The 3-dimensional miniplate is more effective than the standard miniplate for the management of mandibular fractures: a meta-analysis

PURPOSE: The study aimed to determine the superiority between 3-dimensional (3D) miniplate and standard miniplate for mandibular fractures (MFs) treatment. BACKGROUND: Controversial results on the use of standard miniplate and 3D miniplate have remained for management of MFs. METHODS: Several electronic databases were retrieved up to September 2014 to identify eligible studies. The quality of studies was assessed, and the relative risk (RR) with its corresponding 95% confidence interval (CI) was assessed to measure the effect size. Subgroup analyses by different fracture regions and different 3D miniplate sizes were performed. Publication bias was measured by a funnel plot. RESULTS: There were 13 studies included for the meta-analysis, consisting of 593 participants. The 3D miniplate achieved significant lower incidences of malocclusion (RR 0.43, 95% CI 0.24-0.77, P = 0.004) and hardware failure (RR 0.31, 95% CI 0.13-0.74, P = 0.008) than the standard miniplate. There were no significant differences between the two miniplates on the incidence of the remaining outcomes: wound dehiscence, infection, paresthesia, and nonunion/malunion. Subgroup analyses indicated that 3D miniplate caused a lower hardware failure than standard with the size of 8 or 10 holes (RR 0.23, 95% CI 0.08-0.66, P = 0.006). Besides, publication bias was not detected. CONCLUSION: The 3D miniplate is superior to the standard miniplate on the reduction of postoperative complication rates for the management of MFs. More holes in the 3D miniplate might contribute to a successful treatment.