Observational studyHead & face medicine2025
One-plate versus two-plate fixation in the treatment of mandibular angle fractures: a retrospective two-centre comparative study.
Observational study in Head & face medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Assessment of accuracy and efficiency of guided fixation of customized 3D miniplates vs Champy's technique in stabilization of mandibular angle fractures: A randomized controlled trial.Clinical oral investigations · 2026Trial
- A novel plate design versus two conventional miniplates for treatment of mandibular angle fractures (a pilot randomized controlled clinical trial).BMC oral health · 2026Trial
- Feasibility assessment of fixation patterns in multiple mandibular fractures: A clinical study.Bioinformation · 2026Article
- Reconstruction plates versus single or dual miniplates for angle fractures: Hardware failure and non-union rates.Bioinformation · 2026Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe treatment of mandibular angle fractures remains controversial, particularly regarding the method of fixation. The primary aim of this study was to compare surgical outcomes following treatment with 1-plate versus 2-plate fixation across two oral and maxillofacial surgery clinics. The secondary aim was to evaluate associations between patient-, trauma-, and procedure-specific factors with postoperative complications and to identify high-risk patients for secondary osteosynthesis.
methodsIn this retrospective two-center cohort study, patients who underwent surgical treatment for mandibular angle fractures via a transoral approach using either 1-plate or 2-plate fixation over a 10-year period were included. Clinic A exclusively performed 1-plate fixation, while clinic B used 2-plate fixation. Demographic, clinical, radiological, and treatment data were analysed. Multivariable analyses were conducted to identify predictors of postoperative complications and secondary osteosynthesis.
resultsA total of 253 patients with 264 mandibular angle fractures were included. Violence was the most common mechanism of injury (n = 131; 49.6%). Postoperative complications occurred in 34.6% of the cases at clinic A and 26.8% at clinic B (p < 0.0001). Secondary osteosynthesis was required in 9.4% at clinic A and 7.6% of the cases at clinic B, respectively (p = 0.6547). Multinomial regression analysis identified smoking, diabetes mellitus, patient noncompliance, left-sided mandibular angle fractures, presence of a third molar (M3), partial M3 eruption, vertical depth A of M3 and horizontal impaction class II (Pell and Gregory) as significant predictors of postoperative complications. Logistic regression analysis identified smoking, diabetes mellitus, patient noncompliance, left mandibular angle fractures, mandibular angle und body fractures and presence of third molars as significant predictors of secondary osteosynthesis. As patient age there is an increased tendency for wound infection and plate/screw loosening (p = 0.06). A longer interval between trauma and surgery was associated with a higher risk of postoperative occlusal disturbances (p = 0.06). Patients with a longer duration of postoperative IMF were significantly associated with a higher rate of wound infection and secondary osteosynthesis (p < 0.05).
conclusionsBoth 1-plate and 2-plate fixation techniques demonstrated acceptable outcomes. Single-plate fixation offers sufficient stability for most mandibular angle fractures with fewer complications, supporting its use in uncomplicated cases. Double-plate fixation may be reserved for complex cases. Higher complication rates were associated with patient-related and anatomical risk factors. Individualized treatment and further prospective studies are needed to refine surgical strategies.
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