Patient-Specific Guides vs. Classical Workflow in Class IV Mandibular Fracture Fixation

Precision of Patient-specific Screw Holes Locating Surgical Guide and Pre-bent Plates Osteosynthesis Versus Classical Workflow in the Management of Class IV Mandibular Fractures

This study aims to overcome the limitations of current, standard approach of mandibular fracture reduction and fixation including improper alignment of segments, malocclusion, nerve affections and related teeth roots injury. The introduction of Computer Aided designing/Computer Aided manufacturing software has provided surgeons with an opportunity to perform virtual manipulations of computed tomography datasets preoperatively and production of corrected mandibular model for plate pre-bending and fabrication of plate locating surgical guide which provide accurate segment reduction and fixation with accurate post-operative occlusion and minimal post-operative complication.

Inclusion Criteria:

• Patients with delayed mandibular class IV fracture need open reduction and internal fixation.
• Patients with a medical history that did not hinder plate placement (uncontrolled diabetes) and adequate proper oral hygiene.
• Both genders, males and females, will be included

Exclusion Criteria:

• General contraindications to surgery.
• Patients with unfavorable or comminuted fractures.
• Subjected to irradiation in the head and neck area less than 1 year before fixation.
• Poor oral hygiene and motivation.
• Uncontrolled diabetes.
• Pregnant or nursing.
• Substance abuse.
• Psychiatric problems or unrealistic expectations.
• Severe bruxism or clenching.
• Immunosuppressed or immunocompromised.
• Treated or under treatment with intravenous amino-bisphosphonates.
• Patients participating in other studies, if the present protocol could not be properly followed.