Computer Guided Lag Screw Fixation Versus Conventional Lag Screw Fixation in Anterior Mandibular Fractures

NCT ID: NCT03530891

Last Updated: 2018-05-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

26 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-01-11

Study Completion Date

2019-06-01

Brief Summary

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Comparison between computer guided lag screw fixation versus traditional lag screw fixation in open reduction and internal fixation of anterior mandibular fractures.

Detailed Description

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Two groups of patients with anterior mandibular fractures indicated for open reduction and internal fixation. First group will be subjected to computer guided lag screw fixation. Second group will be subjected to traditional lag screw fixation.

Eligible patients will be randomised in equal proportions between study group (computer guided lag screw fixation) and control group (conventional lag screw fixation).

A- Computer guided lag screw fixation group:

* Pre operative Computed tomography will be done for the patient.
* Computed tomography data will be imported into Computer aided surgical simulation software.
* Utilizing Computer aided surgical simulation software the fracture segments are virtually reduced and patient specific surgical guide is designed and sent to three dimension printer before operation.
* Intra operative: All cases will undergo surgery under general anaesthesia.
* Exposure of the fractured segments will be done using vestibular incision.
* Inter-maxillary fixation will be done
* The fractured segments will be reduced in normal anatomic position guided by occlusion.
* Fracture fragments will be fixed using lag screws utilizing patient specific surgical guide.
* Closure of the surgical incision.
* Post operative at first week Computed tomography will be done for the patient.
* Computed tomography data will be imported into computer aided surgical simulation software.
* Utilizing computer aided surgical simulation software the post operative computed tomography will be superimposed onto the pre operative planned simulation.

B- Conventional titanium plates:

* Pre operative Computed tomography will be done for the patient.
* Computed tomography data will be imported into Computer aided surgical simulation software.
* Utilizing Computer aided surgical simulation software the fracture segments are virtually reduced.
* Intra operative: All cases will undergo surgery under general anaesthesia.
* Exposure of the fractured segments will be done using vestibular incision.
* Inter-maxillary fixation will be done.
* The fractured segments will be reduced in normal anatomic position guided by occlusion.
* The fracture fragments will be fixed using lag screws.
* Closure of the surgical incision.
* Post operative at first week Computed tomography will be done for the patient.
* Computed tomography data will be imported into computer aided surgical simulation software.
* Utilizing computer aided surgical simulation software the post operative computed tomography will be superimposed onto the pre operative planned simulation.

Follow up for both groups:

Clinical evaluation will be performed at first week postoperative then patients will be recalled every week for one month. Final follow up visit will be at 3 months post operative.

Conditions

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Mandible Fracture

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

* A Randomized clinical trial.
* Parallel group study.
* A trial will be carried out in hospital of Oral and Maxillofacial surgery department- Faculty of Oral and Dental Medicine Cairo University
* Equal randomization: participants with equal probabilities for intervention.
* Positive controlled: Both groups receiving treatment.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Because the two interventions requires different pre operative preparation, both the participants and investigators can't be blinded.

Study Groups

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Computer guided lag screw fixation

Patient specific surgical guided will be used for open reduction and internal fixation for anterior mandibular fracture by lag screws.

Group Type EXPERIMENTAL

Computer guided lag screw fixation

Intervention Type PROCEDURE

Under general anaesthesia: Patient specific pre operative prefabricated surgical guide will be used intra operative for open reduction and internal fixation for anterior mandibular fracture using lag screws.

Conventional lag screw fixation

Open reduction and internal fixation for anterior mandibular fracture using lag screws.

Group Type ACTIVE_COMPARATOR

Conventional lag screw fixation

Intervention Type PROCEDURE

Under general anaesthesia: Open reduction and internal fixation for anterior mandibular fracture utilising lag screws.

Interventions

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Computer guided lag screw fixation

Under general anaesthesia: Patient specific pre operative prefabricated surgical guide will be used intra operative for open reduction and internal fixation for anterior mandibular fracture using lag screws.

Intervention Type PROCEDURE

Conventional lag screw fixation

Under general anaesthesia: Open reduction and internal fixation for anterior mandibular fracture utilising lag screws.

