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Abstract The present study was conducted to compare between using A combination of microplate and miniplate in the fixation of mandibular intermental foramina fractures versus usig two miniplates plates both clinically and radiographically. This study involved 14 adult patients suffering from fracture of anterior mandible (symphyseal –parasymphyseal) selected from outpatient clinic and in patient department of the MaxilloFacial Surgery Department, National Bank hospital for integrated care(Al-Bank Al-Ahly hospital) & from the outpatient clinic, Oral and Maxillofacial Surgery Department at Ain Shams University. A randomized clinical trial was conducted on those patients who have the following inclusion and exclusion criteria. Inclusion criteria: • Fit and well patients whom have no medical compromising conditions that affect bone or soft tissues healing. • Adult patients 18 to 50 years old. • Patients with anterior mandibular fractures. • Dentate or partial edentate patients. Exclusion criteria: • Metabolic bone diseases as osteoporosis. • Comminuted anterior mandible fracture. • Associated pathological condition or pathological fracture. • Infected fractures or osteomyelitis. Patients were randomly allocated using by pulling envelopes from a desk of shuffled envelopes containing cards dividing patients into one of the two groups: • Study group: in this group 7 patients with anterior mandibular fractures was treated with ORIF using intraoral approach and application of 1.6 microplate at superior border and 2.0 miniplate at inferior border. • Control group: in this group 7 patients with anterior mandibular fractures was treated with ORIF using intraoral approach and application of 2.0 miniplate at the inferior border and 2.0 miniplate at the superior border. Clinical assessment was done for all patients according to the following schedule: 1. Immediate postoperative. 2. Two weeks postoperative. 3. One month postoperative. • Stability of the fractured segments. Clinical follow up parameters: • Dehiscence of the soft tissue and hardware exposure. • Neurosensory deficit • Occlusion • Stability of the fractured segments. Radiographic follow-up parameters: Intermental distances measured using CT immediately post-operative and after 6 months postoperatively and compare these results in relation to each others to assess the degree of displacement using ICAT Vision Software. For non-comminuted symphyseal and parasymphyseal mandibular fractures, the application of a combination of one microplate and one miniplate was efficient for open reduction and internal fixation of isolated symphyseal-parasymphyseal mandibular fracture and provided fracture stability the same as using two miniplates allowing for early mobilization. Its advantages include a high adaptability to the fracture site, occlusal selfadjustment, a minimal mass effect, and a relatively strong holding power of two-point fixation. |