Factors associated with plate fractures in mandibular reconstruction

Mandibular plate fracture (MPF) is a serious complication of mandibular reconstruction, leading to postoperative morbidity and potential revision surgeries. Recently, there has been an increased utilization of virtual surgical planning (VSP) with patient-specific reconstruction plates to decrease operative time and improve postoperative outcomes. It is critical for surgeons performing mandibular reconstruction to have a comprehensive understanding of the contributing factors and strategies for minimizing the likelihood of MPF.

This review examines the patient-related and surgical factors contributing to MPF. The literature highlights that patient-related factors include younger age and degree of occlusion, while surgical factors include lateral mandibular defects, the absence of coronoidectomy, and the use of bridging plates without bony reconstruction. Notably, recent studies suggest a reduction in MPFs with the implementation of VSP and patient-specific reconstruction plates.

This review aims to inform surgeons about patients who are at increased risk of MPF following mandibular reconstruction, emphasizing the need for close monitoring. Furthermore, it underscores the additional benefits of VSP and patient-specific reconstruction plates in improving postoperative outcomes. However, further research is required to assess the long-term efficacy of these reconstruction plates.