Comparative Evaluation of Conventional Miniplates, Three-Dimensional Miniplates and Lag Screws for Internal Fixation of Parasymphysis Fracture of Mandible-A Double-Blind Randomized Clinical Study.

Purpose: The aim of this study is to clinically and radiographically evaluate the stability of parasymphysis fracture managed with lag screws, miniplates and 3D miniplates. Materials and Method: Ninety- eight patients diagnosed with parasymphysis fracture were treated using lag screws in group 1, two 4-hole miniplates in group 2 and 3D miniplates in group 3. Intraoperative stability and duration of fixation was assessed. Postoperative clinical evaluation was done at 1 week, 1 month, 3rd month, 6th month and 1 year for complications and oral function. Radiological evaluation was done at 3rd and 6th month. Only 92 patients were considered for statistical analysis since 6 patients were lost during follow-up.
Results: Road traffic accident (65.3%) was the primary cause of mandibular fractures. Postoperative pain score showed a statistically significant difference after 1 week and 1 month duration (P value < 0.001). ANOVA test showed VAS was significantly higher at pre-op followed by 1st day and 1 week, but no significant difference after 3 months in all groups. Radiographic analysis did not show significant difference in approximation of fracture segment among 3 groups after 6 months (P-value = 0.117). Chewing efficiency at 6 months and occlusion by surgeon evaluation at 3 months showed a significant difference (P value < 0.001).
Conclusion: Lag screw fixation was technique-sensitive, relatively inexpensive and was less time consuming method when compared to miniplates and 3D plates. Lag screws and 3D plates are superior in reducing the incidence of complications and better in oblique or sagitally displaced mandibular fractures. Supplementary Information: The online version contains supplementary material available at 10.1007/s12663-021-01647-5. © The Association of Oral and Maxillofacial Surgeons of India 2021.