A COMPARATIVE STUDY OF CORTICAL LAG SCREWS AND MINIPLATES FOR INTERNAL FIXATION OF MANDIBULAR SYMPHYSEAL REGION FRACTURES | ||
| Alexandria Dental Journal | ||
| Article 1, Volume 42, Issue 1, April 2017, Pages 1-6 PDF (1.26 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/adjalexu.2017.57849 | ||
| Authors | ||
| Mohamed S. Elhussein* 1; Ahmed A. Sharara2; Hala R. Ragab3 | ||
| 1B.D.S. Faculty of Dentistry, Alfateh University, Lybia | ||
| 2Professor of Oral & Maxillofacial Surgery, Faculty of Dentistry, Alexandria University | ||
| 3Assistant Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University | ||
| Abstract | ||
| INTRODUCTION: The management of facial trauma is one of the most rewarding and demanding aspects of oral and maxillofacial surgery. Being the most prominent mobile bone of the facial skeleton, mandible fracture occurs more frequently than any other fracture. OBJECTIVES: The aim of this study was to compare the outcomes of treatment by the use of cortical lag screws versus miniplates, in patients who have a fracture in the mandibular symphyseal region. MATERIALS AND METHODS: The present study was conducted on fourteen patients with age ranged from 19-48 years. The patients had mandibular symphyseal region fractures requiring open reduction and internal fixation. The patients were clinically examined postoperatively by assessment of pain, edema, surgical wound, occlusion, teeth vitality and nerve injury. They also were assessed radiographically using orthopantomogram and cone beam computerized tomography (CBCT) to evaluate the adequacy of reduction, healing progression and bone density of the fractured segments. CONCLUSIONS: Cortical screw fixation using the lag screw principle offers the advantages of fixation, using minimal hardware, and achieving inter-fragmentary compression, and associated with minimal pain and edema when considering the treatment of linear symphyseal region fractures. | ||
| Keywords | ||
| Lag screw; Miniplate; Symphyseal; fracture | ||
| References | ||
|
1. Ogundara BO, Bonnick A, Bayley N: Pattern of mandibular fractures in an urban major trauma center. J Oral Maxillofac Surg 2003; 61:713
2. Fasola AO, Obiechina AE, Arotiba JT: Incidence and pattern of maxillofacial fractures in the elderly. Int J Oral Maxillofac Surg 2003; 32:206
3. Tiwana PS, Kushner GM, Alpert B. Lag screw fixation of Anteriormandiblular fracture: a retrospective analysis of intraoperative and postoperative complications. J Oral MaxillofacSurg 2007; 65:1180-5
4. Iizuka T, Lindqvist C. Rigid internal fixation of mandibular fractures. Int J Oral Maxillofac Surg 1992; 21:65-9.
5. Sauerbier S, Schon R, Otten JE, Schmelzeisen R, Gutwald R. The development of plate osteosynthesis for the treatment of fractures of the mandibular body a literature review. J Cranio Maxillofac Surg 2008; 36:251-9.
6. Szabo G, Kovacs A, Pulay G. Champey‘s plates in mandibular surgery. Int J Oral Maxillofac Surg 1991; 29:73-4
7. Ikemura K, Kouno Y, Shibita H, Yamasaki k. Biomechanical study on monocortical osteosynthesis for the fracture of the mandible. Int J Oral Surg 1984; 13:290- 3.
8. Brons R, Boering G. Fractures of mandibular body treated by Stable internal fixation a preliminary report. J Oral Maxillofac Surg 1970; 28:407–15.
9. Niederdellmann H, Schilli W, Duker J, Akuaoma-Boateng E. Osteo- synthesis of mandibular fractures using lag screw. Int J Oral Surg1996; 5:117–21
10. Ellis III Edward, Ghali GE. Lag screw fixation of anterior mandibular fractures. J Oral Maxillofac Surg 1991; 49:13- 21
11.Chang JD, Bird SR, Bohidar NR, King T. Analgesic efficacy of rofecoxib compared with codeine/ acetaminophen using a model of acute dental pain. Oral Surg Oral Med Oral Path Oral RadiolEndod 2005; 100:74- 80.
12. Wakuloba G, Mahallawy A, Ragab H. Evaluation of dynamic compression miniplates in treatment of mandibular angle fractures using trocar. ADJ 2015;40: 86- 93.
