Miniplate osteosynthesis在下颌骨骨折中的使用

… Moments of flexion were found at the upper part of the mandible, increasing progressively from the front teeth to a maximum of approximately 600 N in the angle. Torsion moments also exist between the canines, which increase in strength toward the midline to 1000 N.

… They recommended that behind the mental foramen only one plate should be applied, immediately below the dental roots and above the inferior alveolar nerve. In front of the mental foramen, in order to neutralize the higher torsion forces between the canines, another plate near the lower border of the mandible is necessary in addition to the subapical plate. These miniplates required screws to be fixed only in the outer cortex of the mandible.


  • To stabilize fractures of the angle, adapt a plate as high as possible on the oblique line. Twisting of the plate over its plane so that the distal part can be fixed from the medial aspect and the anterior part can be fixed on the lateral aspect of the external cortical layer is more convenient.

  • In some cases, rounding of the sharp crest of the oblique line with a bone cutter facilitates adaptation of the plate. Fractures between the canine and the angle are stabilized with a single plate in subapical position. To avoid damage to the dental roots, place the screws at a distance at least three times the height of the tooth crown from the occlusal plane.

  • Stabilize fractures between the canines using two parallel plates: Place the subapical plate first, and place the second plate at least 5 mm caudally from the first.

  • In case of fractures near the mental foramen, place one plate above and one below the nerve. Placement of the concave part of the plate between two holes exactly over the foramen is advisable. Alternatively, use a plate with an intermediate spacing section to prevent damage to the canine apices and the inferior alveolar nerve.

  • Administer a semifluid diet for 1 week.


Exerpted from Maxillofacial surgery by Peter Brennan.