Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

39 questions · 39 findings · 3 reviews · Oral and maxillofacial surgery

No studies found 17 · 43.6%GRADE not reported 17 · 43.6%Very low 5 · 12.8%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation

Need for retreatment or replacement of fixation due to failure of the fixation · Adults (>16 years old) undergoing orthognathic surgery
1 finding from 1 review
  • Resorbable versus titanium plates for orthognathic surgery 2017 · Cochrane All outcomes
    Mean 1 year
    SoF row (Resorbable plates compared to titanium plates for stabilization after orthognathic surgery). Need for retreatment or replacement of fixation due to failure of the fixation (plates failed or removed in each…
    1 study · 60 participants
    Very low

Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation

Wound dehiscence · Adults (>16 years old) undergoing orthognathic surgery
1 finding from 1 review
  • Resorbable versus titanium plates for orthognathic surgery 2017 · Cochrane All outcomes
    Up to 3 years postoperatively
    Three patients (10%) in the titanium group and two patients (6.7%) in the resorbable group presented with wound dehiscence. One patient in each group with dehisced wounds became infected; all non-infected wounds closed…
    1 study · 60 participants
    GRADE not reported

Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation

Complications: chronic wound pain · Adults (>16 years old) undergoing orthognathic surgery

It is very uncertain whether resorbable (bioresorbable) plates or screws for fixation changes postoperative chronic or lasting pain (wound discomfort) at 4 to 6… compared with titanium plates or screws for fixation (very low certainty).

1 finding from 1 review

Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation

Swelling (mean) · Adults (>16 years old) undergoing orthognathic surgery
1 finding from 1 review
  • Resorbable versus titanium plates for orthognathic surgery 2017 · Cochrane All outcomes
    Up to 3 years postoperatively
    Though Cheung 2004 reported the presence of postoperative swelling, it was only noted in conjunction with infection and pus discharge; assessment of this outcome did not include the use of photography or digital…
    1 study · 60 participants
    GRADE not reported

Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation

Adverse effects (composite: plate exposure, wound infection, sinus tract, wound dehiscence, plate removal) · Adults (>16 years old) undergoing orthognathic surgery
1 finding from 1 review
  • Resorbable versus titanium plates for orthognathic surgery 2017 · Cochrane All outcomes
    Up to 24 months postoperatively
    SoF row. Adverse effects; 60 participants (1 RCT); Quality of the evidence (GRADE): VERY LOW. Exposure of the plate: both titanium and resorbable groups experienced 2 plate exposures which occurred between the third…
    1 study · 60 participants
    Very low

Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation

Wound infection · Adults (>16 years old) undergoing orthognathic surgery
1 finding from 1 review
  • Resorbable versus titanium plates for orthognathic surgery 2017 · Cochrane All outcomes
    Up to 3 years postoperatively
    The trialists did not differentiate between superficial and deep wound infection. Three (10%) of the patients in each group developed infections accounting for six plates: 3/196 (1.53%) in the titanium group and 3/165…
    1 study · 60 participants
    GRADE not reported

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

Restoration of function (occlusion) · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Restoration of the original occlusion, assessed visually, was similar in both groups (P>0.05); occlusal correction was not achieved in one participant in the two-lag-screws group. Surrogate/proxy outcome.
    1 study
    GRADE not reported

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

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

Post-operative infection · Adults with fractures of the mandibular angle

Two miniplates (transbuccal approach) showed no clear difference in post-operative infection compared with one miniplate plus two screws (intraoral approach at external…; GRADE not reported.

1 finding from 1 review

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

Requirement for additional (surgical) interventions (plate removal) · Adults with fractures of the mandibular angle

Two miniplates (transbuccal approach) showed no clear difference in requirement for additional (surgical) interventions (plate removal) compared with one miniplate plus two screws (intraoral approach at external…; GRADE not reported.

1 finding from 1 review

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

Post-operative adverse events and complications (lip numbness; overall) · Adults with fractures of the mandibular angle
1 finding from 1 review
  • Interventions for the management of mandibular fractures 2013 · Cochrane All outcomes
    Angle of mandible only
    Siddiqui 2007: 22/36 (61%) single-miniplate vs 14/26 (54%) two-miniplate had one or more complications; subjective lip numbness 15/36 (41.7%) vs 10/26 (38.5%) (P=0.82), objective 16/36 (44.4%) vs 8/26 (31.7%) (P=0.29).…
    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