outcome in patients treated for the Champy’s technique. Materials and methods: 32 patients with 32 fractures of the mandibular angle were treated by the Champy’s technique at the department of maxillo facial surgery of Hue University of Medicine and Pharmacy and Hue Central Hospital, from April 2018 to February 2019. Evaluating of results when patients were discharged from hospital, 3 and 6 months after surgery. Results: The majority of the patients were males (84.4%). The majority of angle fractures have unfavorable fractures (96.9%) and displaced fractures (68.7%). The most common symptoms were pain, throbbing pain, mouth limited opening, swelling, malocclusion. Panoramic radiographs plays an important role in diagnosis (96.9). The patients were treated successfully according to Champy’s principle of osteosynthesis. Conclusions: The Michelet – Champy’s technique for surgical treatment of mandibular angle fractures was simple, easy to use, had high success rates and few complications. Key words: mandibular angle fracture, Champy’s technique


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Dattani ◽  
A Aslam ◽  
K McMillan

Abstract Aim: To evaluate the risk of complications associated with retaining or extracting an asymptomatic third molar in the line of an angle fracture. Aiming to seek a consensus whether third molars should be extracted or retained during surgical repair of mandibular angle fractures. Method A retrospective study was undertaken at the Queen Elizabeth Hospital, Birmingham. 150 patients across a span of three years underwent open reduction and internal fixation of mandibular angle fractures with third molar involvement. Patients were classified into two groups, tooth retention during angle fracture and tooth removal during angle fracture repair. Hospital records were evaluated to seek the rate of post-operative complications at follow-up Results 162 angle fractures were identified with ipsilateral wisdom teeth present. In 37 cases the wisdom tooth was removed during surgery. 6 complications (16.2%) occurred in this group necessitating a return to theatre. In 125 cases the wisdom tooth was left in-situ. Complications necessitating a return to theatre occurred in 14 cases (11.1%). Conclusions This study indicates that retention of wisdom tooth overall did not significantly increase the risk of complications associated with angle fractures (p = 0.42). Where wisdom tooth pathology was noted its retention was associated with complications requiring a return to theatre (X2=4.40, p = 0.036).


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