EVALUATION OF DYNAMIC COMPRESSION MINIPLATES IN TREATMENT OF MANDIBULAR ANGLE FRACTURES USING TROCAR | ||||
| Alexandria Dental Journal | ||||
| Article 14, Volume 40, Issue 1, July 2015, Page 86-93 PDF (447.05 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/adjalexu.2015.58741 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| G Wakuloba1; A Mahallawy2; H Ragab3 | ||||
| 1Visiting resident, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University. | ||||
| 2Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University | ||||
| 3Assistant Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University | ||||
| Abstract | ||||
| Introduction: Mandibular angle fractures (MAFs) account for 23% to 42% of all mandibular fractures. The frequent involvement of the angle in mandibular fractures can be attributed to its thin cross-sectional bone area and the presence of a third molar Objectives: The aim of this study was to evaluate clinically and radiologically the use of two dynamic compression miniplates in treatment of mandibular angle fractures using Trocar instrumentation Materials and methods: The study was conducted on ten patients diagnosed with a single mandibular angle fracture indicated for open reduction and internal fixation. The fracture was exposed through transoral vestibular incision and reduced under general anesthesia. Third molar tooth in the fracture line was extracted. Temporary Maxillomandibular fixation was done using 26gauge stainless steel wires with arch bars. One dynamic compression miniplate was fixed on the external oblique ridge. The second miniplate was fixed on the lower border of the mandible using Trocar instrumentation. Results: Pain, edema and trismus decreased significantly over the follow up period. Maximum interincisal mouth opening and bone density along the fracture line increased significantly over the follow up period. Five patients had parasthesia of the inferior alveolar and mental nerve preoperatively. The parasthesia decreased progressively from the fourth week. Postoperative panorama radiographs showed adequate reduction and increase in bone density along the fracture line. No postoperative complication occurred. Conclusion: Two 2.0 mm dynamic compression miniplates are suitable for treatment of mandibular angle fractures using Trocar instrumentation. | ||||
| Keywords | ||||
| Dynamic compression miniplates; mandibular angle fractures; Trocar | ||||
| References | ||||
|
1. Schierle HP, Schmelzeisen R, Rahn B, Pytlik C. Oneor two-plate fixation of mandibular angle fractures? J Craniomaxillofac Surg 1997; 25: 162- 8.
2. Safdar N, Meechan JG. Relationship between fractures of the mandibular angle and the presence and state of eruption of the lower third molar. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995; 79: 680-4.
3. Sorel B. Open versus closed reduction of mandible fractures. Oral Maxillofac Surg Clin North Am 1998; 10: 553.
4. Lee JK. Angled eccentric osteosynthesis, a new technique for simple mandibular fracture. Surgical Techniques Development 2011; 1: 1-2.
5. Mehra P, Van Heukeloom E, Cottrel DA. Rigid internal fixation of infected mandibular fracture. J Oral Maxillofac Surg 2009; 67: 1046-51.
6. Scolozzi P, Ritchre M. Treatment of severe mandibular fracture using AO reconstruction plates. J Oral Maxillofac Surg 2003; 61: 458-61.
7. Hylander WL. Mandibular function in Galago crassicaudatus and Macaca fascicularis: an in vivo approach to stress analysis of the mandible. J Morphol 1979; 159: 253-96.
8. Lovald ST, Wanger JD, Baack B. Biomechanical optimization of bone plates used in rigid fixation of mandibular fracture. J Oral Maxillofac Surg 2009: 67: 1046-51.
9. Ward BB, Edward SP, Feinberg SE. Healing of Traumatic Injury. In: Walker F, Powers BB. Oral and Maxillofacial Trauma. 3rd ed. Ch. 39. USA: Elsevier Saunders, 2005. 1140-48.
10. Ellis E, Gltali GE. Lag screw fixation of anterior mandibular fracture. J Oral Maxilllofac Surg 1991; 49: 13-21.
11. Wan K, Williamson RA, Gebauer D, Hird K. Open reduction and internal fixation of mandibular angle fractures: does the transbuccal technique produce fewer complications after treatment than the transoral technique? J Oral Maxillofac Surg 2012; 70: 2620-8.
12. Champy M, Loddé JP, Schmitt R, Jaeger JH, Muster D. Mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg 1978; 6: 14-21.
13. Numerical Rating Pain Scale. 2009. Available at: http://pain.about.com/od/testingdiagnosis/ig/painscales/Numerical-Scale.htm.
