Agarwal Mohit, Mohammad Shadab, Singh Rakesh K, Singh Vibha
Department of Oral and Maxillofacial Surgery, Government Dental College, Jaipur, India.
J Oral Maxillofac Surg. 2011 Jul;69(7):1995-2000. doi: 10.1016/j.joms.2010.10.014. Epub 2011 Jan 26.
To compare the efficacy of the 2-mm locking miniplates to 2-mm standard miniplates in the osteosynthesis of mandibular fractures on the basis of clinical parameters and bite force recording.
A prospective randomized clinical trial was conducted at the Faculty of Dental Science, CSMMU (formerly King Georges Medical College), Lucknow, India, from January 1, 2007, to January 31, 2008, to treat consecutive mandible fractures. The patients were randomly divided into 2 groups. The patients underwent osteosynthesis--group 1 with Synthes 2-mm locking titanium miniplates and group 2 with Synthes 2-mm nonlocking titanium miniplates. The cause of trauma, the number of days from injury to surgery, average age, gender, and site distribution were all reviewed. The assessment of the patients was done at 1, 3, and 6 weeks and 3 months using the clinical parameters and bite force recording.
A total of 20 patients with 32 fractures met the inclusion criteria. In our study, a statistically significant difference was not found in the clinical parameters such as pain, swelling, infection, paresthesia, hardware failure, and mobility between the fracture segments. A statistically significant difference was found between the change in bite force from the previous follow-up visit in groups 1 and 2. From 1 week to 3 months, the change in the incisor bite force was significantly greater for group 1 than for group 2. At 6 weeks and 3 months, the change in right molar bite force from the previous follow-up visit was significantly greater for group 1 than for group 2. At the 1-, 3-, 6-week and 3-month follow-up visits, the change in left molar bite force from the previous follow-up visit was significantly greater for group 1 than for group 2.
These findings show that the use of locking miniplates plate in mandibular fracture was efficacious enough to bear the masticatory loads during osteosynthesis of the fracture. The locking miniplates provide the advantage of a greater bite force, with clinical results almost similar to those seen with nonlocking miniplate osteosynthesis.
基于临床参数和咬合力记录，比较2毫米锁定微型钢板与2毫米标准微型钢板在下颌骨骨折骨接合术中的疗效。
2007年1月1日至2008年1月31日，在印度勒克瑙市CSMMU牙科学院（原乔治国王医学院）开展了一项前瞻性随机临床试验，用于治疗连续性下颌骨骨折。患者被随机分为两组。患者接受骨接合术——第1组使用Synthes 2毫米锁定钛微型钢板，第2组使用Synthes 2毫米非锁定钛微型钢板。对创伤原因、受伤至手术的天数、平均年龄、性别和部位分布进行了回顾。在1周、3周、6周和3个月时，使用临床参数和咬合力记录对患者进行评估。
共有20例患者的32处骨折符合纳入标准。在我们的研究中，骨折段之间在疼痛、肿胀、感染、感觉异常、内固定失败和活动度等临床参数方面未发现统计学上的显著差异。第1组和第2组在前次随访至本次随访期间咬合力的变化存在统计学上的显著差异。从1周龄至3月龄，第1组切牙咬合力的变化显著大于第2组。在6周龄和3月龄时，第1组右磨牙咬合力相对于前次随访的变化显著大于第2组。在1周、3周、6周和3个月的随访中，第1组左磨牙咬合力相对于前次随访的变化显著大于第2组。
这些研究结果表明，在下颌骨骨折中使用锁定微型钢板在骨折骨接合术期间足以承受咀嚼负荷。锁定微型钢板具有咬合力更大的优势，临床结果与非锁定微型钢板骨接合术几乎相似。
