A NEW DESIGN TITANIUM MINIPLATE VERSUS CONVENTIONAL 4-HOLE TITANIUM MINIPLATE FOR MANAGEMENT OF MANDIBULAR ANGLE FRACTURES: A COMPARATIVE STUDY

Purpose: This study was done to compare and evaluate the type of plate design i.e., new design titanium miniplate and conventional 4-hole titanium miniplate in management of mandibular angle fractures Materials and methods: 20 patients with non-comminuted, minimally displaced, dentulous fractures of mandibular angle with or without other associated maxillofacial fractures, were randomly selected & distributed into two groups. Group I patients were treated by new design titanium miniplate, while those in Group II were treated by conventional 4-hole titanium miniplate. Transaoral approach was primarily used for open reduction and internal fixation of fracture of the angle of mandible, while in few of the cases of Group I an adjunctive tansbuccal stab incision was used for posterior screw fixation via trocar. All cases were followed up periodically for 6 weeks. Results: Complications were relatively minor such as transient paresthesia which gradually improved over a period of 4 to 6 weeks postoperatively. Mild to moderate occlusal discrepancies were noted, which needed postoperative intermaxillary fixation with elastics. Postoperative infection (10%) was mild to moderate which was managed with antibiotic therapy except in one case, plate removal was done because of recurrent infection. None of the subjects exhibited malunion/nonunion postoperatively. Conclusion: The use of new design titanium miniplate is an effective and reliable mode of fixation for non- comminuted, minimally displaced dentulous fractures. Although the adaptation of the miniplate and placement of posterior screw of the distal extension is quite cumbersome, it exhibited marginally better anatomical reduction of fracture segments. Factors like operator experience, preoperative selection of case and use of trocar in some cases for transbuccal fixation should be considered. Key words: Mandibular angle fracture, new design titanium miniplate, transoral approach, trocar