Lakshmi Vijaya G, Nithin V M, Patil Vinay, Kumar Prasanna D, Sharma Mandeep, Ranganathan Ajeya H K
Department of Oral and Maxillofacial Surgery, Priyadarshini Dental College and Hospital, Tamil Nadu, India.
Department of Oral and Maxillofacial Surgery, Nanded Rural Dental College and Research Center, Nanded, Maharashtra, India.
Natl J Maxillofac Surg. 2025 May-Aug;16(2):315-320. doi: 10.4103/njms.njms_82_23. Epub 2025 Aug 30.
Three-dimensional (3-D) miniplates have shown better results in the treatment of mandibular fractures but it is difficult in the treatment of mandibular parasymphysis fracture that involves mental foramen or in close proximity. To overcome this, we have modified the 3-D miniplate with a single vertical bar and assessed its efficacy in the mandibular body or parasymphysis fracture.
A clinical prospective study was carried out in 20 patients with mandibular body or parasymphysis fractures involving or near mental foramen and treated with a modified 3D miniplate under general anesthesia (GA). The parameters assessed were state of occlusion, neurosensory disturbances, visual analog scale (VAS) score for pain, infection pus, mobility of fracture segment, operating time for adaptation and fixation of the plate, surgeon's opinion on ease of adaptability of the plate, and union of fracture site radiologically. The patients were assessed pre-operatively, first, second, eighth, and 16 week postoperatively.
The data obtained was analyzed using McNemar's test and paired -test. Occlusal derangement was corrected and was statistically significant ( < 0.5). The mean operating time for adaptation and fixation was 8.45 min. Temporary paresthesia of the mental nerve was very minimal ( < 0.5). The rate of infection was significantly less. There was no incidence of mobility or fracture of the modified 3D miniplate.
The modified 3D miniplate was efficient in restoring the occlusion, reducing the incidence of temporary paresthesia of mental nerve, and was easy to adapt which aided in bringing down the treatment duration in the management of mandibular body or parasymphysis fracture.
三维（3-D）微型钢板在治疗下颌骨骨折方面已显示出更好的效果，但在治疗涉及颏孔或紧邻颏孔的下颌骨正中联合骨折时存在困难。为克服这一问题，我们对带有单个垂直杆的3-D微型钢板进行了改良，并评估了其在下颌骨体部或正中联合骨折中的疗效。
对20例下颌骨体部或正中联合骨折累及或靠近颏孔的患者进行了一项临床前瞻性研究，在全身麻醉（GA）下用改良的3D微型钢板进行治疗。评估的参数包括咬合状态、神经感觉障碍、疼痛视觉模拟量表（VAS）评分、感染脓液、骨折段的活动度、钢板适配和固定的手术时间、外科医生对钢板适配容易程度的意见以及骨折部位的影像学愈合情况。在术前、术后第1周、第2周、第8周和第16周对患者进行评估。
使用McNemar检验和配对检验对获得的数据进行分析。咬合紊乱得到纠正，具有统计学意义（P<0.05）。适配和固定的平均手术时间为8.45分钟。颏神经的暂时性感觉异常非常轻微（P<0.05）。感染率显著降低。改良的3D微型钢板没有出现活动或断裂的情况。
改良的3D微型钢板在恢复咬合、降低颏神经暂时性感觉异常的发生率方面是有效的，并且易于适配，有助于缩短下颌骨体部或正中联合骨折治疗的持续时间。
