Title

One Or Two Non-Compression Mini-plates Produce Equally Good Occlusal Outcomes in Patients With Fracture Of The Mandibular Angle

Clinical Question

In patients with mandibular angle fractures, does one single non-compression mini-plate give better occlusion than does treatment with two such mini-plates?

Clinical Bottom Line

The best published comparative studies of one vs. two non-compression mini-plates show no difference between the two treatments for 13 clinical outcomes, including malocclusion. (See Comments on the CAT below)

Best Evidence

PubMed ID	Author / Year	Patient Group	Study type (level of evidence)
20430504	Danda / 2010	54 patients with unilateral noncomminuted mandibular angle fractures	Randomized Controlled Trial
Key results	27 patients in each treatment group received one vs two non-compression mini-plates. Outcomes studied were evaluated at 1, 2, 4 and 6 weeks post-operatively and were: wound dehiscence, infection, need for plate removal, and need for plate removal. None of these outcomes differed statistically significantly between the two groups. Scarring at the transcutaneous incision site developed in 5 patients in the two-plate group. “No patients in either group complained of malocclusion”; although this outcome did not appear in the statistical analysis, its context suggest that it did describe the postoperative state.
17110006	Siddiqui A / 2007	85 patients with	Randomized Controlled Trial
Key results	36 patients received a single mini-plate, and 26 received two-mini-plate. They were evaluated 12 weeks post-operatively for the following outcomes: subjective malocclusion, objective malocclusion, infection, malounion, delayed union, subjective numbness, objective numbness, facial nerve weakness, tooth damage, scarring, plate removal, additional use of fixation, overall complication rate. No statistically significant differences were found between groups on any of these.

Evidence Search

("Bone Plates"[Mesh] AND "Mandibular Fractures"[Mesh]) AND (single OR two OR 2)

Comments on
The Evidence

Danda mentioned no loss of patients to followup. Siddiqui started with 85 patients, losing 8 in the single mini-plate group and 15 in the two-min-iplate group.

Applicability

Both studies included adult patients (Siddiqui ages 16-60, Danda ages 18-49 years) with exclusion of preoperatively complicated cases.

Specialty

(Oral Surgery)

Keywords

mandibular angle fracture, noncompression miniplate

ID#

870

Date of submission

05/05/2011

E-mail

bechara@uthscsa.edu

Author

Boulos Bechara, DDS

Co-author(s)

Co-author(s) e-mail

Faculty mentor

S. Thomas Deahl, II, DMD, PhD

Faculty mentor e-mail

DEAHL@uthscsa.edu

Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)

None available

Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)

by Trey Patterson, Rebecca Neitzke (San Antonio, TX) on 10/03/2014
A recent PubMed search on single mini plate vs. two mini plates for patients with mandibular angel fracture was performed in September 2014. A more recent publication was found: Yazdani in 2013, PMID 24350144, in the prospective study by Yazdani they showed that 25 pts receiving a single mini plate and 22 pts receiving two plates had no malocclusion's. Due to the similar incidences of complications the use of two plates shouldn't be used due to cost and similar results to only one plate.