EVALUATION OF DYNAMIC COMPRESSION MINIPLATES IN TREATMENT OF MANDIBULAR ANGLE FRACTURES USING TROCAR

Abstract

The objective of this study was to evaluate clinically and radiologically the use of two dynamic compression miniplates in treatment of fractures of the angle of the mandible using Trocar instrumentation. The study was conducted on ten patients diagnosed with a single mandibular angle fracture indicated for open reduction and internal fixation. They were selected from the patients received in the emergency department Alexandria University Hospital and treated in operating room of Oral and Maxillofacial Surgery department, faculty of Dentistry Alexandria University. Patient valuation All patients were evaluated preoperatively as follows: - History of the presenting injury as well as the past medical history. - Clinical examination including general and local examination. - Radiographic examination including orthopantomogram (OPG) and posterior anterior (PA) views. - Edema, trismus, inferior alveolar nerve sensory function and maximum mouth opening were measured preoperatively. Surgical procedures - Arch bars or Ivy loops were fixed on the upper and lower teeth. The third molar tooth found in the fracture line was extracted. The mandibular angle fracture was exposed through transoral vestibular incision and reduced. Temporary Maxillomandibular fixation was done using 24gauge stainless steel wires. One dynamic compression miniplate was fixed on the external oblique ridge through the transoral incision and the second plate was fixed on the lower border of the mandible. - The bicortical screws for the dynamic compression miniplate placed on the lower border of the mandible were fixed using Trocar instrumentation. The Trocar was inserted through a skin puncture perpendicular to the fracture line. The fixation was tested manually for stability before removal of the temporary Maxillomandibular fixation.