THESIS SYNOPSIS

DR. AMIT MOHAN

DEPARTMENT OF ORAL AND MAXILLOFACIAL

SURGERY

A.B. SHETTY MEMORIAL INSTITUTE OF DENTAL SCIENCES, DERALAKATTE, MANGALORE – 575018

RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCES

4th BLOCK, JAYANAGAR,BANGALORE,KARNATKA

ANNEXURE-11

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. / NAME OF THE CANDIDATE AND ADDRESS / DR.AMIT MOHAN
POST GRADUATE STUDENT,
DEPT. OF ORAL AND MAXILLOFACIAL
SURGERY,
A.B.SHETTY MEMORIAL INSTITUTE OF DENTAL SCIENCES.
DERALAKATTE- MANGALORE – 575 018
2. /

NAME OF THE INSTITUTION

/ A.B.SHETTY MEMORIAL INSTITUTE OF DENTAL SCIENCES.
DERALAKATTE – MANGALORE – 575 018
3. / COURSE OF THE STUDY AND SUBJECT / MASTER OF DENTAL SURGERY
DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY.
4. / DATE OF ADMISSION TO COURSE / MAY – 2008
5. / TITLE OF TOPIC
“COMPARATIVE EVALUATION OF 3-DIMENSIONAL MINIPLATES AND MONOCORTICAL CHAMPY’S MINIPLATES FOR INTERNAL FIXATION’’
6. / BRIEF RESUME OF THE INTENDED STUDY:
6.1 NEED FOR THE STUDY:
Treatment of the maxillofacial fractures has made significant advances over the years due to improved understanding of biomechanical principles, advances in biomaterials and instrumentation, and scientifically based research of treatment outcomes. The treatment choices include closed and open techniques.
Monocortical Miniplates have been used during the last decade to facilitate the stability between bony fragments in maxillofacial region, and are currently the preferred surgical method for the fixation of fractures and osteotomies. Today, rigid internal fixation can be achieved with a variety of plating systems that provides the best means to achieve undisturbed healing of the bone segments.
Although, there have been a number of studies on linear and curvilinear plates for rigid fixation, there have been only a few reports on the use of 3-dimensional plates. The geometry of 3-dimensional plates conceptually allows for an increased number of screws, stability in 3 dimensions and resistance against torque forces while maintaining a low profile and malleability.
The aim of this study is to evaluate the clinical results obtained with 3-dimensional miniplates and to compare them with the results obtained with conventional miniplates.
6.2 REVIEW OF LITERATURE
In 2007, a study was done to evaluate the clinical usefulness of 3-dimensional (3D) miniplates for open reduction and monocortical fixation of mandibular angle fractures. It was concluded that the 3D plating system is suitable for fixation of simple mandibular fractures and is an easy-to-use alternative to conventional miniplates1.
A study done in Beijing stated that the three-dimensional (3-D) Titanium miniplate system is one of the newest internal rigid fixation for the maxillo-mandibular surgery in recent years.The geometry of the plate assures a good stability in the three-dimensions of the fracture sites. The 3-D Titanium miniplate as an ideal easy to use, good resistance against torque forces and, compact forms of the miniplate were the some of the advantages. It was the author's opinion that the internal rigid fixation by 3-D Titanium miniplates is a promising method of treating fractures of the maxilla and is to be better tolerated by the patients and surgeons2.
A study done in 1992 demonstrated the value of 3-dimensional plates in maxillofacial surgery. It stated that the geometry of the plate assures a good stability in the three dimensions of the space. Easy use, good resistance against torque forces, compact form of the plate are some of the advantages3.
Another study was done to evaluate the use of 3-D plating system in maxillofacial surgery. The study showed that these plates can be used successfully in different ages in craniofacial, orthognathic, reconstructive surgery and in trauma cases. The clinical results and biomechanical investigations showed the good stability against traction and torsion forces despite the small size and thickness of the plates4.
A prospective study done in Texas evaluated the use of 3-D plate for fixation of mandibular angle fractures. The author suggested that the 3-D plates provide adequate fixation for mandibular angle fractures. Also, the plate can be rapidly applied and patient is allowed to function immediately with a reasonable level of success5.
