MODERN METHODS OF OSTEOSYNTHESIS IN MANDIBULAR FRACTURES: TOWARD STABLE, COMPLICATION‑SPARING FIXATION

Abstract

Modern osteosynthesis for mandibular fractures has shifted from wire fixation and prolonged maxillomandibular fixation toward rigid and semi‑rigid internal fixation concepts that enable early function and lower complication rates. Contemporary strategies are grounded in AO load‑bearing and load‑sharing principles and include monocortical miniplates along Champy’s ideal osteosynthesis lines, locking plate–screw systems, three‑dimensional (3D) plates, lag screws, and bioresorbable plating systems. Evidence from comparative studies suggests that 3D plates and lag screws can reduce postoperative complications or operative time in selected fracture patterns, while locking plates improve stability in more demanding situations. Bioresorbable systems are increasingly used for linear, non‑displaced fractures, particularly where hardware removal is undesirable. This narrative review summarizes the biomechanical principles underlying modern mandibular osteosynthesis, describes key fixation systems, and discusses their indications, advantages, and limitations. A descriptive comparison of methods and an illustrative analysis of complication trends are provided to support evidence‑based selection of fixation strategies in clinical practice.