CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(03): 501-512
DOI: 10.1055/s-0044-1787864
Original Article

Comparative Evaluation of Clinical Outcome Including Neurosensory Deficit and Pain Score Variables Using Rigid Internal Fixation with Three-Dimensional Miniplate Internal Fixation in Simultaneous Angle and Contralateral Body/Parasymphysis Fractures of the Mandible: A Prospective, Randomized Controlled Study

Satish Kumar
1   Department of Dentistry, Civil Hospital, Siwani, Bhiwani, Haryana, India
,
Ajay Chandran
2   Department of Oral and Maxillofacial Surgery, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
,
Syed Sirajul Hassan
3   Oral and Maxillofacial Surgery Section, Oral and Maxillofacial Surgery and Rehabilitation Department, Dentistry Administration, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Kingdom of Saudi Arabia
,
Davide Rocchetta
3   Oral and Maxillofacial Surgery Section, Oral and Maxillofacial Surgery and Rehabilitation Department, Dentistry Administration, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Kingdom of Saudi Arabia
,
Abdulsalam S. Alshammari
4   Oral and Maxillofacial Surgery/Head and Neck Surgical Oncology Section, Oral and Maxillofacial Surgery and Rehabilitation Department, Dentistry Administration, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Kingdom of Saudi Arabia
,
Faris Jaser Almutairi
5   Maxillofacial Surgery and Diagnostic Sciences Department, College of Dentistry, Qassim University, Buraydah, Quassim, Kingdom of Saudi Arabia
,
Suresh Babu Jandrajupalli
6   Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
,
Swarnalatha Chandolu
6   Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
,
7   Department of Oral Medicine and Radiology, Saraswati Dhanwantari Dental College and Hospital and Post-graduate Research Institute, Parbhani, Maharashtra, India
› Author Affiliations
Funding None.

Abstract

Purpose There have been numerous advancements in the strategies used for treating mandibular fractures in the present times, while open reduction and internal fixation is still accepted as the most preferred treatment option for such fractures despite numerous drawbacks. The aim of the present prospective, randomized controlled study was to evaluate the clinical outcome including neurosensory deficit and pain score variables in mandibular fractures that were treated using rigid internal fixation with three-dimensional (3D) miniplate internal fixation.

Materials and Methods For the present study, a total of 20 patients of either sex in an age range of 18 to 55 years with simultaneous angle and contralateral body/parasymphysis fractures of the mandible were included, while the clinical outcome was compared in relation to the two groups wherein different treatment options were used including using rigid internal fixation in one as against 3D miniplate internal fixation in the other.

Results Pairwise comparison of pain scores in Group I and Group II patients by the Mann–Whitney U-test at different time zones revealed the results to be statistically significant for all pairs except when the findings were compared between 1 month and 3 months after the procedure in Group II patients. Also, significant recovery was observed in both Group I and II patients during healing when assessed preoperatively to 1 month and then 3 months after the procedure with the results being statistically highly significant in case of the variations observed in relation to the neurosensory deficit observed at different time zones for both Group I and II patients (p = 0.0001).

Conclusion Based on the results obtained, it can be concluded that 3D miniplate-led osteosynthesis was found comparable to the osteosynthesis accomplished using reconstruction plates during fixation of unfavorable body/parasymphysis fractures of mandible in study, providing optimal stability, while satisfactorily meeting the biomechanical requirements for occlusal loading, and an early return to normal function.

Ethical Approval

All the patients were duly informed about the protocol of the study. Also, a written, informed consent was duly obtained from all the patients prior to their inclusion in the study, while ethical clearance was obtained from the Institutional Ethics Committee via Institutional Ethics Committee Letter approval no. SDDC/IEC/01–72–2022 before the start of the study.


Patients' Consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.




