Management of Mandibular Fractures Using Locking and Nonlocking Miniplates

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Engineering
• Clinical Research Methodology

Background:

• Mandibular fractures (MFs) are common injuries requiring surgical intervention.
• Plate fixation is a standard treatment, with evolving techniques comparing locking and nonlocking systems.
• Optimizing fixation methods aims to minimize complications and improve functional recovery.

Purpose of the Study:

• To determine the superiority of locking plates versus nonlocking miniplates in the treatment of mandibular fractures.
• To compare complication rates, infection incidence, malocclusion, and maxillomandibular fixation requirements.
• To provide evidence-based guidance for selecting fixation devices in MF management.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials and controlled clinical trials.
• Searched Medline-Ovid, Embase, and PubMed databases without date restrictions.
• Assessed study quality and calculated relative risk (RR) with 95% confidence intervals (CI) for effect size.

Main Results:

• Thirteen publications were included in the analysis.
• Locking plates showed a trend towards reduced overall complications (RR 0.62) and infection (RR 0.503).
• Locking plates significantly reduced the need for postoperative maxillomandibular fixation (RR 0.414, P=0.002).

Conclusions:

• Locking plates demonstrate superiority over nonlocking plates in managing mandibular fractures.
• The use of locking plates is associated with lower postoperative complication rates.
• This meta-analysis supports the adoption of locking plates for improved outcomes in mandibular fracture treatment.