Efficacy of Three-Dimensional Miniplates Versus Conventional Miniplates in The Management of Mandibular Angle Fractures: A Comparative Clinical Study
Abstract
Background: Mandibular angle fractures present a unique biomechanical challenge due to high distraction forces exerted by the masticatory muscles. Open reduction and internal fixation (ORIF) strategies continue to evolve to optimize stability while reducing complications.
Objective: To compare the intraoperative efficiency, biomechanical stability, and postoperative complication rates of three-dimensional (3D) miniplates versus conventional 2.0 mm miniplates for managing isolated mandibular angle fractures.
Methods: A prospective, randomized clinical trial was performed on 60 adult patients presenting with recent, isolated mandibular angle fractures. Patients were allocated into two equal cohorts: Group A (n=30) underwent fixation utilizing a single 1.0 mm thick titanium 3D miniplate via Champy's ideal osteosynthesis line, while Group B (n=30) underwent fixation using two conventional 2.0 mm titanium miniplates via a standard transbuccal approach. Primary outcome variables measured included operative time, primary hardware stability, post-surgical malocclusion, and hardware failure rates.
Results: The mean operative time was significantly shorter in Group A (46.5+- 5.1) minutes) compared to Group B (64.8+-7.2) minutes; (p < 0.001). Postoperative occlusal discrepancy was observed in 3.3% (n=1) of patients in Group A compared to 16.7% (n=5) in Group B (p = 0.03). Hardware failure, presenting as minor plate bending or splaying, occurred exclusively in Group B (6.7%, n=2). Both groups achieved satisfactory long-term bone healing, but Group A exhibited reduced early postoperative morbidity.
Conclusion: 3D miniplates offer superior geometric stability against torsional forces at the mandibular angle compared to conventional miniplates. The 3D system dramatically reduces intraoperative time and minimizes immediate post-surgical malocclusion, rendering it a highly reliable clinical choice for mandibular angle trauma reconstruction.
