Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

53 questions · 53 findings · 4 reviews

No studies found 17 · 32.1%GRADE not reported 31 · 58.5%Very low 5 · 9.4%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

2 mm titanium plates vs 2.5 mm bioresorbable plates

Restoration of function (inability to chew hard food) · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement

2 mm titanium plates showed no clear difference in restoration of function (inability to chew hard food) compared with 2.5 mm bioresorbable plates; GRADE not reported.

1 finding from 1 review

2 mm titanium plates vs 2.5 mm bioresorbable plates

Post-operative neurosensory disturbance (mental nerve paraesthesia) · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement

2 mm titanium plates led to higher post-operative neurosensory disturbance (mental nerve paraesthesia) compared with 2.5 mm bioresorbable plates; GRADE not reported.

1 finding from 1 review

2 mm titanium plates vs 2.5 mm bioresorbable plates

Requirement for additional (surgical) interventions (plate removal / re-operation) · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Plate removal was statistically more likely in the titanium group (Fisher's exact P<0.05); infection led to plate removal in one titanium participant at 2 months and a further 4/21 (19%) titanium participants (six…
    1 study
    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

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

Costs (fixation materials, hospital bed days, retreatment) · Adults over 18 years of age with fractures of the facial skeleton including the mandible, maxilla, zygoma (malar); studies on fractures of…

The review found no eligible studies for this question.

1 finding from 1 review
  • Resorbable versus titanium plates for facial fractures 2009 · Cochrane All outcomes
    Up to 3 years postoperatively
    Planned cost outcome not assessed: none of the retrieved studies met the inclusion criteria, so no data were available for analysis. Verbatim (Effects of interventions): "Although 53 studies were retrieved in our…
    0 studies
    No studies found

Locking plate vs 2 mm non-locking titanium plates

Post-operative adverse events and complications (paraesthesia, swelling, segmental mobility) · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Agarwal 2011: paraesthesia in one participant in the non-locking plate group (resolved by 3 months), none in the locking group; infection rates similar at 6 weeks and 3 months; post-operative swelling in 20% of both…
    1 study
    GRADE not reported

Locking plate vs 2 mm non-locking titanium plates

Requirement for additional (surgical) interventions · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Only Collins 2004 provided data: 6/122 participants had minor complications (three in each group); five required surgical removal of the locking plates and one post-operative malocclusion was managed with elastic…
    1 study · 122 participants
    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

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

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

Quality of life (validated questionnaire) · Adults over 18 years of age with fractures of the facial skeleton including the mandible, maxilla, zygoma (malar); studies on fractures of…

The review found no eligible studies for this question.

1 finding from 1 review
  • Resorbable versus titanium plates for facial fractures 2009 · Cochrane All outcomes
    Up to 3 years postoperatively
    Planned secondary outcome not assessed: none of the retrieved studies met the inclusion criteria, so no data were available for analysis. Verbatim (Effects of interventions): "Although 53 studies were retrieved in our…
    0 studies
    No studies found

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

Swelling (mean) · Adults over 18 years of age with fractures of the facial skeleton including the mandible, maxilla, zygoma (malar); studies on fractures of…

The review found no eligible studies for this question.

1 finding from 1 review
  • Resorbable versus titanium plates for facial fractures 2009 · Cochrane All outcomes
    0 to 48 hours after surgery
    Planned secondary outcome not assessed: none of the retrieved studies met the inclusion criteria, so no data were available for analysis. Verbatim (Effects of interventions): "Although 53 studies were retrieved in our…
    0 studies
    No studies found

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

Degree of function postoperatively (mastication, swallowing, speech) · Adults over 18 years of age with fractures of the facial skeleton including the mandible, maxilla, zygoma (malar); studies on fractures of…

The review found no eligible studies for this question.

1 finding from 1 review
  • Resorbable versus titanium plates for facial fractures 2009 · Cochrane All outcomes
    Up to 3 years postoperatively
    Planned primary outcome not assessed: none of the retrieved studies met the inclusion criteria, so no data were available for analysis. Verbatim (Effects of interventions): "Although 53 studies were retrieved in our…
    0 studies
    No studies found

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

Adverse effects (insufficient fixation; re-operation/revision; plate exposure; superficial or deep wound infection; sinus tract; wound dehiscence; giant cell/foreign body or inflammatory reaction; post-traumatic dystrophy) · Adults over 18 years of age with fractures of the facial skeleton including the mandible, maxilla, zygoma (malar); studies on fractures of…

The review found no eligible studies for this question.

1 finding from 1 review
  • Resorbable versus titanium plates for facial fractures 2009 · Cochrane All outcomes
    Up to 3 years postoperatively
    Planned adverse-effects outcome not assessed: none of the retrieved studies met the inclusion criteria, so no data were available for analysis. Verbatim (Effects of interventions): "Although 53 studies were retrieved…
    0 studies
    No studies found