COMPARISON OF DIFFERENT ALTERNATIVE TYPES OF OSTEOSYNTHESIS FOR MANAGEMENT OF PEDIATRIC MANDIBULAR FRACTURES

This study was planned to evaluate both clinically and radiographically different plating systems for treatment of pediatric mandibular fractures.
Patients and Methods: 36 children with mandibular fractures at different sites, their ages in between 5-12 years with a mean of age 8.5 years. All patients treated via an intraoral approach with open reduction and internal fixation, using miniplates, microplates, biodegradable plates. All patients were examined clinically by inspection and palpation both extra orally and intra orally. Radiographically by orthopantomograms. All patients were evaluated both clinically and radiographically immediately, at one week, two weeks, at one month, three and six months postoperatively.
Results: the results of this study revealed primary wound healing was achieved uneventfully in 32 patients with no signs of infection. Proper occlusion without any discrepancy postoperatively, except only minor occlusal derangement in only two cases of group (3) corrected by placement of light guiding elastics. Radiographic examination revealed significant bone healing at the fracture line, nonunion didn’t occur in any patient of our study.
Conclusion: Monomandibular osteosynthesis using miniplates, microplates, and biodegradable plates precludes dependence on the maxillomandibular fixation, ensure respiratory care, nutritional intake in children, provided adequate stability of the fracture segments, minimize the possibility of trauma to the teeth buds. In addition the biodegradable plates characterized by no need for removal of the plates later on.