الفهرس 
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Abstract
The primary objective of this study was to compare the 3D trapezoidal condylar plate versus the standard two miniplates clinicallyو radiographically and biomechanically in fixation of subcondylar fractures.
The secondary objective was to evaluate the use of the TMAP approach in surgical reduction and fixation of the subcondylar fracture.
Twenty patients were enrolled in the study, selected from Emergency Department, Teaching Hospital of Alexandria University. selected patients were operated upon in the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University.
The patients were randomly assigned into two groups:
group I (Study group): 10 Patients were operated for subcondylar fracture fixation with the trapezoidal condylar plate (TCP).
group II (Control group): 10 Patients were operated for subcondylar fracture fixation with the two 4- holes miniplates.
Patients were followed up for 6 months postoperatively and the collected clinical and radiographic data was statistically analyzed.
Clinical results
The following clinical parameters were followed postoperatively at 1week, 1 month, 3 months and 6 months intervals: Maximal mouth opening, lateral excursions, Protrusive excursive movement, occlusion, Pain, Helikmo index.
There was only a statistically significant difference in the MMO at 3 months between the two groups. The rest of parameters showed statistically insignificant differences.
The exposure time and accessibility of the TMAP for reduction and fixation of the subcondylar fractures were assessed intraoperatively. The approach had an exposure time of 20.54 ± 5.1 minutes. All fractures were adequately reduced and fixed through the approach.
Radiographic findings
The mean bone density was higher in the TCP group in both 3 months and 6 months follow up and was with statistically significant difference.
The shortening of the ramus and the condylar angulation measurements were statistically significant in the two groups between the preoperative and immediate postoperative follow up. However, these measurements were statistically insignificant between in the two groups between the immediate postoperative and 6 months follow up.
Biomechanical results
The results revealed that there was a difference in the values of Von Mises stresses induced on the plates, screws and the fracture site during the clenching maxillofacial application between the two models.
The results of the amount of vertical displacement induced around the fracture surface revealed that TCP reflects a lower displacement (116 µm) than miniplate (207.3 µm).