الفهرس 
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Abstract
The purpose of this study is to compare the effect of using a two perpendicular miniplates versus two conventional miniplates in the treatment of anterior mandibular fractures on both clinical and radiographic levels.
The study included twenty patients with anterior mandibular fractures who were admitted to the Emergency Department of Alexandria University Teaching Hospital. The patients were chosen at random, with no preference for age or gender, and had a recent anterior mandibular fracture requiring open reduction and internal fixation. Patients with systemic diseases that could interfere with the healing process were excluded.
Each patient underwent a thorough clinical and radiographic examination, as well as a thorough history. Patients were divided into two groups: group A (n=10) a two perpendicular miniplates with a thickness of 2 mm and monocortical screws with a diameter of 2 mm and a length of 11 mm were used. In group B (n=10), two conventional miniplates with 1.0 mm thickness plates and mono-cortical screws with 2.0 mm diameter and a length of 11 mm were used.
6.1.1 Surgical procedure
Following IMF, the fracture line was exposed through an intra-oral incision, and bone fragments were reduced. In group A, perpendicular two miniplates were applied, one on the inferior border of mandible and the other subapical. For group B, conventional two mini-plates based on Champy’s osteosynthesis lines were used. All patients were admitted and received antibiotics both pre-and post-operatively for 5-7 days after discharge.
6.1.2 Clinical and radiographic follow up
For 12 weeks after surgery, the pain was assessed using the Visual Analogue Scale, as while edema was assessed using the Visual Descriptor Scale (ability to pit) , maximal inter-incisal mouth opening, state of occlusion, and infection. All patients reported pain levels decreased statistically significantly over the course of the study (p<0.001). According to the ANOVA test for repeated measures, all of the cases showed no statistically significant improvement in their maximal mouth opening over the course of the study; p<0.001 for group A and p<0.001 for group B. Occlusal examination revealed that all of the patients occlusal and inter-cuspal relations were normal except for one patient in group A due to in appility of the patient to commit to traction elastics. After the first week of surgery, two cases in each group developed a postoperative wound infection, which was treated with an antibiotic course and proper wound care. However, the wound had healed by the end of the follow-up period due to secondary intention.
6.1.3 Radiographic Evaluation
To calculate mean bone density, an immediate post-operative CBCT-scan, and a three-month CBCT-scan were performed. During the follow-up period, the mean bone density showed significance .