This document summarizes a study of 20 patients treated for isolated mandibular fractures over one year. The majority of fractures were in the body of the mandible. Patients were treated with miniplate fixation, intraosseous wiring, or reconstruction plating with bone grafting and miniplates. Outcomes were generally good with miniplate fixation showing fewer complications like malocclusion or delayed union compared to other methods. The study concluded that miniplate osteosynthesis provides rigid fixation and good long-term results for displaced mandibular fractures.

1. P
PRASANNA DATTA,PGT, MS (ENT)
MEDICAL COLLEGE, KOLKATA

2.  Upper third : Frontal bone.
 Middle third: From
Frontal bone to upper
teeth/ alveolus.
 Lower third: Mandible.

3.  Pain.
Malocclusion.
Inability to fully open mouth.
Preauricular pain while biting.

4. Panoramic radiograph of mandible.
Plain films including lateral/ postero
anterior and periapical views.
CT scan with 3 D reconstruction.

5. OPG & CT SCANS

6. 3D RECONSTRUCTION

7.  TOTAL CASES: 20
 STUDY PERIOD: September 2013 to October 2014
 STUDY PLACE: Department of ENT, Medical College
Kolkata.
 TYPE OF STUDY: Hospital based prospective &
comparative study.

8.  INCLUSION CRITERIA: Adult patients having
isolated mandibular fracture/ fractures.
• EXCLUSION CRITERIA:
a. Condylar fracture.
b. Paediatric patients.
c. Associated other
maxillofacial fracture.
MATERIALS AND METHODS

9.  Among these 20 patients, 10 patients were treated
using miniplate reconstruction
 6 patients underwent bone grafting with
reconstruction plate and miniplate fixation.
 4 patients were treated by intraosseus wiring.
 Patients were followed after 4 weeks & then 3 months
interval & results were analyzed.

10. Ranging from 15 years to 60 years.
Peak age incidence 25 – 34 years.
Age group in
years
Percentage
15-24 25(5 patients)
25-34 40(8 patients)
35-44 20(4 patients)
45-54 8(2 patients)
>55 5(1 patient)
0
5
10
15
20
25
30
35
40
45

11. Fractures (#) Percentage
Body of
Mandible
35
(7patients)
Condyle 00
Angle of
mandible
30
(6 patients)
Symphysis 25
(5 patients)
Ramus 10
(2 patients)
Alveolar 00
Coronoid 00
DISTRIBUTION
BODY(35%)
ANGLE(30%)
SYMPHYSIS(25%)
RAMUS(10%)

12. DISTRIBUTION
(NONE)
( 2 PATIENTS)
(6 PATIENTS)
(7 PATIENTS)
(NONE)
(NONE)
(5PATIENTS)

13.  Miniplate fixation : 10 patients ( 50 %)
 Intraosseus fixation : 4 patients ( 20 %)
 Reconstruction plate plus bone grafting plus
miniplate :
6 patients ( 30 %)

14. MINIPLATE(50%)
INTRAOSSEUS(20%)
RECONSTRUCTION(30%)

16. 35 years male patient
presented with fracture
mandible with soft tissue
injury following RTA.

17. Parasymphyseal fracture on right side.

20. Fixation by miniplate and
reinforcement with
reconstruction plate and
bone grafting for gap
fracture.

21. 38 years old male patient having left
sided angle fracture with
parasymphyseal fracture.

22. Fixation by intraosseous
wiring.

23. 36 years female patient
presented with
parasymphyseal fracture
(R) following assault

26. 34 years male patient
presented with double
fracture mandible
following RTA

31. Patients - reviewed 4-6 weeks following operation and followed
every 3 months interval.
Complications Intraosseous
Wiring
osteosynthesis
Miniplate
osteosynthesis
Reconstruction
plate + Bone
grafting +
Miniplate
Malocclusion 2 patients 1 patient 2 patients
Intra-oral
exposure
0 0 0
Wound
Dehiscence
0 1 patient 0
Delayed Union 1 patient 0 1 patient
Plate fracture
Non union NIL
Neuro sensory deficit

32.  Use of miniplate for mandibular fracture gives
excellent results as high adaptability to the fracture
site - minimal mass effect, relatively strong holding
power of two point fixation.
 Temporary interdental wiring done in all cases before
application of miniplate.
 Intra osseus wiring alone always did not give rigid
fixation in unstable & comminuted fractures.

33. Open reduction & internal fixation is the treatment of
choice for displaced, comminuted and multiple
fractures of mandible.
Rigid internal fixation by monocortical miniplate
osteosynthesis provides good long term results and
satisfactory cosmesis without any significant sequelae.