Reconstruction plate-related complications in mandibular continuity defects

PURPOSE

The purpose of this study was to evaluate the complications associated with the use of reconstruction plates with or without non-vascularized bone graft in reconstruction of mandibular segmental defects caused by trauma and tumor resection and to analyze various factors that are associated with the development of complications.

METHODS

A retrospective observational study was conducted, and the investigated variables included the age and gender of the patients, etiology of the defect, the site of the defect, the size of the defect, whether bone graft was used or not, type of plate used, and whether the reconstruction was immediate or delayed. The outcome variables were the postoperative complications and the success rate.

RESULTS

Fifty-one patients were enrolled in this study; the etiology of mandibular defect was trauma in 39 patients (76.5%) and resection of benign or malignant tumors in 12 patients (23.5%). The complication rate was (58.8%) and the success rate was (94.1%); the only factor that significantly increased the incidence of postoperative complications was the size of the defect.

CONCLUSION

Reconstruction plates demonstrated a high success rate despite the high complication rate. Segmental defects caused by trauma were smaller than those created after tumor resection and the only factor that increased complication rate was the size of the defect; other factors did not affect the complication rate.

Does Mixed Conventional/Piezosurgery Implant Site Preparation Affect Implant Stability?

The aim of this study was to compare the effect of conventional implant site preparation technique and a combination of conventional/piezosurgery preparation on implant stability measured at different time intervals, insertion torque, and preparation time. A randomized controlled study was designed, it included 26 patients who received 54 dental implants randomly assigned to 2 groups; in the control group, implants were installed after conventional preparation with drills whereas the study group received implants after mixed conventional/piezosurgery preparation. The outcome variables included: implant stability measured immediately after implant insertion, at 8 weeks and 16 weeks postoperatively, insertion torque and preparation time. All the investigated variables were analyzed statistically using 1 sample Kolmogrov-Simirenov test, Mann-Whitney U test, paired and unpaired Student t test, the Pearson χ test, Fisher exact test, and analysis of variance (1-way ANOVA). The differences were considered significant at P ≤ 0.05. Implant stability showed a similar pattern in both the groups which consists of a statistically significant decrease in implant stability quotient values at the 8th week followed by a statistically significant increase at the 16th week, where the implant stability quotient values return close to those of primary stability. The 2 groups revealed a statistically not significant difference in insertion torque and implant stability changes throughout the study period, whereas the preparation time was significantly longer in the study group than the control group. The mixed conventional/piezosurgery method of implant site preparation offers no additional advantage over the conventional drilling method in terms of values of insertion torque and patterns of implant stability change throughout the healing period.