Fixation of mandibular fractures with plates or miniplates: prospective study

The choice of a more adequate internal fixation system in the treatment of mandibular fractures still originates controversy in the literature. The purpose of this study was to evaluate the effectiveness of internal fixation systems in the fixation of mandibular fractures, comparing indications and postoperative results between 2.4-mm plates and 2.0-mm miniplates.

A total of 42 consecutive patients with 71 mandibular fractures that had undergone either 2.4-mm plates (N.=20) or 2.0-mm miniplates (N.=22) were prospectively analyzed. Patients had a minimum follow-up of 6 months. Statistical analyses were made in the comparison between systems.

There was no significant difference in the choice of systems as to age and characteristics of the fractures, but in patients with systemic diseases or chronic substance abuse, as well as in exposed fractures, with more frequency of 2.4-mm plates. 2.0-mm miniplates presented better recovery of jaw opening in the postoperative period. Temporary facial nerve deficit was observed exclusively in the case of extraoral approach. Both systems presented low rate of complications which required reoperation, however 2.0-mm miniplates presented better efficacy when compared to 2.4-mm plates.

In conclusion, 2.0-mm miniplates should be always used when possible in the fixation of mandibular fractures, respecting their contraindications.