A biomechanical study investigated the effectiveness of fixation by 3-dimensional plates of simulated angle fractures in sheep mandible. It was shown that there was no failure in bone/screw interface. The results indicated that a 3-D plate can be used for fixation of mandibular angle fracture6.
6.3OBJECTIVES OF THE STUDY
1.The purpose of the study is to evaluate the clinical results of 3-dimensional miniplates in stabilization of fractured or osteotomized bone segments.
2. To assess the efficacy,stability and rigidity of 3-dimensional miniplates for osteosynthesis.
3.To demonstrate its biocompatibility with surrounding soft tissue and bone.
4. To compare the results with monocorticalchampy’sminiplates.
7 / MATERIALS AND METHODS
7.1 SOURCE OF THE DATA
The study is set up in Department of oral and maxillofacial surgery, A.B. Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore. This study will include 20 cases of either trauma, reconstructive or orthognathic surgery in which internal fixation is indicated.
7.2 METHOD OF COLLECTION OF DATA
In this study patients will be randomly assigned to any one group. The clinical preoperative examination will focus on dental occlusion and preoperative radiographs. All patients will undergo open reduction and rigid fixation with either of
plate depending upon their group. Postoperative clinical examination will be carried out on the 10th day, in the 1st and the 3rd postoperative months. Post-operative clinical evaluation will include assessment of infection, bony union, occlusion, nerve function and range of motion. The results of two groups will be comparedstatistically.
INCLUSION CRITERIA
1.Fracture mandible without gross-comminution of the fracture segments.
2.Fracture mandible with no/minimal displacement of fracture segments.
3. Osteotomized bone segmentsfor orthognathic surgery.
EXCLUSION CRITERIA
1. Severely infected fractures with large hematoma.
2. Grossly comminuted fractures with extensive damage of fractured bony segments.
3. Cases where outer cortical plate is fractured obliquely resulting in too thin a portion of mandible for retention of screws.
7.3 DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR INTERVENTIONS TO BE CONDUCTED IN PATIENTS OR OTHER HUMANS
This study includes placement of 3-D miniplates and conventional miniplates for rigid internal fixation in patients with fractured or osteotomized bone fragments.
Radiographical examination will be performed using OPG, lateral view, CT- Scan depending upon patient’s medical condition.
7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION :
8. / List of references
  1. Zix J, Lieger O, Iizuka T. Use of straight and curved 3-dimensional titanium miniplates for fracture fixation at the mandibular angle.J Oral Maxillofac Surg. 2007 Sep; 65(9):1758-63.
  2. Lai G. The three-dimensional titanium miniplate rigid fixation in the treatment of fracture of maxilla.Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 1997 Jul; 11(4):196-8.
  3. Farmand M, Dupoirieux L. The value of 3-dimensional plates in maxillofacial surgery.Rev Stomatol Chir Maxillofac. 1992; 93(6):353-7.
  4. Farmand M. The 3-D plating system in maxillofacial surgery. J Oral Maxillofac Surg. 1993; 51(suppl 3):166.
  5. Joerg M. Wittenberg. Treatment of mandibular angle fractures with 3-D titanium miniplates. J Oral Maxillofac Surg. 1994; 52(suppl 2):106.
  6. J. M. Wittenberg, D. P. Mukherjee, B. R. Smith, R. N. Kruse. Biomechanical evaluation of new fixation devices for mandibular angle fractures. Int. J. Oral Maxillofac. Surg. 1997; 26:68-73.

9. / SIGNATURE OF CANDIDATE
10. / REMARKS OF THE GUIDE:
11. / 11.1NAME AND DESIGNATION( IN BLOCK LETTERS) OF
GUIDE / DR. B.RAJENDRA PRASAD
PROFESSOR AND DEAN
DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY,
A.B.SHETTY MEMORIAL INSTITUTE OF DENTAL SCIENCES, DERALAKATTE, MANGALORE- 575018.
SIGNATURE
11.2 CO-GUIDE ( if any )
SIGNATURE
11.3 HEAD OF THE DEPARTMENT / DR. S.M.SHARMA
PROFESSOR AND HEAD,
DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY,
A.B.SHETTY MEMORIAL INSTITUTE OF DENTAL SCIENCES, DERALAKATTE, MANGALORE- 575018.
11.4 SIGNATURE
11.5 REMARKS OF THE CHAIRMAN & PRINCIPAL
11.6 SIGNATURE