Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

353 questions · 366 findings · 17 reviews · Oral and maxillofacial surgery

No studies found 86 · 23.5%GRADE not reported 233 · 63.7%Very low 42 · 11.5%Low 3 · 0.8%Moderate 2 · 0.5%High 0 · 0%

Two lag screws vs One lag screw (with arch bars and IMF)

Post-operative adverse events and complications · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Three participants in the two-lag-screws group experienced complications: malocclusion (one) and mental-nerve paraesthesia (two, resolved after 3 months). There were no post-operative complications in the one-lag-screw…
    1 study
    GRADE not reported

3-dimensional (3D) miniplates vs Standard (Champy) plates

Post-operative adverse events and complications · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Jain 2010 (3D group): segmental mobility (two), proximity to mental nerve or roots (two), radiologically unsatisfactory reduction (one) and unsatisfactory fixation (four) vs one (standard); only fixation differed…
    2 studies
    GRADE not reported

Two miniplates (transbuccal approach) vs One miniplate plus two screws (intraoral approach at external oblique ridge)

Restoration of function (malocclusion) · Adults with fractures of the mandibular angle

Two miniplates (transbuccal approach) showed no clear difference in restoration of function (malocclusion) compared with one miniplate plus two screws (intraoral approach at external…; GRADE not reported.

1 finding from 1 review

Immediate mobilization vs 2 weeks delayed mobilization (IMF)

Average pain scores (0-100 VAS) · Adults with mandibular fractures excluding condyles (fixed with 2 mm titanium miniplates)
1 finding from 1 review
  • Pain (scale 1 to 10) was minor in both groups with no significant differences (Table 4): 6 weeks 1.55 vs 1.20; 3 months 1.00 vs 2.64; 6 months 1.30 vs 2.71 (immediate release vs IMF). 95% confidence interval not…
    1 study
    GRADE not reported

Locking plate vs 2 mm non-locking titanium plates

Drop-out rate due to protocol deviation · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Early premature removal of IMF (from hours up to 2 weeks) was reported in 13 of the 90 participants analysed (Collins 2004); participants released their own IMF or reported that "the wires fell off".
    1 study · 90 participants
    GRADE not reported

2 mm titanium plates vs 2.5 mm bioresorbable plates

Post-operative pain (residual pain, any severity) · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement

2 mm titanium plates showed no clear difference in post-operative pain (residual pain, any severity) compared with 2.5 mm bioresorbable plates; GRADE not reported.

1 finding from 1 review

Immediate mobilization vs 2 weeks delayed mobilization (IMF)

Post-operative adverse events and complications · Adults with mandibular fractures excluding condyles (fixed with 2 mm titanium miniplates)
1 finding from 1 review
  • One wound separation and one infection in the immediate-mobilization group. Inferior alveolar nerve status (scale 1 to 3) showed no significant difference at 6 weeks (P=0.76), 3 months (P=0.87) or 6 months (P=0.99).…
    1 study
    GRADE not reported

Locking plate vs 2 mm non-locking titanium plates

Restoration of function (functional occlusion; bite force as surrogate) · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Functional occlusion was achieved in all participants in both intervention groups (Agarwal 2011); the measurement of this outcome was not clearly reported. Bite force was reported as a surrogate/proxy outcome.
    1 study
    GRADE not reported

One microplate plus one miniplate vs Two miniplates

Efficacy and stability of fixation (bite force) · Adults with isolated mandibular fractures in the interforaminal region
1 finding from 1 review
  • Only one study (Gupta 2012) compared one microplate in conjunction with one miniplate versus two miniplates in isolated interforaminal fractures; however, the data reported in the trial did not satisfy the review's…
    1 study
    GRADE not reported