Intervention Type PROCEDURE

Other Intervention Names

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computer assisted surgery traditional lag screw fixation

Eligibility Criteria

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Inclusion Criteria

* Patients with anterior mandibular fracture indicated for open reduction internal fixation alone or in combination with fracture elsewhere in the mandible or mid face.
* All ages and both sexes were included in this study.
* Patients should be free from any systemic disease that may affect normal healing of bone, and predictable outcome.
* Patients with good general condition allowing major surgical procedure under general anaesthesia .
* Patients with physical and psychological tolerance.

Exclusion Criteria

* Patients with comminuted fractures as it is not indicated for compression osteosynthesis like lag screws.
* Patients with high risk systemic diseases like uncontrolled diabetes mellitus. As uncontrolled diabetes mellitus has a negative impact on normal bone healing.
* Patients with old and/or mal-union fractures. As they will affect accuracy of reduction of the fractured segments.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cairo University

OTHER

Sponsor Role lead

Responsible Party

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Mohamed Kadry

Assistant lecturer

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Khaled S Amr, PhD

Role: STUDY_DIRECTOR

Faculty of oral and dental medicine, Cairo University.

Locations

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Faculty of Oral and Dental Medicine - Cairo University

Giza, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Mohamed N Kadry, MSc

Role: CONTACT

+201200560027

Facility Contacts

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Mohamed N Kadry, MsC

Role: primary

+201200560027

Khaled S Amr, PHD

Role: backup

+201006029031

References

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Ellis E 3rd, Ghali GE. Lag screw fixation of anterior mandibular fractures. J Oral Maxillofac Surg. 1991 Jan;49(1):13-21; discussion 21-2. doi: 10.1016/0278-2391(91)90259-o.

Reference Type BACKGROUND
PMID: 1985177 (View on PubMed)

Ellis E 3rd. Is lag screw fixation superior to plate fixation to treat fractures of the mandibular symphysis? J Oral Maxillofac Surg. 2012 Apr;70(4):875-82. doi: 10.1016/j.joms.2011.08.042. Epub 2011 Dec 30.

Reference Type BACKGROUND
PMID: 22209100 (View on PubMed)

Kallela I, Ilzuka T, Laine P, Lindqvist C. Lag-screw fixation of mandibular parasymphyseal and angle fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996 Nov;82(5):510-6. doi: 10.1016/s1079-2104(96)80195-8.

Reference Type BACKGROUND
PMID: 8936514 (View on PubMed)

Xia JJ, Gateno J, Teichgraeber JF, Christensen AM, Lasky RE, Lemoine JJ, Liebschner MA. Accuracy of the computer-aided surgical simulation (CASS) system in the treatment of patients with complex craniomaxillofacial deformity: A pilot study. J Oral Maxillofac Surg. 2007 Feb;65(2):248-54. doi: 10.1016/j.joms.2006.10.005.

Reference Type BACKGROUND
PMID: 17236929 (View on PubMed)

Zachariades N, Mezitis M, Papademetriou I. Use of lag screws for the management of mandibular trauma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996 Feb;81(2):164-7. doi: 10.1016/s1079-2104(96)80407-0.

Reference Type BACKGROUND
PMID: 8665308 (View on PubMed)

Tiwana PS, Kushner GM, Alpert B. Lag screw fixation of anterior mandibular fractures: a retrospective analysis of intraoperative and postoperative complications. J Oral Maxillofac Surg. 2007 Jun;65(6):1180-5. doi: 10.1016/j.joms.2006.11.046.

Reference Type BACKGROUND
PMID: 17517303 (View on PubMed)

Jones JK, Van Sickels JE. Rigid fixation: a review of concepts and treatment of fractures. Oral Surg Oral Med Oral Pathol. 1988 Jan;65(1):13-8. doi: 10.1016/0030-4220(88)90183-1.

Reference Type BACKGROUND
PMID: 3277107 (View on PubMed)

Retzepi M, Donos N. The effect of diabetes mellitus on osseous healing. Clin Oral Implants Res. 2010 Jul;21(7):673-81. doi: 10.1111/j.1600-0501.2010.01923.x. Epub 2010 May 3.

Reference Type BACKGROUND
PMID: 20465554 (View on PubMed)

Parashar A, Sharma RK. Unfavourable outcomes in maxillofacial injuries: How to avoid and manage. Indian J Plast Surg. 2013 May;46(2):221-34. doi: 10.4103/0970-0358.118597.

Reference Type BACKGROUND
PMID: 24501458 (View on PubMed)

Other Identifiers

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CEBD-CU-2018-5-4

Identifier Type: -

Identifier Source: org_study_id

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