Bruxism-Related Titanium Miniplate Fracture in the Mandibular Condyle

Fracture of titanium miniplates after internal fixation of mandibular condylar fractures is rare, accounting for 2.6% of cases in our previous study. A 54-year-old woman presented with a right condylar neck fracture with medial displacement from a fall due to alcohol. Internal fixation was performed with two 4-hole titanium miniplates with nonlocking screws. Postoperative images showed anatomic reduction without deviation. No intermaxillomandibular fixation was performed, and the patient followed a soft diet for 3 weeks. A panoramic radiograph at 5 months postoperatively showed a miniplate fracture. The patient's maximum mouth opening was 45 mm, with no malocclusion or symptoms. Scanning electron microscopy revealed striation lines on the removed, fractured hole, indicating a metal fatigue fracture. Postoperative interviews revealed the patient had bruxism and failed to follow the no smoking protocol.