Clinical comparison of bridging plates in complex mandibular reconstruction - A randomized controlled trial

This prospective study aims to compare the clinical outcomes of two different bridging plate systems in complex mandibular reconstruction surgery. A prospective, single-blinded, randomized controlled clinical trial was conducted on 40 patients with complex mandibular bone defects requiring reconstruction using load-bearing osteosynthesis. Patients were randomly assigned to receive either a novel bridging plate method (MODUS 2 Mandible TriLock Bridging Plate, intervention group) or a traditional method (MODUS 2.5 Locking Reconstruction Plate; control group). The outcome of the two systems was evaluated through an intraoperative usability assessment done by surgeons, as well as multiple assessments concerning complication rates and patient-reported quality of life using the SF-36 questionnaire, up to one year post-operation. The intervention group showed significantly improved intraoperative usability across most evaluated categories (wilcoxon rank sum test: p < 0.05). Postoperative complication rates were lower in the intervention group, with a hazard ratio of 0.36 (cox proportional hazards regression model: 95 % CI, 0.14-0.95). Quality of life improved in both groups over time, however the intervention group demonstrated higher scores at 6 and 12 months post-surgery. For mandibular reconstruction, the novel grid plates offer improved intraoperative usability and demonstrated reduced complications in comparison to the traditional reconstruction system. The novel system is efficient to use and entirely clinically reliable.