The use of microplates for internal fixation of mandibular fractures

Background: The use of microplates in mandible fractures is not widely accepted, although microplate systems are commonly used for treatment of maxillofacial fractures. This study evaluated the use of microplates for internal fixation of mandibular fractures with no comminution or bony defects. Methods: Thirty-five patients with mandibular fractures (26 double and nine single) were treated. Of the 61 fractures, 54 were stabilized using 0.55-mm-thick microplates and 1.2-mm monocortical microscrews. The fractures were exposed through either an intraoral or a percutaneous approach. In general, two-point fixation with two microplates or one microplate and wires was performed. Interdental wiring was added for symphyseal or body fractures to confer further stability onto the dental arch. No intermaxillary fixation was used. Results: During a follow-up period ranging from 3 to 29 months, all fractures showed complete bone healing. There were eight complications in seven patients with a double fracture, including mild malocclusion (n = 3), paresthesia (n = 3), asymptomatic delayed union (n = 1), and asymptomatic plate fracture (n = 1). No further orthodontic or surgical treatment was performed as a result of these complications. No other complications requiring further treatment occurred. There were three residual complications of mild malocclusion, paresthesia, and asymptomatic plate fracture at final follow-up. Conclusions: These results indicate that two-point fixation with microplates is appropriate for the internal fixation of simple, isolated mandibular fractures. Its advantages include a high adaptability to the fracture site, occlusal self-adjustment, a minimal mass effect, and a relatively strong holding power of two-point fixation.