Does Random Osteosynthesis Material Affect the Preventive Mandible Plating Osteosynthesis (PMP) During Various Mandibular Lesions Surgery?—Lessons Learned

INTRODUCTION: A mandibular plating procedure during ORIF (open reduction and internal fixation) is a very common procedure during various types of mandibular fractures. The scope of each trauma can be caused by a majority of factors; however, maintaining proper bone shape, immobility, stable anatomic position, and improving healing after trauma is essential. Various titanium plating systems can be used. The so-called prophylactic or preventive mandibular plating (PMP) is a rare approach and can be applied in some special cases when the possibility of iatrogenic or pathologic mandibular fracture might happen at some period of time after mandibular surgery. The authors want to share and present their experience with PMP based on evaluated cases. METHODS: A total of 19 cases of PMP from the past 7 years were reviewed and evaluated to measure the necessity for this procedure, its outcomes, and to explore important bone-related remarks. RESULTS: When PMP was used in different cases of bone lesions treated, no pathologic fractures occurred after the procedure (P<0.05). A combination of some bone graft and PMP influenced good and improved healing. The scope of used plating systems, screws, their shape, position, and length have no standardization, and all of them worked in terms of bone stability (P>0.05). Inflammation in the operated area was rare (5.3%), whereas in 21.1% of cases, plates were removed because of further dental and implant procedures. Each mandibular lesion type, patient's age, sex, occurrence side, and used plating system does not have any correlation. The use of random plating in PMP is purely individual case-related, and each plating platform works regardless of load-bearing, load-sharing, or the combination of plates used. CONCLUSIONS: A PMP procedure is not a standard approach during teeth, cyst, or mandibular tumor removal; however, it can significantly improve patients' bone stability, healing, and greatly lower the ratio of some unwanted bone events. The authors noted that proper bone stability promotes greater healing, decreases bone bending, and reduces the possibility of granulation tissue formation. Used bone grafts with simultaneous PMP, which promoted good and desired bone healing. It seems that the necessity for PMP removal after some months is case-dependent.