scholarly journals A review of biomechanical studies for mandibular angle fracture internal fixation

2021 ◽  
Vol 4 (1) ◽  
pp. 01-14
Author(s):  
Fernando P.S. Guastaldi
Keyword(s):  
Bone Plates ◽  
Biomechanical Analysis ◽  
Facial Fractures ◽  
Inclusion Criteria ◽  
Mandibular Angle ◽  
Fixation Methods ◽  
Mandibular Angle Fracture ◽  
Mandible Fractures ◽  
Angle Fractures

Mandible fractures correspond to 19-40% of all facial fractures. Among all mandible fractures, 12-30% are fractures of the mandibular angle. These fractures are mainly caused by sports activities, interpersonal violence and car accidents. The presence of the third molar and the thin transverse bone area seem to be responsible for the frequent involvement of the mandibular angle in facial fractures. Before the advent of antibiotics, a high frequency of infection was always associated after an open reduction in mandibular angle fractures. Wired osteosynthesis and maxillomandibular fixation (MMF) were traditional methods for fixing mandibular angle fractures. The limitation of both methods has influenced the development of new approaches for the treatment of mandibular angle fractures. Currently, osteosynthesis of mandibular angle fractures with plates and screws has become an effective treatment option. Several forms are described in the literature as: fixation of bone segments with a miniplate on the upper edge of the mandible, fixation with two miniplates, lag screw or by a single rigid plate on the lower edge of the mandible. The purpose of this study was to summarize the main characteristics of biomechanical studies such as the type of mandible source used, the plating techniques employed, the plate material, and the loading protocols used to evaluate the stability of the fixation methods. The Medline (PubMed) database was searched combining relevant terms and pertinent articles in English were included. Articles had to meet the following inclusion criteria: be in vitro biomechanical studies evaluating fixation methods for mandibular angle fractures. A total of 27 articles fulfilled the inclusion criteria. Synthetic mandibles (n=12), animal mandibles (n=9), and human cadaveric mandibles (n=5) were used as the sample source to perform the biomechanical analysis. One article used both synthetic and human cadaveric mandibles. Also, a variety of fixation techniques was described such as mini-plates, lag-screws, reconstruction plates, and three-dimensional plates. The materials of the bone plates used were: stainless steel, commercially pure titanium, titanium alloy or bioresorbable. However, there was inconsistency in reporting the materials and not all studies clearly stated the material of the bone plates. For the biomechanical analysis, there was a high variation among all studies regarding the loading protocols used. The same side of fixation, the anterior part of the mandible (central incisors) or the contralateral side were reported as the dentate regions in which the force was applied. For more than 2 decades, in vitro biomechanical studies have been used to help researchers and clinicians in the field of Oral and Maxillofacial Surgery to properly evaluate and compare the different devices and techniques available for the treatment of mandibular angle fractures. Also, biomechanical studies are important to answer questions on fatigue performance and fracture strength on the gross level.

scholarly journals Effect of plate configuration on resistance in mandibular angle fractures

2020 ◽  
Vol 10 (1) ◽  
pp. 6-11
Author(s):  
Mehmet Emrah Polat ◽  
Hojjat Ghahramanzadeh Asl ◽  
Saim Yanık
Keyword(s):  
Experimental Study ◽  
Peak Load ◽  
Mandibular Angle ◽  
Peak Displacement ◽  
Mandibular Angle Fracture ◽  
Angle Fracture ◽  
Force Peak ◽  
Miniplate Osteosynthesis ◽  
Angle Fractures

Aim:  This in-vitro experimental study compared the biomechanical behaviors of three single-miniplate osteosynthesis configurations used in the treatment of mandibular angle fractures. Methodology: Twenty-one synthetic polyurethane hemimandible replicas including the medullar and cortical portions were used in this study. The replicas were divided randomly into three groups (n = 5/group). Data from the three groups were compared using analysis of variance and the Tamhane T2 test. P values < 0.05 were considered to indicate significance. The replicas in all groups were fixed with 7-mm-long self-tapping screws and 2.0-mm four-hole miniplates in three different configurations external oblique, lateral angulus superior and lateral angulus inferior configuration. Results: The replicas were tested on a servohydraulic apparatus, and the data were transmitted to a computer for analysis of peak displacement and peak force. Peak load and peak displacement did no differ significantly among the three groups.. Conclusion: This experimental study showed that the torsional forces resulting from the fixation of miniplates for the treatment of mandibular angle fracture did not differ among the three configurations tested.   How to cite this article: Polat ME, Ghahramanzadeh asl H, Yanık S. Effect of plate configuration on resistance in mandibular angle fractures. Int Dent Res 2020;10(1):6-11. https://doi.org/10.5577/intdentres.2020.vol10.no1.2   Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

scholarly journals A Prospective Study of Strut versus Miniplate for Fractures of Mandibular Angle

2013 ◽  
Vol 6 (3) ◽  
pp. 191-196 ◽  
Author(s):  
Amy S. Xue ◽  
John C. Koshy ◽  
Erik M. Wolfswinkel ◽  
William M. Weathers ◽  
Kristina P. Marsack ◽  
...  
Keyword(s):  
Mandibular Angle ◽  
Patient Demographics ◽  
Mandibular Angle Fracture ◽  
Plate Group ◽  
Angle Fracture ◽  
Significant Difference ◽  
Comminuted Fractures ◽  
Angle Fractures ◽  
A Prospective Study ◽  
To Receive

