Treatment of mandibular fractures with or without intermaxillary fixation--a comparative study

The aim of the present study was to evaluate titanium miniplates for treatment of mandibular fractures compared to routine treatment of the department (control). The study included 74 dentate patients with fractures within the tooth bearing regions of the mandible. Two groups of patients were studied:(A), 42 patients with unilateral fractures of the angle or anterior to the mental foramen and (B), 32 patients with bilateral fractures of the mandible. Patients with unilateral fractures were randomized for the control group (n = 20) or the experimental group (n = 22). Group B included two groups of patients, a control group of 16 consecutive patients previously treated, and an experimental group of 16 consecutive prospectively studied patients. All patients in the control groups received open reduction and IMF for 5 weeks. Fractures of the angle were stabilized with an 0.4 stainless-steel wire superior border osteosynthesis, whereas fractures anterior to the mental foramen were treated with a stainless steel plate osteosynthesis. Patients in the experimental groups were treated with IMF only during surgery, thereafter the IMF was released. In fractures of the angle, one titanium mini-plate was used, whereas two were employed in fractures anterior to the mental foramen. The results were comparable in both groups with respect to occlusion and complications. We conclude that the titanium mini-plates offer sufficient stabilization of mandibular fractures to allow treatment without post-reduction IMF. This technique is associated with a low complication rate and reduced morbidity as compared to conventional treatment.