EC Dental Science

Background: The introduction of the locking plate/screw system has offered certain advantages over conventional plating systems in the management of facial fractures. This system does not require intimate adaptation of the mini plates to the underlying bone and has greater stability. This study compares the clinical efficacy of locking mini plate/screw system and conventional mini plate system in the treatment of mandibular angle fractures.

Materials and Methods: Of ten patients with isolated angle of the mandible fractures five were treated surgically by open reduction and internal fixation using 2.3 mm locking titanium miniplate system and five using 2.0 mm conventional titanium mini plate system. All the patients were followed up on the first, third and seventh postoperative days for evaluation of post operative pain, swelling, mouth opening and one month and 3 months postoperatively for stability and failure of hardware. Pain was evaluated using a visual analog scale on which the patient scored in the first, third and seventh post-operative days. Swelling was measured using an inch tape from the tragus of the ear to commissure of the mouth and lateral canthus of the eye to the angle of mandible on the first, third and seventh post-operative days. Mouth opening was measured using a calibrated metal scale from the incisal edge of upper incisor to the incisal edge of lower incisor on the first, third and seventh post-operative days. Stability was checked by palpation at subsequent monthly reviews. Failure of hardware was observed for a period of six months and more. The patients were enquired about functional restoration postoperatively. A statistical analysis of all the collected data was done and the results were compared between both groups.

Results: Post operative pain after using locking miniplate system is lower in patients on the third postoperative day when compared to those who had conventional mini plates fixed but it is not statistically significant. Swelling after using locking miniplate is lower in patients on the third post-operative day but it is not statistically significant. Mouth opening after using locking miniplate is higher in patients on the seventh post operative day but it is not statistically significant. On digital palpation the stability of both the plates was found to be similar clinically. There was an infection three months postoperatively in one of the conventional plate patients which was attributed to his poor oral hygiene.

Conclusion: In this study, even though the results when compared were not statistically significant in the clinical aspects studied, earlier restoration of function was noted in patients treated with locking plates. However considering the cost factor involved we can reserve locking plates for very special cases such as those with osteoporosis alone.

Keywords: Mandibular Fractures; Locking Plate; Rigid Fixation; Mandibular Angle Fractures; Trauma

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