Surgical Management of Mandibular Angle Fractures

The study proposed to determine the superiority between different fixation methods in the mandibular angle fractures (MAFs) and to evaluate best option for surgeon and patient.

A systematic review was conducted according to PRISMA guidelines, examining Medline-Ovid, Embase, and Pubmed databases. The quality of studies was assessed, and the odds risk (OR) with its corresponding 95% confidence interval (CI) was assessed to measure the effect size. Subgroup analyses by different fracture regions and different miniplate sizes were performed. Publication bias was measured by a funnel plot.

Twenty-one articles were enrolled in this review: 8 randomized controlled trials , 2 controlled clinical trials, and 11 retrospective studies. There were significant advantages for 3-dimensional (3D) miniplate (OR = 0.48, P = 0.003, 95% CI, 0.35-0.67) and 1 miniplate (OR 0.38, 95% CI 0.25-0.58, P < 0.00001). The cumulative OR for locking miniplate was 0.45, showing that the utilizing of locking mini-plate in management of MAFs decreases postoperative complications risk by 55% over the use of nonlocking mini-plate.

The results of this review indicated that the use of 3D miniplate, locking plate, and 1 plate were more advanced to 2 miniplates technique in low incidence of postoperative complications in the treatment of MAFs.