Titanium Lag Screw Versus Miniplate Fixation In The Treatment Of Anterior Mandibular Fractures

Publication date: Available online 15 January 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Manish Tiwari, Vikas Meshram, Pravin Lambade, Gabriela Fernandes

Abstract

Purpose

The use of plates for open reduction and internal fixation of mandibular fractures has become a widely accepted method in the past three decades. However, the anterior mandible is well suited to lag screw fixation owing to the thickness of its bony cortices. Hence, the purpose of the present study was to comparatively evaluate clinical outcomes of fixation using lag screws and miniplates in anterior mandibular fractures.

Patients and Methods

A total of 50 patients reporting to the Department of Oral and Maxillofacial Surgery with non-comminuted anterior mandibular fractures were randomly divided into two groups of 25 patients each. Group A patients were treated with 2.5 mm lag-screws of 22 to 26mm length and Group B patients were treated with 2.0 mm four hole miniplates with gap using monocortical screws. Subsequent follow-up was done at 3, 6, 12, 24 weeks postoperatively. The primary determinants included radiographic analysis of the fracture gap and biting efficiency of the patients in two groups. The secondary determinants included evaluation of duration of surgery, pre-injury and post-injury occlusion and postoperative complications. Results were evaluated using Chi square and the unpaired t test.

Results

The mean age of the patients in this study was 29.1±8.32 years, ranging between 18 to 67 years. The mean post-operative fracture gap was considerably greater in group B. The mean duration of surgery (minutes) was 37.60 ± 9.30 for group A and 47 ± 6.55 for group B. The difference was found to be statistically significant (p = 0.001). The lag screw group showed faster improvement in terms of biting efficiency as compared to mini-plate group.

Conclusions

Lag screw fixation was found to have good stability, rigidity, was inexpensive, and less time consuming in anterior mandibular fractures when compared with miniplates.

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