Publication History

Article published online:
24 June 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Banks P, Killey HC. Killey's Fractures of the Mandible. Oxford:: John Wright;; 1991
  • 2 Boole JR, Holtel M, Amoroso P, Yore M. 5196 mandible fractures among 4381 active duty army soldiers, 1980 to 1998. Laryngoscope 2001; 111 (10) 1691-1696
  • 3 Ellis III E. Open reduction and internal fixation of combined angle and body/symphysis fractures of the mandible: how much fixation is enough?. J Oral Maxillofac Surg 2013; 71 (04) 726-733
  • 4 Peled M, Laufer D, Helman J, Gutman D. Treatment of mandibular fractures by means of compression osteosynthesis. J Oral Maxillofac Surg 1989; 47 (06) 566-569
  • 5 Dodson TB, Perrott DH, Kaban LB, Gordon NC. Fixation of mandibular fractures: a comparative analysis of rigid internal fixation and standard fixation techniques. J Oral Maxillofac Surg 1990; 48 (04) 362-366
  • 6 Prein J, Kellman RM. Rigid internal fixation of mandibular fractures–basics of AO technique. Otolaryngol Clin North Am 1987; 20 (03) 441-456
  • 7 Champy M, Loddé JP, Schmitt R, Jaeger JH, Muster D. Mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg 1978; 6 (01) 14-21
  • 8 Anderson T, Alpert B. Experience with rigid fixation of mandibular fractures and immediate function. J Oral Maxillofac Surg 1992; 50 (06) 555-560 , discussion 560–561
  • 9 Theriot BA, Van Sickels JE, Triplett RG, Nishioka GJ. Intraosseous wire fixation versus rigid osseous fixation of mandibular fractures: a preliminary report. J Oral Maxillofac Surg 1987; 45 (07) 577-582
  • 10 Spiessl B. Internal Fixation of the Mandible. Berlin-Heidelberg, Germany:: Springer-Verlag;; 1989: 23
  • 11 Sauerbier S, Schön R, Otten JE, Schmelzeisen R, Gutwald R. The development of plate osteosynthesis for the treatment of fractures of the mandibular body - a literature review. J Craniomaxillofac Surg 2008; 36 (05) 251-259
  • 12 Farmand M. Ein neues Implantat-System fur die Befestigung von Epithesen (Epitec(R)-System. Dtsch Z Mund Kiefer Gesichtschir 1991; 15 (06) 421-427
  • 13 Farmand M, Dupoirieux L. Intérêt des plaques tridimensionnelles en chirurgie maxillo-faciale. Rev Stomatol Chir Maxillofac 1992; 93 (06) 353-357
  • 14 Farmand M. Three-dimensional plate fixation of fractures and osteotomies. Facial Plast Surg Clin North Am 1995; 3: 39-56
  • 15 Ellis III E, Walker L. Treatment of mandibular angle fractures using two noncompression miniplates. J Oral Maxillofac Surg 1994; 52 (10) 1032-1036 , discussion 1036–1037
  • 16 Ellis III E, Walker LR. Treatment of mandibular angle fractures using one noncompression miniplate. J Oral Maxillofac Surg 1996; 54 (07) 864-871 , discussion 871–872
  • 17 Feller KU, Schneider M, Hlawitschka M, Pfeifer G, Lauer G, Eckelt U. Analysis of complications in fractures of the mandibular angle–a study with finite element computation and evaluation of data of 277 patients. J Craniomaxillofac Surg 2003; 31 (05) 290-295
  • 18 Ellis III E. A prospective study of 3 treatment methods for isolated fractures of the mandibular angle. J Oral Maxillofac Surg 2010; 68 (11) 2743-2754
  • 19 Paza AO, Abuabara A, Passeri LA. Analysis of 115 mandibular angle fractures. J Oral Maxillofac Surg 2008; 66 (01) 73-76
  • 20 Sybil D, Gopalkrishnan K. Assessment of masticatory function using bite force measurements in patients treated for mandibular fractures. Craniomaxillofac Trauma Reconstr 2013; 6 (04) 247-250
  • 21 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 (02) 167-170
  • 22 Zix J, Lieger O, Iizuka T. Use of straight and curved 3-dimensional titanium miniplates for fracture fixation at the mandibular angle. J Oral Maxillofac Surg 2007; 65 (09) 1758-1763
  • 23 Rix L, Stevenson AR, Punnia-Moorthy A. An analysis of 80 cases of mandibular fractures treated with miniplate osteosynthesis. Int J Oral Maxillofac Surg 1991; 20 (06) 337-341
  • 24 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) 1737-1741
  • 25 Scolozzi P, Martinez A, Jaques B. Treatment of linear mandibular fractures using a single 2.0-mm AO locking reconstruction plate: is a second plate necessary?. J Oral Maxillofac Surg 2009; 67 (12) 2636-2638