Use of Transgingival Lag Screw Osteosynthesis in the Management of Alveolar Process Fracture

Comparative evaluation of lag screws and miniplates in the fixation of anterior mandibular fractures- a prospective study

INTRODUCTION

Mandibular fractures are among the commonest fractures of maxillofacial region with anterior-mandibular fractures accounting for 8-15%. Mini-plates with or without arch bar is the most commonly used fixation method to achieve ORIF. However, the mandible symphysis is uniquely shaped for the application of lag-screws.

AIM

This study aims at evaluating the effectiveness of lag-screws in comparison with mini-plates in fixation of anterior mandibular fractures.

METHODOLOGY

20 patients diagnosed with anterior mandibular fractures were divided into 2 equal groups. Group-A was treated using lag-screws and Group-B was treated using mini-plates. Radiographs were taken for evaluation of fracture site. The results were assessed for mobility of fracture segments, stability of occlusion, paresthesia, and pre-operative, intra-operative and post-operative distances between fracture segments.

RESULTS

There was a significant reduction in clinical distance between the reduced fracture fragments in the lag-screw group. A substantial reduction of radiographic distance between fracture segments was observed post-operatively in the lag-screw group, unlike the mini-plate group. A lesser interfragmentary distance was observed in patients treated with the lag-screw technique.

CONCLUSION

While lag screws and miniplate techniques are both stable forms of fixation, there is more interfragmentary bony contact with lag-screws, thus ideal for fixation of anterior mandibular fractures.

Osteosynthesis of segmental alveolar fractures by internal fixation and the prognosis of the fractures and teeth

BACKGROUND/AIMS

Fracture of the alveolar process is a common injury, but the traditional splinting fixation may not be possible in some cases. The aim of this study was to describe the osteosynthesis performed in segmental alveolar fractures by internal fixation and evaluate the prognosis of the fractures and teeth involved.

MATERIALS AND METHODS

Twenty-two patients who were identified as having segmental alveolar fractures treated with osteosynthesis by internal fixation at the authors' department from January 2007 to December 2016 were included with 90 traumatized teeth. The prognosis of the fractures and teeth involved in the fractures was evaluated by the post-operative computed tomography combined with a follow-up study.

RESULTS

All patients achieved healing and consolidation of the alveolar fractures. Furthermore, the occlusion was restored and the wounds healed. During the surgical procedures, no observed iatrogenic dental damage caused by the interdental drilling was found. Eventually, only 15.6% of the teeth had pulp necrosis, whereas the other healing complications were rare or not observed in the study.

CONCLUSIONS

Osteosynthesis by internal fixation is an effective and safe treatment for some segmental alveolar fractures. The teeth involved in these fractures also have good prognosis.