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• W2904249084 abstract "INTRODUCTION:Mandibular fractures accounts for 36-70% of all maxillofacial trauma, as the mandible is the only mobile facial jaw bone, with various functions such as mastication, phonation and respiration. Hence the treatment of facial fractures is important for both functional and cosmetic reasons. Champy’s ideal lines of osteosynthesis with monocortical mini plate system is the time tested and considered gold standard in the management of mandibular fractures. Transoral placements of miniplates have gained popularity in the last decade. But the quest to improve stability along the fracture fragments has been the need of the hour because of the increased incidence of high velocity road traffic accidents which does not involve normal fracture pattern and in which chances of crush injuries are high, requiring better stability. Conventional screw plating system engages only the bone and may lead to reduced stability by the way of screw loosening which is enhanced by mandibular torsional movements, bony pathologies and age. To overcome this problem newer innovation like locking plates have been developed in which the screws engage both the bone and the plate thus increasing the stability of screws which in turn increases the stability of fracture segments. AIMS & OBJECTIVES:The purpose of the study is to evaluate the clinical efficacy of interlocking titanium miniplates by Occlusal stability, post operative infection, postoperative fragment rigidity, wound dehiscence, and the outcomes will be compared with that of conventional titanium miniplates. MATERIALS & METHODS:MATERIALS:1. Titanium 2. 0 mm locking miniplates, 2. Conventional 2. 0 mm miniplates, 3. 8 mm and 10 mm self threading titanium screws, 4. 8 mm and 10 mm locking screws,5. Titanium bone plating kit.METHODS: 1. Detailed clinical examination was carried out for all patients and following parameters were noted. 2. Facial asymmetry, occlusion, mouth opening were assessed. 3. Radiographic evaluation of the fractured site. 4. Routine haematological investigations. 5. Medical assessment of the patient by physician and anesthesiologists was done. 6. Informed consent obtained from patient prior to surgery. 7. After the routine clinical and radiological examination protocol the fracture sites were exposed by both intraoral and extra oral approaches with osteosynthesis using 2.0 mm titanium locking plates and screws. 8. Closure was done with 3 - 0 vicryl and 3 - 0 chromic gut sutures. 9. Povidine - Iodine mouthwashes and antibiotic cover (Inj. Cefotaxime - 1gm 12th hourly and Inj. Metronidazole – 500mg 8th hourly) were given preoperatively from the time of admission till 5th post-operative day. The patients were followed up for a period of 6 months in a time interval of 1st week, 1st month, 3rd month and 6th month. RESULTS:The use of a single locking plate in the treatment of mandibular fractures proved advantageous when compared to the use of conventional miniplate systems. Locking plates showed lesser intra operative time, lesser hardware cost, lesser post operative pain and lesser incidences of post operative complications. CONCLUSION:In order to achieve better fixation, increased stability and early return to function while treating minimally displaced or undisplaced maxillofacial fractures various techniques and biomaterials have evolved in the past. The present study was conducted to evaluate the efficacy of 2.0 mm titanium locking miniplates in the management of mandibular trauma. Thirty cases reporting to the Department of Oral & Maxillofacial Surgery, Adhiparasakthi Dental College & Hospital, Melmaruvathur presenting with mandibular fractures requiring open reduction and internal fixation were selected for the study. In the titanium locking plate and screw system, the screw locks not only to the bone but also to the bone plate. This is accomplished by having a screw with a double thread. One thread will engage the bone; another will engage a threaded area of the bone plate. The result is a locking titanium plate system which in effect provides a mini-internal fixator, since the plate locks to the screw rather than gaining its rigidity by being compressed against the bone. The study observed that locking plates/screw system offers significant advantages over conventional plates & screws. 1. Less screw loosening, 2. Greater stability across the fracture site, 3. Less precision required in plate adaptation,4. Less alteration in osseous or occlusal relationship upon screw tightening. In all the thirty cases satisfactory occlusion and anatomic reduction achieved intraoperatively. The operating time is considerably reduced since accurate adaptation to the underlying bone is not required in this system and also because only plate is used for the reduction of a fracture. Post-operative complications were reported in 1 fracture out of 30 fractures. One minor complication was plate exposure which required removal of the plate. The stability achieved by this system is satisfactory and can be used in all mandibular fractures. We would like to conclude that the use of 2.0 mm titanium locking miniplates/screw system was found to be advantageous with adequate stability post-operatively. However the use of this system does not eliminate postoperative complications. As we did not encounter any cases with bony pathologies during our study course, we recommend further studies for fixation of fractures in more number of patients with the locking plate design in geriatric and patients with bony pathologies." @default.
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• W2904249084 date "2018-05-01" @default.
• W2904249084 modified "2023-09-27" @default.
• W2904249084 title "Efficacy of Titanium Locking Mini Plates in the Management of Mandibular Fractures: A Comparative Randomized study" @default.
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