FIXATING THE MANDIBULAR ANGLE. IS THE SECOND MINIPLATE NECESSARY OR ONE MINIPLATE IS ENOUGH? A SYSTEMATIC REVIEW AND META - ANALYSIS
Authors:
Vitkos N. Evangelos1, Papadopoulos A. Konstantinos2, Dimasis Periklis3, Anestis Chrisostomidis4, Kyrgidis Athanassios4
Affiliation:
1 Department of Oral and Maxillofacial Surgery, University Hospital of Heraklion, Crete, Greece
2 Department of Orthopaedics and Traumatology, ST. Anna-Hospital Herne, Germany
3 Department of General Surgery, General Hospital of Katerini, Katerini, Greece
4 Department of Oral and Maxillofacial Surgery, General Hospital Georgios Papanikolaou, Thessaloniki, Greece
Doi: 10.54936/haoms242p12
ABSTRACT:
Objectives: The aim of this study is to compare the outcomes after using one miniplate fixation in the external oblique ridge versus two miniplate fixation for mandibular angle fractures.
Methods: A systematic review of MEDLINE (via PubMed), Scopus and Cochrane Library database was performed according to the PRISMA guidelines. The research question was addressed using the PICO criteria. Only comparative studies between the two techniques were included. Random-effects model meta-analyses were performed.
Results: Seventeen studies, comprising a total of 1667 patients, 846 undergoing one miniplate fixation and 854 undergoing two miniplate fixation for mandibular angle fractures were identified. No statistically significant differences were observed regarding surgical site infection (standardized mean difference [SMD]= 0.94, 95% confidence interval [CI]: [0.69] – [1.28], p=0.68, I2=0.00%), post-operative malocclusion (SMD= 0.97, 95% CI: [0.53] – [1.18], p=0.25, I2=0.00%), post-operative neurosensory dysfunction (SMD= 0.67, 95% CI: [0.37] – [1.22], p=0.19, I2=73.93%), pseudoarthrosis formation (SMD=0.90, 95% CI: [0.58] – [(1.39], p=0.63, I2=0.00%). Wound dehiscence was marginally less common in the one miniplate group (SMD=0.52, 95% CI: [0.28] – [0.98], p=0.04, I2=54.34%). The probability of scarring formation (SMD=0.13, 95% CI: [0.05] – [0.32], p=0.00, I2=0.00%) and hardware failure (SMD=0.36, 95% CI [0.21] – [0.62], p=0.00, I2=29.33%) were statistically significantly higher in the two miniplates arm.
Conclusion: One miniplate fixation and two miniplates fixation of mandibular angle fractures have similar results regarding post operative infection, malocclusion, neurosensory dysfunction and pseudoarthrosis formation while wound dehiscence, hardware failure and scarring seem to be more common when two miniplates are used as a fixation technique.
KEY WORDS: One miniplate; Two miniplates; Mandibular angle fracture; Meta-Analysis; Complications;
Authors:
Vitkos N. Evangelos1, Papadopoulos A. Konstantinos2, Dimasis Periklis3, Anestis Chrisostomidis4, Kyrgidis Athanassios4
Affiliation:
1 Department of Oral and Maxillofacial Surgery, University Hospital of Heraklion, Crete, Greece
2 Department of Orthopaedics and Traumatology, ST. Anna-Hospital Herne, Germany
3 Department of General Surgery, General Hospital of Katerini, Katerini, Greece
4 Department of Oral and Maxillofacial Surgery, General Hospital Georgios Papanikolaou, Thessaloniki, Greece
Doi: 10.54936/haoms242p12
ABSTRACT:
Objectives: The aim of this study is to compare the outcomes after using one miniplate fixation in the external oblique ridge versus two miniplate fixation for mandibular angle fractures.
Methods: A systematic review of MEDLINE (via PubMed), Scopus and Cochrane Library database was performed according to the PRISMA guidelines. The research question was addressed using the PICO criteria. Only comparative studies between the two techniques were included. Random-effects model meta-analyses were performed.
Results: Seventeen studies, comprising a total of 1667 patients, 846 undergoing one miniplate fixation and 854 undergoing two miniplate fixation for mandibular angle fractures were identified. No statistically significant differences were observed regarding surgical site infection (standardized mean difference [SMD]= 0.94, 95% confidence interval [CI]: [0.69] – [1.28], p=0.68, I2=0.00%), post-operative malocclusion (SMD= 0.97, 95% CI: [0.53] – [1.18], p=0.25, I2=0.00%), post-operative neurosensory dysfunction (SMD= 0.67, 95% CI: [0.37] – [1.22], p=0.19, I2=73.93%), pseudoarthrosis formation (SMD=0.90, 95% CI: [0.58] – [(1.39], p=0.63, I2=0.00%). Wound dehiscence was marginally less common in the one miniplate group (SMD=0.52, 95% CI: [0.28] – [0.98], p=0.04, I2=54.34%). The probability of scarring formation (SMD=0.13, 95% CI: [0.05] – [0.32], p=0.00, I2=0.00%) and hardware failure (SMD=0.36, 95% CI [0.21] – [0.62], p=0.00, I2=29.33%) were statistically significantly higher in the two miniplates arm.
Conclusion: One miniplate fixation and two miniplates fixation of mandibular angle fractures have similar results regarding post operative infection, malocclusion, neurosensory dysfunction and pseudoarthrosis formation while wound dehiscence, hardware failure and scarring seem to be more common when two miniplates are used as a fixation technique.
KEY WORDS: One miniplate; Two miniplates; Mandibular angle fracture; Meta-Analysis; Complications;