Mohamed A Abdel Monem, Mohammed H El-kenawy And Noha A Mansour,

ABSTRACT
Aim Of The Study: The Purpose Of This Study Is To Evaluate The Outcomes Of Two Different Treatment Modalities For Parasymphyseal Fracture. Patients And Methods: This Study Included Fourteen Patients With Parasymphyseal Mandibular Fractures, Indicated For Open Reduction And Internal Fixation. All Patients Received Intermaxillary Fixation (IMF) Using Erich Arch Bars. First Group Included 7 Patients Treated With Internal Fixation By Two Titanium Miniplates, Placed According To Champy?s Ideal Osteosynthesis Lines. Both Arch Bars Were Removed Immediately After Surgery. Second Group Treated With Internal Fixation By One Titanium 2.3 Mm Plate Placed Across The Fracture Line, Below The Level Of Mandibular Canal, For This Group Of Patients, Only Mandibular Arch Bar Left Secured To Lower Teeth To Act As A Tension Band. All Patients Were Recalled At 1, 3 And 6 Months For Clinical Assessment. Radiographic Assessment By Panoramic View Was Done At 1 Week, 3rd And 6th Months. Image J Software Was Used For Bone Healing Assessment By Gray Level Scale. All Clinical And Radiographic Parameters Were Subjected To Statistical Analysis.

Results: Statistical Analysis Showed Significant Difference Regarding Working Time Between The Two Groups. All Patients Had Excellent Reduction, No Hardware Failure Or Malocclusion Occurred. No Statistically Significant Difference Was Found In Respect Of Wound Dehiscence, Infection, Parasthesia Or Occlusal Discrepancy. Gray Level Scale For Bone Healing Evaluation Displays No Significant Difference Between Both Groups.

Conclusions: The Two Treatment Protocols Used In This Study To Treat Mandibular Anterior Fractures Resulted In Extremely Successful Outcomes Such As Obtaining The Pre-injury Occlusion And Osseous Union. However, The Protocol Of Using One Plate In Addition To Lower Arch Bar Splint Provided The Advantages Of Less Cost, Less Operative Time, Less Wound Dehiscence And Plate Exposure, Good Choice For Patients With Minimal Vertical Mandibular Height To Decrease Incidence Of Root Injury And Mental Nerve Injury.