Management of Mandibular Angle Fractures Using One Miniplate or Two Miniplate Fixation System: A Systematic Review...

The management of mandibular angle fractures is controversial. The present study proposed to determine the superiority between the 1 miniplate and 2 miniplate fixation system and evaluated the best option for patients.

A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, examining Medline-Ovid, Embase, and PubMed databases for relevant reports in English without date restrictions in October 2018. The inclusion criteria were studies of humans, including randomized controlled trials, controlled clinical trials, and retrospective studies, with the aim of comparing the 2 techniques. The incidence of postoperative complications and operative times were evaluated, and the relative risk and corresponding 95% confidence intervals were assessed to measure the effect size. Subgroup analyses of the different fracture regions and different miniplate sizes were performed. Publication bias was measured using a funnel plot.

Thirteen reports were enrolled for analysis. The results showed that the 1 miniplate fixation system reduced the overall complication rate compared with the 2 miniplate fixation system (P = .02). The incidence of wound dehiscence, hardware failure, scarring, and paresthesia showed statistically significant differences in favor of the 1 miniplate system (P < .05). The subgroup analyses indicated that 1 miniplate with isolated fractures caused a lower incidence rate of wound dehiscence, scarring, and hardware failure compared with the 2 miniplate fixation technique (P < .05).

The results of the present study suggest that the 1 miniplate system is superior to 2 miniplates with a reduction in postoperative complication rates for the management of mandibular angle fractures.