Abstract

Objective: To compare the efficacy of titanium 2-D miniplates and titanium lag screws in treatment of anterior mandibular fracture.

Materials and Methods: A total of 14 patients were treated in our institution with open reduction and internal fixation applying miniplates and lag screws for the anterior mandibular fracture. They were divided equally and randomly into two groups: Group 1 patients were treated with 2-D Titanium miniplates and Group 2 patients with Titanium lag screws. Duration of the surgery was measured from the time of incision placement to the suture placement. Postoperative pain was measured on Wong Baker’s Scale and interfragmentary gaps were assessed using radiographs taken preoperatively and 24 hrs postoperatively. Postoperative complications such as infection, wound dehiscence, exposure, loss of teeth vitality, neurosensory deficit were also documented. Follow up was done at predefined intervals. Results were evaluated using Mann-Whitney test, chi square test, unpaired t-test.

Results: In this study, the mean duration of surgery in case of group 1 patients (2-D miniplates) was approximately 37.86 ± 16.03 min. and in group 2 (lag screws), it was approximately 25.71 ± 7.3 min. The gap difference between the fractured fragments were significantly greater in group 1 (miniplates) than group 2 (lag screws). Lag screw group showed minimal post operative pain and post operative complications.

Conclusion: In this study, lag screws fixation showed better results than miniplates for the fixation of anterior mandibular fractures as it offers advantages of rigid internal fixation apart from being cost effective. It not only reduces time and effort but also assists in primary healing without any major complications.

Keywords: Anterior Mandibular Fractures, Internal Fixation Techniques, Miniplates, Lag Screws, Rigid Internal Fixation.

References

1. Al-Moraissi EA and Ellis E. “Surgical management of anterior mandibular fractures: A systematic review and meta-analysis”. Journal of Oral and Maxillofacial Surgery 72 (2014): 2507.e1- 2507.e11.
2. Tiwana PS., et al. “Lag screw fixation of anterior mandibular fractures: A retrospective analysis of intraoperative and postoperative complications”. Journal of Oral and Maxillofacial Surgery 65 (2007): 1180-1185.
3. Dingman RO and Natvig P. “Surgery of facial fractures”. Philadelphia, PA, WB Saunders (1964).
4. Goyal M., et al. “A comparative evaluation of fixation techniques in anterior mandibula fractures using 2.0mm monocortical titanium miniplates versus 2.4 mm cortical titanium lag screws”. Journal of Maxillofacial and Oral Surgery 11.4 (2012): 442-450.
5. Iizuka T C Lindqvist. “Rigid internal fixation of mandibular fractures”. International Journal of Oral and Maxillofacial Surgery 21 (1992): 65-69.
6. Farwell DG. “Management of symphyseal and parasymphyseal mandibular fractures”. Operative Techniques in Otolaryngology. 19 (2008): 108-112.
7. Niederdellmann H., et al. “Osteosynthesis of mandibular fractures using lag screws”. International Journal of Oral and Maxillofacial Surgery 5 (1976):117-121.
8. Schaaf H., et al. “Comparison of miniplate versus lag-screw osteosynthesis for fracture of the mandibular angle”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 111 (2011): 34-40.
9. Champy M., et al. “Mandibular osteosynthesis by miniature screwed plates via a buccal approach”. Journal of Oral and Maxillofacial Surgery 6 (1978): 14-21.
10. Michelet FX., et al. “Osteosynthesis with miniaturized screwed plates in maxilla-facial surgery”. Journal of Oral and Maxillofacial Surgery 1 (1973): 79-84.
11. Sauerbier S., et al. “The development of plate osteosynthesis for the treatment of fractures of the mandibular body – a literature review”. Journal of craniofacial Maxillofacial Surgery 36 (2008): 251-259.
12. Ellis E. “Lag screw fixation of anterior mandibular fractures”. Journal of Oral and Maxillofacial Surgery 49 (1991): 13-21.
13. Zachariades N., et al. “Use of lag screws for the management of mandibular trauma”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 81 (1996): 164-167.
14. Renton TF and Wiesenfeld D. “Mandibular fracture osteosynthesisa: comparison of three techniques”. British Journal of Oral and Maxiilofacial Surgery 34 (1996): 166-113.
15. Wong DL and Baker CM. “Pain in children: Comparison of Assessment scales”. Pediatric Nursing 14.1 (1988): 9-17.
16. Peter ILG and Ellis E. “A comparison of two methods for inserting lag screws”. Journal of Oral and Maxillofacial Surgery 50 (1992): 119-123.
17. Kallela I and Lindqvist C. “Lag- screw fixation of mandibular parasymphyseal and angle fractures”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 81 (1996): 510-516.
18. Lee T. “Miniplate fixation of fractures of the symphyseal and parasymphyseal regions of the mandible”. JAMA Facial Plastic Surgery 15.2 (2013): 121-125.
19. Ellis E III. “A study of 2 bone plating methods for fracturesof the mandibular Symphysis / body”. Journal of Oral and Maxillofacial Surgery 69 (2011): 1978-1987.
20. Cawood JI. “Small plate osteosynthesis of mandibular fractures”. British Journal of Oral and Maxillofacial Surgery 23 (1985): 77-91.
21. Bhatnagar A., et al. “Comparative analysis of osteosynthesis of mandibular anterior fractures following open reduction using stainless steel lag screws and miniplates”. Journal of Oral and Maxillofacial Surgery 12.2 (2013):133-139.

Citation

Citation: Priyanka Sharma. “Comparative Analysis of the Efficacy of Titanium 2-D Miniplates and Titanium Lag Screws in Treatment of Anterior Mandibular Fracture”. Acta Scientific Dental Sciences 4.2 (2020): 129-134.

Copyright

Copyright: © 2020 Priyanka Sharma. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.