Two-plate Fixation of Mandibular Angle Fracture Along Champy's Line With Contra-angle Handpiece

Seung Min Oh DDS, Oral and Maxillofacial Surgery, Hallym University College of Medicine Sacred Heart Hospital, Anyang, South Korea
Byoung Eun Yang PhD, Oral and Maxillofacial Surgery, Hallym University College of Medicine Sacred Heart Hospital, Anyang, South Korea
Jwa Young Kim , Oral and Maxillofacial Surgery, Hallym University College of Medicine Sacred Heart Hospital, Anyang, South Korea
Kang Nam Park DDS, Oral and Maxillofacial Surgery, Hallym University College of Medicine Sacred Heart Hospital, Anyang, South Korea
In Hee Woo DDS, Oral and Maxillofacial Surgery, Hallym University College of Medicine Sacred Heart Hospital, Anyang, South Korea
Purpose: In mandible angle fractures, one rigid fixation is sometimes not sufficient to fix the mandible. One rigid fixation requires an extended intermaxillary fixation period, and its resistance to distortion is not always satisfactory. In comparison, the use of two fixing plates can solve these problems.

Materials and Methods: A total of 14 mandible angle fracture patients who visited the Department of Oral Surgery, Hallym University Sacred Heart Hospital between January 2011 and March 2013 were selected for this study. Open reduction and internal fixation were performed intraorally under general anesthesia. One fixing plate was attached to the mandibular oblique ridge, and another fixing plate was attached to the side of the mandibular corpus. For the approach to the lateral mandibular corpus, a specially prepared contra-angle drill and a driver were used. The radiologic outcomes, patients’ statements, and changes in the occlusal points were obtained and measured at baseline and at 2, 4, and 6 weeks postoperative.

Results: The mean operative time was 85.3 minutes. The number of occlusal points increased postoperatively compared with the baseline. The subjective comfort level of the patients on occlusion increased, but it did not reach the level prior to their trauma.

Conclusion: The procedure of using two fixing plates in mandibular angle fracture (MAF) provides patients with the advantage of early mandibular exercise without an extended intermaxillary fixation period. In addition, this method can reduce patient discomfort and can make the procedure simple.

Reference: 

Deng X, Wan Z, He SS, et al. [The centric relation-maximum intercuspation discrepancy in adult angle's class II pretreatment patients]. Hua Xi Kou Qiang Yi Xue Za Zhi 2011;29:48-52

Seeman R, Schicho K, Wutzl A, Koinig G, Poeschl WP, Krennmair G et al. Complication rates in the operative treatment of mandibular angle fractures: a 10-year retrospective. J Oral Maxillofac Surg 2010;68:647-50