Comparative study between lag screw and miniplate fixation for straight midline mandibular osteotomy.

Area of Science:

• Oral and Maxillofacial Surgery
• Surgical Oncology

Background:

• The mandibular swing approach is crucial for resecting malignant lesions in the posterior oral cavity and oropharynx.
• Midline mandibulotomy is a key component of this surgical approach.

Purpose of the Study:

• To compare the efficacy and complication rates of lag screw versus miniplate fixation for straight midline mandibulotomy.
• To evaluate the long-term outcomes of these fixation methods over 15 years.

Main Methods:

• Retrospective analysis of 117 patients undergoing straight midline mandibulotomy.
• Comparison of fixation using lag screws (n=85) versus miniplates (n=32).
• Assessment of complication rates, including non-union, orocutaneous fistula, and infection.

Main Results:

• Low overall complication rates for both fixation methods (9% miniplates vs. 7% lag screws).
• No significant difference in complication rates between lag screws and miniplates.
• Lag screw fixation demonstrated superior fragment compression, potentially leading to faster bone healing.

Conclusions:

• Lag screw fixation is a safe and effective alternative to miniplate fixation for midline mandibulotomy.
• The method provides comparable safety with potential advantages in bone healing speed.
• Radiotherapy is considered safe in patients undergoing midline mandibulotomy.