13.Balasubramanian S, Kumaravelu C, Elavenil P, Krishnakumar Raja V B. Solitary lag-screw fixation for mandibular angle fractures: Prospective study. SRM J Res Dent Sci 2014; 5:180-5
14. Subhashraj K, Ramkumar S, Ravindran C. Pattern of mandibular fractures in Chennai, India. Br J Oral Maxillofac Surg. 2008; 46:126–7
15. Lee T, Sawhney R, Ducic Y. Miniplate fixation of fractures of the symphyseal and parasymphyseal regions of the mandible: a review of 218 patients. JAMA facial plastic surgery 2013; 15:121-25
16.Bakardjiev A, Pechalova P. Maxillofacial fractures in Southern Bulgaria– a retrospective study of 1706 cases. J Cranio Maxillofac Surg 2007; 35:147–50.
17. Gutta R, Tracy K, Johnson C, James LE, Krishnan DG, Marciani RD. Outcomes of mandible fracture treatment at an academic tertiary hospital: a 5-year analysis. J Oral Maxillofac Surg 2014:72:550-8.
18.Brasileiro BF, Passeri LA. Epidemiological analysis of maxillofacial fractures in Brazil: a 5-year prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102:28-34.
19. Bormann KH, Wild S, Gellrich NC, Kokemüller H, Stühmer C, Schmelzeisen R, et al. Five-year retrospective study of mandibular fractures in Freiburg, Germany: incidence, etiology, treatment, and complications. J Oral Maxillofac Surg 2009; 67:1251-5.
20. Ellis E III: Treatment methods for fractures of the mandible angle. Int J Oral Maxillofac Surg 1999; 28:243-52.
21. Potter J, Ellis E 3rd. Treatment of mandible angle fractures with a malleable noncompression miniplate. J Oral Maxillofac Surg 1999; 57:288-92.
22. Saad KA. Evaluation of one non-compression miniplate with or without maxillomandibular fixation for the treatment of mandibular angle fracture. Master Thesis in Oral Surgery. Faculty of Dentistry, Tanta University, 2000.
23. Schaaf H, Kaubruegge S, Streckbein P, Wilbrand JF, Kerkmann H, Howaldt HP. Comparison of miniplate versus lag-screw osteosynthesis for fractures of the mandibular angle. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:34-40.
24. Bhatnagar A, Bansal V, Kumar S, Mowar A. Comparative analysis of osteosynthesis of mandibular anterior fractures following open reduction using ‘Stainless Steel Lag Screws and Mini Plates. J maxillofac Oral Surg 2013; 12:133-9.
25. Agnihotri A, Prabhu S, Thomas S. A comparative analysis of the efficacy of cortical screws as lag screws and miniplates for internal fixation of mandibular symphyseal region fractures: a randomized prospective study. Int J Oral Maxillofac Surg 2014;43: 22-8.
26. Guimound C, Johanson JV, Marchena JM. Fixation of mandibular angle fractures with a 2.0 mm 3-dimentional curved angle strut plate. J Oral Maxillofac Surg 2005; 63:209-14
27. Haranal S R, Neeli A S, Suryavanshi R K, Kotrashetti S M, Naresh N. Titanium lag screw osteosynthesis in the management of mandibular fractures. Int Multidiscip Res J 2012; 2:5-8
28.Jadwani S, Snehal B. Lag screw fixation of fracture of the anterior mandible: a new minimal access technique. J Maxillofac Oral Surg 2011; 10:176-180.
29. Lee JK, Angled eccentric osteosynthesis, a new technique for simple mandibular fracture. Surgical Techniques Development 2011; 1:1-2.
30. Grigor‘ian AS, Barsegian SN, Laptev PI. Comparative histomorphological analysis of bone fragments consolidation in compression and non-compression mandible osteosynthesis. Stomatologia 2010; 13:89-7.
31. Goyal M, Jhamb A, Chawla S, Marya K, Dua JS, Yadav S. A comparative evaluation of fixation techniques in anterior mandibular fractures using 2.0 mm monocortical titanium miniplates versus 2.4 mm cortical titanium lag screws. J Maxillofac Oral Surg 2012;11:442-50
32. Suomalainen A, Esmaeili E P, Robinson S. Dentomaxillofacial imaging with panoramic views and cone beam CT. Insights into imaging 2015;6:1-16.
33. Heiland M, Schulze D, Rother U, Schmelzle R. Postoperative imaging of zygomaticomaxillary complex fractures using digital volume tomography. J Oral Maxillofac Surg 2004; 62:1387-91. | ||
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