This prospective randomized clinical trial compared the treatment outcomes of strut plate and Champy miniplate in fixation of mandibular angle fractures. Patients with mandibular angle fracture were consented and enrolled into this study. Exclusion criteria include patients with severely comminuted fractures. The patients were randomly assigned to receive the strut plate or Champy miniplate for angle fracture fixation. Patient demographics, fracture characteristics, operative and postoperative outcomes were collected prospectively. Statistical analysis was performed to evaluate the significance of the outcome. A total of 18 patients were included in this study and randomly assigned to receive either the strut plate or Champy miniplate. Out of which five patients were excluded postoperatively due to complex fracture resulting in postoperative maxillomandibular fixation. The final enrollment was 13 patients, N = 6 (strut) and N = 7 (Champy). There was no statistically significant difference in the pretreatment variables. Nine of these patients had other associated facial fractures, including parasymphyseal and subcondylar fractures. Most of the (11) patients had sufficient follow-up after surgery. Both groups exhibited successful clinical unions of the mandibular angle fractures. The complications associated with the mandibular angle were 20% in the strut plate group and 16.7% in the Champy group. One patient in the strut plate group had a parasymphyseal infection, requiring hardware removal. The strut plate demonstrated comparable surgical outcome as the Champy miniplate. It is a safe and effective alternative for management of mandibular angle fracture.

Biomechanical analysis of titanium fixation plates and screws in mandibular angle fractures

2016 ◽  
Vol 19 (3) ◽  
pp. 386 ◽  
Author(s):  
M Arslan ◽  
F Atik ◽  
MS Ataç ◽  
A Özkan ◽  
Y Kilinç
Keyword(s):  
Biomechanical Analysis ◽  
Mandibular Angle ◽  
Angle Fractures

scholarly journals Qualitative and quantitative assessment of relationship between mandibular third molar and angle fracture on North Indian population: A clinico-radiographic study

2013 ◽  
Vol 07 (02) ◽  
pp. 212-217 ◽  
Author(s):  
Suresh Yadav ◽  
Shallu Tyagi ◽  
Naveen Puri ◽  
Prince Kumar ◽  
Puneet Kumar
Keyword(s):  
Third Molar ◽  
Indian Territory ◽  
Mandibular Angle ◽  
The North ◽  
Mandibular Angle Fracture ◽  
Mandibular Third Molar ◽  
Angle Fracture ◽  
Angle Fractures ◽  
Inferior Border ◽  
The Relationship

ABSTRACT Objective: To assess the relationship between impacted mandibular third molar presence and the risk for mandibular angle fracture with the effect of various positions of mandibular third molar and the risk of mandibular angle fracture. Materials and Methods: In the North Indian territory, a total of 289 patients with mandibular angle fractures were studied and evaluated for the possible relationship with impacted third molar on the basis of clinical and panoramic radiographical findings. Results: Results that confirmed the highest risk for mandibular angle fracture was associated with mesioangular angulations (45.42%) followed by vertical (26.34%), distoangular in sequence and least risk was found with bucco-version angulations (2.67%) according to Winter′s classification. Additionally, the highest risk of mandibular angle fracture was reported with partially erupted third molar (47.75%), followed by erupted (23.53%) and unerupted third molar (19.38%). Conclusion: The risk for mandibular angle fracture is not only affected by status of eruption, angulations, position, number of roots present in third molar but also by the distance of mandibular third molar from inferior border of mandible and the percentage of remaining amount of bone at the mandibular angle region.

scholarly journals Transoral Miniplate Fixation of Mandibular Angle Fracture with and without 2 Weeks of Maxillomandibular Fixation: A Clinical Trial Study

2013 ◽  
Vol 6 (2) ◽  
pp. 107-113 ◽  
Author(s):  
Kazem S. Khiabani ◽  
Meghdad Khanian Mehmandoost
Keyword(s):  
Facial Trauma ◽  
Mandibular Angle ◽  
Maxillomandibular Fixation ◽  
Mandibular Angle Fracture ◽  
Angle Fracture ◽  
Ideal Line ◽  
External Oblique ◽  
Angle Fractures ◽  
Sufficient Strength ◽  
Single Miniplate

Background and Objectives The ideal line of osteosynthesis in mandibular angle fractures indicates that a plate might be placed either along or just below the external oblique ridge. Some authors believe that using one miniplate at this line at the mandibular angle region provides sufficient strength to stabilize the fracture but others imply a second plate is required. Such controversies exist in the use of maxillomandibular fixation (MMF). The intention of the present study was to compare efficiency and complications of using one miniplate with and without MMF in mandibular angle fractures. Methods and Materials Forty patients with facial trauma with mandibular angle fractures including displaced and unfavorable fractures were categorized into two groups of 20 persons. In all patients, one miniplate was placed on the external oblique ridge. In the first group, patients had light maxillomandibular elastic bands just after surgery but no rigid MMF. In the second group, patients had rigid MMF for 2 weeks after surgery. Patients were followed to evaluate complications and treatment efficiency. Conclusions Our study showed that use of a single miniplate in the external oblique ridge is a functionally stable treatment for all types of angle fractures (including displaced and unfavorable fractures) except comminuted and long oblique fractures, which were not included in our study. Use of postoperative MMF did not improve the results.

Biomechanical Analysis of Mandibular Angle Fractures

2011 ◽  
Vol 69 (12) ◽  
pp. 3010-3014 ◽  
Author(s):  
Julie Kimsal ◽  
Bret Baack ◽  
Lionel Candelaria ◽  
Tariq Khraishi ◽  
Scott Lovald
Keyword(s):  
Biomechanical Analysis ◽  
Mandibular Angle ◽  
Angle Fractures
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