Locking v/s non-locking reconstruction plates in mandibular reconstruction

To compare the efficacy of locking plates to non-locking plates in the osteosynthesis of mandibular fractures on the basis of clinical parameters.

A prospective randomized clinical trial was conducted at the Faculty of Dental Science, CSMMU (formerly King Georges Medical College), Lucknow, to treat consecutive mandible fractures. The patients were randomly divided into two groups. The patients underwent osteosynthesis-group 1 with 2.4-mm locking titanium plates and group 2 with 2.7 mm non-locking titanium plates. The cause of trauma, the number of days from injury to surgery, average age, gender, and site distribution were all reviewed. The assessment of the patients was done at 1, 3, and 6 weeks and 3 months using the clinical parameters.

A total of 12 patients with mandibular fractures met the inclusion criteria. In our study, a statistically significant difference was not found in the clinical parameters such as infection, paraesthesia, hardware failure, and mobility between the fracture segments. A statistically significant difference was found between pain and swelling from the previous follow-up visit in groups 1 and 2. In locking group, pain decreases significantly at 3(rd) week, 6(th) week, 12(th) week from 1(st) week and pain was absent after 3 week. In non-locking group, pain decreases significantly at 3(rd) week, 6(th) week and 12(th) week from 1(st) week but pain was present till 12(th) week. Pre-operative swelling was present only in case of non-locking group. Swelling was present in 66.7% of non-locking group and 0% in locking group. After one week swelling was absent in 100% patients at 3(rd), 6(th) and 12(th) week. Swelling was considerably decreased in locking group as compared to the non-locking group.

These findings show that the use of locking plates in mandibular fracture was efficacious enough to bear the masticatory loads during osteosynthesis of the fracture. The locking plates provide the advantage of a greater stability, with clinical results almost similar to those seen with non-locking plate osteosynthesis.