Management of anterior mandibular fractures using four fixation methods: A clinical comparative study

Purpose: To compare the surgical outcomes of three-dimensional (3D) mini-plates for fixation
of anterior mandibular fractures (AMFs) and those of bone plates and lag screws.
Materials and methods: Patients with AMFs, who met the inclusion criteria, were equally
distributed into 4 groups. Those in Group I were treated with double 2.0 mm mini-plates, patients
in Group II were treated with double lag screws, 2.3mm locking plates were used in group III,
while in Group IV 2.0 mm 3D mini-plates were used. Prior to the surgical intervention, MMF was
performed to verify the centric occlusion in all patients. After hardware fixation, the MMF was
intraoperatively released, and the adequacy of fixation and occlusion was verified. The operation
time and postoperative outcomes were also analyzed.
Results: Sixty patients (41 males and 19 females) were included in this prospective study.
There were no significant differences in demographic data. The clinical examination showed stable
fixation with no mobility in all cases. None of the patients in the 3D mini-plates group showed
clinical manifestations of infection or dehiscence. The incidence of malocclusion was the highest
in the mini-plates group. There was no statistically significant difference among the groups in all
parameters, except for infection and paresthesia. They were significantly greater in double miniplates
and 2.3 mm locking plate groups respectively.
Conclusion: The use of 3D mini-plates is a viable option for fixation of AMFs. It has advantages
of both lag screws and bone plates. A 3D mini-plate provided sufficient inter-fragmentary stability
with a relatively low rate of complications when compared with other conventional fixation
techniques.