Width-Controlling Fixation of Symphyseal/Parasymphyseal Fractures Associated With Bilateral Condylar Fractures With 2 2.0-mm Miniplates: A Retrospective Investigation of 45 Cases

Purpose: Symphyseal and parasymphyseal fractures and bilateral condylar fractures represent a pattern that is quite challenging to manage. This study evaluated the treatment outcomes of a group of patients who underwent surgery using miniplate fixation for anterior mandibular fractures. Materials and Methods: This retrospective case series study reviewed patients with bilateral condylar fractures and noncomminuted symphyseal and parasymphyseal fractures. The patients were surgically treated from 2008 to 2014 in the department of oral surgery. Evaluation of facial width control was considered the primary outcome variable, which consisted of clinical assessment and measurement of the lingual gap using computed tomography. Medical information was collected before surgery. Temporomandibular joint function and postoperative complications also were evaluated during follow-up. A paired sample t test was used for statistical analysis. Results: Forty-five patients (37 male, 8 female; mean age, 34.8 +/- 14.5 yr; range, 16 to 74 yr) were included in this study. Lingual gaps measured before surgery (3.38 +/- 0.61 mm) and after surgery (0.64 +/- 0.14 mm) were significantly different (P < .001). No patient was rated as "unsatisfactory" after esthetic evaluation of facial width. Conclusion: For noncomminuted symphyseal and parasymphyseal fractures associated with bilateral condylar fractures, 2 2.0-mm miniplates with monocortical screws are stable and efficacious in controlling mandibular width when bilateral condylar fractures are anatomically reduced and stably fixated. (C) 2016 American Association of Oral and Maxillofacial Surgeons