Comparison of Strengths of Mandibular Angle Fractures Following Different Plate Designs: A Human Cadaver Study.

Study Design: This institutional cross-sectional study using cadaveric mandibles aimed to measure and compare the strengths of three plating designs utilized in osteosynthesis of mandibular angle fractures.

Objective: There have been prior studies on angle fracture fixation though few biomechanical studies on human cadaveric specimen. This study aims to directly compare the biomechanical strength of different plating designs to the mandibular angle fracture using a human cadaveric specimen substrate.

Methods: After receiving an angle osteotomy and either single plate, two plate, or 3D plate fixation, the specimens underwent biomechanical testing using the Instron 5565 mechanical testing unit. The primary outcomes measured were peak load at which permanent deformation started, displacement value at peak load, and load necessary for a specific amount of displacement at 1, 3, 5, and 7 mm.

Results: There were 15 hemi-mandibles in each group. Based on data analysis of all the specimens, there were no significant differences in the mandibular height, ramus width, mandibular thickness, angle height, and gonial angle between the hemimandibles.. This study demonstrated a statistically significant increased strength performance of the 3D plate over the single plate fixation and the 2-plate over the single plate fixation. The results between 2-plate and 3D plate were in similar values.

Conclusions: In terms of biomechanical strength, the 3D plate and two plate designs outperform the single plate design to mandibular angle fractures. There are various anatomical and patient specific situations that can aid in selection between them. In the absence of the favorable angle fracture and patient, biomechanical strength to the method of fixation selection needs to be considered.