The Comparison of Three-dimensional Plate versus Standard Plate in the Management of Mandible Fracture: A Meta-analysis and Systematic Review of Randomized Controlled Trials

Background: A mandible fracture is one of the most common facial fractures commonly seen in the emergency department. Open reduction internal fixation with plates was considered to be an option for mandibular fractures. Three-dimensional (3D plates) are innovations found in the reconstruction of mandible fractures that provide strong resistance to torque forces, ensure good stability, and offer enhanced tension and compression. This study aims to compare the outcome of using a 3D plate and standard plate fixation to manage mandibular fracture. Methods: The meta-analysis and systematic review were conducted based on the PRISMA using PubMed, Cochrane Library, and ScienceDirect. The research foundations were based on PICO criteria, as mentioned: Patients with a mandibular fracture were treated using 3D plates and controlled with standard plates. The outcome will be in terms of infection, wound dehiscence, malocclusion, hardware failure, paresthesia, operative time, need for IMF, fracture gap, and mouth opening. Results: Fourteen randomized controlled trials were included involving 453 participants. Most trials still had a high-risk bias and average quality. This study showed that 3D plates had a faster operation time than standard plates (WMD: −2.71 operative time, 95% confidence interval: −4.71, −0.70, P = 0.008). There is no statistical difference in infection, wound dehiscence, malocclusion, hardware failure, paresthesia, need for IMF, fracture gap, and mouth opening. Conclusion: The treatment of 3D plates has a faster operation time than standard plates. Other indicators had no statistically significant results. There is still a need for wide scale and specific studies on this topic.