Three-dimensional versus standard miniplate, lag screws versus miniplates, locking plate versus non-locking miniplates: Management of mandibular fractures, a systematic review and meta-analysis

BACKGROUND/PURPOSE: The aims of the present study were to 1) evaluate the clinical outcomes between different fixation methods in the management of mandibular fractures (MFs) and 2) determine which fixation method is the best option for the treatment of mandibular fractures. MATERIALS AND METHODS: A systematic review was conducted according to PRISMA guidelines, examining Medline-Ovid, Embase, and Pubmed databases. Inclusion criteria were studied in humans, including randomized controlled trials, controlled clinical trials, and retrospective studies, with the aim of comparing the two techniques. In addition, the incidence of complications was evaluated. RESULTS: Thirty-two publications were included: 20 randomized controlled trials, 4 controlled clinical trials, and 8 retrospective studies. There were statistically significant advantages for 3-dimensional miniplate and lag screws. There was no statistically significant difference between locking plates and standard miniplates (P = 0 0.2). The cumulative odds ratio was 0.64, meaning that the use of locking miniplate in the fixation of MFs decreases the risk for postoperative complications by 36% over the use of standard miniplates. CONCLUSION: The results of the three-Dimensional Versus Standard miniplate showed that 3-dimensional miniplate is the best option for mandibular fractures. Regarding Lag Screws Versus Miniplates results of the meta-analysis found that the use of lag screws is superior to using miniplates in reducing the incidence of postoperative complications. And in regards to locking miniplates versus non-locking miniplate, the analysis indicates that the 2.0-mm locking miniplate is a prospective fixation system in the treatment of maxillofacial fractures.