A Comparative Prospective Study of Three different Bone Plating Methods for treatment of Mandibular Symphysis and Parasymphysis Fractures

Abstract
Background Recently, various modifications in placing miniplates for direct fixation of the mandibular fracture are gaining popularity. The modifications have various advantages like more rigidity, less foreign material, less time in application, etc. Thus the purpose of this prospective study was to evaluate outcomes for three bone plating techniques used in the treatment of mandibular symphysis/ parasymphysis fractures. Methods A prospective study was conducted on 45 patients with mandibular symphysis/parasymphysis fractures and the patients were divided into 3 groups (A, B and C). Patients were followed for 3 months. Outcome parameters like occlusion, distraction of lower border radiologically, parasthesia, infection, failure of bone plate (plate fracture) and screw loosening, postoperative segmental stability and radiological evaluation of fixation were recorded. Results Distraction of lower border was seen in all the groups which were noticed radiographically at all follow ups. There was no occlusal discrepancy present in all the groups after three months post operatively. The fracture segments were stable in all groups at all times. Parasthesia was noticed in all the groups, which gradually decreased in one month and resolved completely by third month follow up. The degree of parasthesia, distraction of lower border, occlusal discrepancy was not statistically significant between the three groups. Hardware failure was not found in all the groups. Conclusion It can be concluded that conventional miniplate system is a better and easier method than the 3D miniplate system for fixation of mandibular fractures. In comparison, the 3D miniplate system is unfavorable for use in cases of oblique fractures and those involving the mental nerve, and is also difficult to adapt.