14. Kindermann M, Meyer T, Kindermann W, Nickenin G. Exercise training in heart failure. Herz 2003; 28: 153-65.
15. Rieder CE. Maximum mandibular opening in patients with and without a history of TMJ dysfunction. J Prosthet Dent 1978; 39: 441-6.
16. Jensen, John R., and Kalmesh Lulla. "Introductory digital image processing: a remote sensing perspective." (1987): 65-65.
17. Zallen RD, Curry JT. A study of antibiotic usage in compound mandibular fractures. J Oral Surg 1975; 33(6): 431-4
18. Michelet FX, Deymes J. Dessus B. Osteosynthesis with miniaturized screwed plates in maxillofacial surgery. J Maxillofac Surg 1973; 1(2): 79-84.
19. Kroon F, Mathisson M, Cordey J, Rahn B. The use of miniplates in mandibular fractures. J Craniomaxillofac Surg. 1991; 19: 199-204.
20. Choi BH, Yoo JH, Kim KN, Kang HS. Stability testing of a two miniplate fixation technique for mandibular angle fractures: an in vitro study. J Craniomaxillofac Surg 1995; 23: 123-5.
21. Levy F, Smith R, Odland R, Marentette L. Monocortical miniplate fixation of mandibular angle fractures. Arch Otolaryngol Head Neck Surg 1991; 117: 149-54.
22. Gamal Eldin E. The use of minidynamic compression plates in the treatment of fractures of the tooth bearing area. Thesis submitted for Master Degree in Oral Surgery, Alexandria University 2014.
23. Ellis E, Karas N. Treatment of mandibular angle fractures using two mini dynamic compression plates. J Oral Maxillofac Surg 1992; 50: 958-63.
24. Zakar K, Farag IA, Zeitoun IM. Review of 509 mandibular fractures treated at the University Hospital, Alexandria, Egypt. Br J Oral Maxillofac surg 2006; 44: 107-11.
25. Telfer MR, Jones GM, Shepherd JP. Trends in the etiology of maxxillofacial fractures in the United Kingdom. Br J Oral Maxillofac Surg 1991; 29: 250-5.
26. Kellman MR, Fox JA. Mandibular Angle Fractures: Two-Miniplate Fixation and Complications. Arch Facial Plast Surg 2003; 5: 464-9.
27. Mishra GS. Use of dynamic compression plates in rigid internal fixation of mandibular fractures. Indian J of Otolaryngol Head and Neck Surg 1998; 50: 326-32.
28. Shetty V, Freymiller E. Teeth in the line of fracture: a review. J Oral Maxillofac Surg 1989;47:1303–6.
29. Ellis III. Management of fractures through the angle of the mandible. Oral Maxillofacial Surg Clin N Am 2009; 21: 163-74.
30. Kale PT, Baliga SD, Ahuja N, Kotrasheti SM.A comparison between transbuccal and extraoral approaches in treatment of mandibular angle fractures. J Maxillofac Oral Surg 2010: 9: 9-12.
31. Ellis E 3rd. Treatment methods for fractures of mandibular angle. Int J Oral Maxillofac Surg 1999; 28: 243-52.
32. Rahpeyma A, Khajehahmadi S, Bakhori Mehni S. Treatment of Mandibular Fractures by Two Perpendicular Mini-Plates Iran . J otolaryngol 2014; 26: 31-6.
33. Gulses A, Kilic C, Sencimen M. Determination of a safety zone for transbuccal trocar placement: an anatomical study. Int J Oral Maxillofac Surg 2012; 41: 930-3.
34. Doblar M, Garcia JM. Modelling bone tissue fracture and healing. Omez Engine Frac Mech 2004; 71: 1809-10.
35. Ellis E, 3rd, Walker LR. Treatment of mandibular angle fractures using one noncompression miniplate. J Oral Maxillofac Surg 1996; 54: 864-71.
36. Shetty V, McBrearty D, Fourney M, Caputo A. Fracture line stability as a function of the internal fixation system: An in vitro comparison using a mandibular angle fracture model Journal of Oral and Maxillofacial Surgery .1995;53:791–801.
37. Green SB, Salkind NJ. Using SPSS for Windows and Macintosh: Analyzing and understanding data. Prentice Hall Press, 2010. | ||||
|
Statistics Article View: 211 PDF Download: 502 |
||||
