Evaluation of The Efficiency of Custom-Made Three-Dimensional PEEK Plates in Mandibular Angle Fractures

Introduction: Mandibular angle fracture management has always posed a dilemma for maxillofacial surgeons. Numerous treatment modalities and plate designs have been proposed. Three-dimensional (3D) plates have gained great acceptance since they can provide rigid and functionally stable fixation. Poly-ether-ether-ketone (PEEK) has lately emerged as a promising material of choice in the manufacturing of internal fixation devices.Aim of the study: To evaluate the efficiency of 3D custom-made PEEK plates in the management of mandibular angle fractures in terms of clinical and radiographic assessment parameters.Materials and Methods: The present study was conducted on nine patients with recent mandibular angle fractures indicated for open reduction and internal fixation. All fractures were fixed with custom-made 3D PEEK plates placed through an extraoral approach. The follow-up period was twelve weeks. Clinical assessment parameters included postoperative occlusion, interfragmentary mobility, and bite force recovery. Radiographic assessment was done with the aid of two computed tomography(CT) scans; one immediate postoperative scan and another one after twelve weeks, to evaluate the healing process and calculate the mean bone density at the fracture site.Results: By the end of the follow-up period, all patients showed satisfactory occlusion and zero interfragmentary stability. Bite force values showed a statistically significant difference across the follow-up period. Upon radiographic assessment, all fractures showed proper healing and the difference in mean bone density between baseline and final values was statistically significant.Conclusion: Custom-made 3D PEEK plates can provide satisfactory clinical and radiographic outcomes in the treatment of mandibular angle fractures.