The application of titanium plates in the jawbone

Compared with traditional treatment methods such as small steel plates and wires internal fixation, steel plate internal fixation in maxillofacial fracture internal fixation has the advantages of simple surgical operation, less damage, precise and reliable anatomical fixation. Except for condylar process and zygomatic arch fractures which require external incisions, other fractures of the upper and lower jaws are mostly treated with internal incisions inside the mouth, leaving no scars on the face. It can also avoid damage to the facial nerve.

It has good biocompatibility, high corrosion resistance, and good compatibility with human bone tissue and soft tissues. Unless there is infection, it can generally be retained in the body for a long time without the need for secondary surgery removal. This reduces the number of hospitalizations and also reduces the economic burden on patients.

The problem of inter-jaw traction in internal fixation with titanium plates. We believe that intraoperative inter-jaw traction can provide the correct repositioning of the fracture ends and a good occlusal relationship. It can also prevent the re-displacement of the fracture segment during drilling and inserting the titanium screw, which may cause disordered occlusal relationship. Except for cases of combined fractures of the upper and lower jaws which require 1-2 weeks of inter-jaw traction fixation after internal fixation, other fracture fixation postoperative generally does not require traction fixation. Because the traction time is short, it has little impact on the temporomandibular joint function of patients, is easy to maintain oral hygiene, allows eating, and is beneficial to patients' nutrition and wound healing. At the same time, it greatly reduces the pain of patients compared to the past.

The selection of the position for titanium plate fixation. We believe that the selection of an appropriate position for the titanium plate is one of the conditions for the success of the internal fixation surgery with titanium plates. Except for condylar process fractures, all fractures of the mandible are fixed according to the Champy ideal line, that is, the titanium plate for mandibular body fractures is fixed on the inner side of the outer slope of the flat bone surface, that is, between the tooth root and the inferior dental nerve canal. For midline and midline-side fractures, two parallel titanium plates are needed for fixation. The best position for placing the micro-titanium plate in the midface should be the orbital margin, zygomatic alveolar ridge, and edge of the piriform foramen. The screw should be placed on the thick bone of the vertical pillar.

The issue of whether to retain the teeth along the fracture line has always been the focus of debate in the treatment of jaw fractures, especially for the lower jaw angle fractures, where the retention of the third molar is more controversial. Because it may cause infection and also has the role of stabilizing the fracture fixation. Shetty advocated that completely impacted teeth should be extracted because they can provide a larger contact surface for fracture repositioning and should be extracted. Many scholars have observed and believed that retaining the teeth along the fracture line can effectively help fracture repositioning fixation and prevent the displacement of the fracture fragments. Unless there are problems such as inflammation, cyst, root fracture, or periodontal disease in the teeth along the fracture line that have lost their retention significance, they should be extracted. Generally, efforts should be made to retain them.