Does the biplane three-dimensional miniplate design provide stable fixation for mandibular angle fractures? A...

The posterior anatomical position and complex biomechanics of mandibular angle fractures (MAF) make their management more complicated than other mandibular fractures. The shortcomings of semi-rigid and rigid fixations have led to the development of a biplane three-dimensional (3D) miniplate design to fixate angle fractures in two perpendicular planes. The aim is to determine whether using a Biplane 3D miniplate could provide a feasible, effective, and reliable fixation for displaced MAFs.

This prospective, quasi-experimental, clinical study was conducted on adult patients with displaced MAFs. The primary outcome (occlusion) and secondary clinical outcomes (fracture stability and adequate mouth opening) were recorded in the first 2 weeks and the 2^nd and 6^th months postoperative. Appropriate reduction (secondary outcome) was assessed with novel radiographic criteria in the vertical and horizontal planes. Statistical analysis was performed using SPSS version 22 and included Fisher's exact and Chi-square tests. The level of significance was set at P < 0.05.

Twenty-one patients with MAFs (nine isolated fractures) were operated on and followed for 3-6 months (mean: 4.95 months). Only two cases (9.52%) in the nonisolated fracture group showed mild occlusal derangement, which resolved with heavy elastic therapy. Adequate mouth opening was gradually resumed in both groups within the 1^st month. No postfixation complications were observed. Radiographic criteria measurement revealed 14.29% and 28.6% mild vertical and horizontal radiographic malalignment without detectable clinical signs.

Biplane 3D miniplate fixation shows promising results in the management of MAFs with minimal complications, suggesting that it is safe and effective. Concomitant management of displaced mandibular fractures does not seem to affect treatment outcomes.