A comparison of the application of one or two miniplate in treatment of mandibular angle fractures

Abstract

Monocortical miniplate fixation of the mandibular angle fractures is an accepted and reliable method for providing rigid internal fixation. It seems that placement of the second miniplate would provide more treatment stability; however, clinical importance of the paired miniplate remained unknown. The present study assessed the postoperative complications associated with the fixation of the mandibular angle fractures with 2- and 1- miniplates in patients referred to Imam Reza Hospital and some private hospitals on Tabriz during 2009-2010. Materials and Methods: In a prospective randomized double-blind clinical trial, a total of 87 patients (73 males, 14 females) with angle fractures were treated. In the first group, a 4-hole miniplate, 2 mm in diameter, fixed at the superior border thorough an intraoral approach. Group 2 patients were also treated by 2 miniplates, one fixing in the similar manner to the group 1 and the other to be fixed to the lateral aspect of the angle thorough intraoral and transcutaneous access by a trocar. Postoperative complications including malocclusion, malunion, nerve and sensory disturbances, teeth trauma, additional use of IMF and infection were tabulated in the patients in both groups up to 12 follow-up examinations. The data were subjected to chi-square test. Results: In the single miniplate group, 25 patients (55.6%), 22 patients (48.9%) and 3 patients (6.7%) showed lip numbness, additional use of IMF and infections respectively. These complications were reported in 20 patients (47.6%), 18 patients (42.9%) and 1 patient (2.4%) in two miniplates group. In the single miniplate group, 30 patients (66.7%) had one or more complications and 25 patients (59.5%) in the two miniplate group showed at least one complication. No patients showed malocclusion, malunion, damage to teeth, scarring or facial nerve weakness in either group. No significant differences were observed between the groups regarding each complication or overall complication incidence. Conclusion: Under the study limitations, the use of single or double miniplates for treating favorable simple mandibular angle fractures was associated with the similar incidence of different complications. However, it seems that the use of two miniplates to be not necessary due to the increased expenses and exposure to more surgery procedures.