Evaluation of the 3-dimensional threadlock plate in the management of mandibular angle fractures: A clinical and radiographic study

PurposeMandibular angle fractures remain among the most difficult and unpredictable fractures to treat compared with those of other areas of the mandible. This study was done to clinically and radiographically evaluate the use of three-dimensional (3D) Threadlock plate for the treatment of mandibular angle fractures.Materials and methodsTen patients were selected from those admitted to the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, suffering from isolated mandibular angle fracture. Management was accomplished after careful case history, clinical examination and radiographic examination. Reduction of the fracture was accomplished through an extraoral approach followed by fixation with 3D Threadlock plates. The patients were then followed up for 6 months postoperatively and the collected clinical and radiographic data was statistically analyzed.ResultsThe following clinical parameters were used: pain intensity, postsurgical edema, maximal mouth opening, sensory function, surgical wound, and occlusion. All the results showed that the clinical findings were within reasonable limits and returned to normal values during the follow up period. Radiographically, the increase in mean bone density was statistically significant from preoperative to 6 weeks postoperative, from 6 weeks to 3 months and from 3 months to 6 months postoperatively, consistent with the progress of fracture bone healing.ConclusionConsidering the results of the current study, it is concluded that the 3-D plate has all the advantages of 2 miniplate fixation i.e. 1) High fracture fragment stability, 2) Harmonius occlusion, 3) Early return of the patient to his/her normal social life and function. 4) At the same time, it overcomes all the shortcomings of single miniplate, and satisfies the biomechanical requirements for occlusal loading. According to this study, the 3D Threadlock plating system through an extraoral/transbuccal approach is a suitable method for fixation of mandibular angle fractures, providing adequate stability especially in severely displaced mandibular angle fractures.