Sundararajan, V (2012) Fixation of Bio-Resorbable and Titanium Miniplates in Mandibular Fractures: A Comparative Study. Masters thesis, Sri Ramakrishna Dental College and Hospital, Coimbatore.
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Abstract
This comparative study of mandibular fractures fixation between titanium and bioresorbable miniplates was conducted in the Department of Oral and Maxillofacial surgery, Sri Ramakrishna Dental College and Hospital, Coimbatore. This study evaluated mandibular fractures under various parameters such as Age, Sex, Etiology, Time elapsed, Anatomic site fractured, fixation of titanium and bioresorbable miniplates and its Complications, Bite force measurement after fixation. 32 patients who had sustained injuries to Mandible over a period of two years were studied. (2009-2011). In our study, mandibular trauma predominantly affected males commonly involving the second and third decades of life pointing out towards the active period of life when they tend to be more energetic and thus involve themselves in high-speed transportation related injuries, which are the leading causes of maxillofacial trauma. Causes of mandibular fractures are constantly changing with changes in life style, industrialization, transportation and legislative measures. There appears to be a shift in the trend of the cause of mandibular trauma from Traffic accidents to violence in most developed countries; on the contrary, our study indicates that Road traffic accidents related injuries to be the primary cause in the patients treated in the unit for mandibular fractures. The issue of time lapse from the moment of injury to the initialization of the treatment could be due to transportation difficulties, socioeconomic conditions and delay due to treatment of associated injuries by various specialties. Mandible, being a mobile bone and having fractures, which are usually of compound types, communicate intraorally, are prone for infections. Majority of cases (66%) referred to our unit were seen within a week following trauma and rest of the patients reported a week later. The reason was that the patients were being treated for their concomitant injuries while a few were unaware of the treatment facilities offered. The most common fracture site involved in the mandible region was the parasymphyseal region (63%) followed by the condylar region (38%) and which were commonly seen with road traffic accidents with the impact occurring at the chin region with forces that were transmitted poster superiorly. Goals in treatment of mandible fractures include restoration of normal function and achievement of normal occlusion with adequate union of fracture segments, maintaining facial symmetry, and an aesthetic balance of the face. The treatment outcome depends on many factors such as type, the location of fractures, single or comminuted fractures, as well as general and local systemic conditions. In our study all the cases were treated as open reduction with titanium and bioresorbable miniplates. Pain, paraesthesia, oedema, occlusion, mouth opening, infection, step deformity and malunion were evaluated during the 1st week, 1st month and after 6 months postoperatively. Oedema and malocclusion were seen more common during the 1st postoperative week in bioresorbable plate fixation than when compared to titanium miniplate fixation. Bite force were evaluated in parasymphysis fractures by using indigenous bite force equipment in anteriors, canines, molars (5 bite point) and no significant change in bite force was noted among bioresorbable, titanium and control group. Complication rate was reduced to 4.1 % in patients with titanium miniplates and 6.3% in those with bioresorbable miniplates during the 6 months follow up period, but the difference was not significant. This comparative study concluded that both titanium and bioresorbable miniplates has both its own advantages and disadvantages. The disadvantages of biodegradable materials include cost, breakage of screws, difficult intraoperative handling, and swelling of the plate during degradation. In case of titanium miniplate fixation there is a potential risk of removing the titanium plates at a later stage resulting in additional cost, time, and a relatively high morbidity. In some places titanium plates are removed routinely, in which case these drawbacks cannot be considered. However the question of long-term titanium toxicity should be borne in mind.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Fixation of Bio-Resorbable ; Titanium Miniplates ; Mandibular Fractures ; Comparative study. |
| Subjects: | DENTAL > Oral and Maxillofacial Surgery |
| Depositing User: | Kambaraman B |
| Date Deposited: | 13 May 2018 16:19 |
| Last Modified: | 13 May 2018 16:19 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7795 |
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