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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(03): 501-512
DOI: 10.1055/s-0044-1787864
Original Article

Comparative Evaluation of Clinical Outcome Including Neurosensory Deficit and Pain Score Variables Using Rigid Internal Fixation with Three-Dimensional Miniplate Internal Fixation in Simultaneous Angle and Contralateral Body/Parasymphysis Fractures of the Mandible: A Prospective, Randomized Controlled Study

Satish Kumar
1   Department of Dentistry, Civil Hospital, Siwani, Bhiwani, Haryana, India
,
Ajay Chandran
2   Department of Oral and Maxillofacial Surgery, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
,
Syed Sirajul Hassan
3   Oral and Maxillofacial Surgery Section, Oral and Maxillofacial Surgery and Rehabilitation Department, Dentistry Administration, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Kingdom of Saudi Arabia
,
Davide Rocchetta
3   Oral and Maxillofacial Surgery Section, Oral and Maxillofacial Surgery and Rehabilitation Department, Dentistry Administration, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Kingdom of Saudi Arabia
,
Abdulsalam S. Alshammari
4   Oral and Maxillofacial Surgery/Head and Neck Surgical Oncology Section, Oral and Maxillofacial Surgery and Rehabilitation Department, Dentistry Administration, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Kingdom of Saudi Arabia
,
Faris Jaser Almutairi
5   Maxillofacial Surgery and Diagnostic Sciences Department, College of Dentistry, Qassim University, Buraydah, Quassim, Kingdom of Saudi Arabia
,
Suresh Babu Jandrajupalli
6   Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
,
Swarnalatha Chandolu
6   Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia
,
Abhishek Singh Nayyar 
7   Department of Oral Medicine and Radiology, Saraswati Dhanwantari Dental College and Hospital and Post-graduate Research Institute, Parbhani, Maharashtra, India
› Author Affiliations
Funding None.
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Abstract

Purpose There have been numerous advancements in the strategies used for treating mandibular fractures in the present times, while open reduction and internal fixation is still accepted as the most preferred treatment option for such fractures despite numerous drawbacks. The aim of the present prospective, randomized controlled study was to evaluate the clinical outcome including neurosensory deficit and pain score variables in mandibular fractures that were treated using rigid internal fixation with three-dimensional (3D) miniplate internal fixation.

Materials and Methods For the present study, a total of 20 patients of either sex in an age range of 18 to 55 years with simultaneous angle and contralateral body/parasymphysis fractures of the mandible were included, while the clinical outcome was compared in relation to the two groups wherein different treatment options were used including using rigid internal fixation in one as against 3D miniplate internal fixation in the other.

Results Pairwise comparison of pain scores in Group I and Group II patients by the Mann–Whitney U-test at different time zones revealed the results to be statistically significant for all pairs except when the findings were compared between 1 month and 3 months after the procedure in Group II patients. Also, significant recovery was observed in both Group I and II patients during healing when assessed preoperatively to 1 month and then 3 months after the procedure with the results being statistically highly significant in case of the variations observed in relation to the neurosensory deficit observed at different time zones for both Group I and II patients (p = 0.0001).

Conclusion Based on the results obtained, it can be concluded that 3D miniplate-led osteosynthesis was found comparable to the osteosynthesis accomplished using reconstruction plates during fixation of unfavorable body/parasymphysis fractures of mandible in study, providing optimal stability, while satisfactorily meeting the biomechanical requirements for occlusal loading, and an early return to normal function.

Keywords

rigid internal fixation - 3D miniplates - simultaneous angle and contralateral body/parasymphysis fractures - randomized controlled study - open reduction and internal fixation (ORIF)

Ethical Approval

All the patients were duly informed about the protocol of the study. Also, a written, informed consent was duly obtained from all the patients prior to their inclusion in the study, while ethical clearance was obtained from the Institutional Ethics Committee via Institutional Ethics Committee Letter approval no. SDDC/IEC/01–72–2022 before the start of the study.


Patients' Consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.




Publication History

Article published online:
24 June 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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