Bite force evaluation of mandibular fractures treated with microplates and miniplates.
The purpose of this study was to determine the clinical stability and efficacy of 1 microplate combined with 1 miniplate in the management of mandibular fractures of the interforaminal region compared with the standard 2-miniplate treatment using bite force measurements. Twenty patients were treated for isolated mandibular fractures of the interforaminal region. They were randomly divided into group A (test group) and group B (control group), with 10 patients per group. Group A underwent osteosynthesis using the combination of 1 microplate (subapical) and 1 miniplate (at the lower border). Group B underwent osteosynthesis using the standard 2-miniplate protocol. The bite force measurements were performed preoperatively and postoperatively at each follow-up using a bite force recorder. As a secondary outcome, the patients also were assessed for complications, such as infection, that might interfere with successful osteosynthesis at the fracture site. A statistically significant increase in incisor bite force was found in the 2 groups compared with the preoperative bite force measurements. No statistically significant difference was seen in the incisor bite force of either group at the different follow-up visits. No statistically significant difference was seen in the molar bite force (right vs left) of the test and control groups during follow-up. Molar bite force on the nonfractured side was greater than on the fractured side in the 2 groups. Infection was seen in 1 patient (ie, 10%) in each group. On surgical exploration, the fracture had united and the infection was resolved in the 2 patients, with no further complications. The replacement of an upper miniplate by a microplate in the management of mandibular fractures is stable and adequately efficacious to withstand the masticatory loads and torsional forces acting in the anterior region of the mandible.