THE MULTIPOINT CONTACT PLATE IN FRACTURE TREATMENT OF THE ATROPHIED MANDIBLE - ANIMAL STUDY AND CLINICAL-APPLICATION

Rapid consolation of osseous fractures requires stable immobilization of the fragments. In the atrophied mandible, the nutrient supply shoul d be ensured by protecting the periosseous soft tissue, i.e., the peri osteum. In the conventional placement of osteosynthesis plates, howeve r, the subimplant nutrition is restricted because of the high surface pressure between the osteosynthesis plate and bone. In order to improv e the subimplant nutrient supply, we designed a nerv osteosynthesis pl ate with a ''knobbed'' underside enabling multipoint contact. Histomor phologic comparative studies were conducted on 16 Gottingen minipigs w ith an average weight of 47.5 +/- 8 kg. In each minipig, one side of t he mandible was fractured and one side was left intact. One side of ea ch mandible was plated with a six-hole dynamic multipoint contact plat e and the other side with a conventional plate, The plates were applie d, either epiosseous or epiperiosteal, with bicortical screws under de fined torque. The results demonstrate the advantages of multipoint con tact plates over the conventional ones and create the clinical basis f or a ''bio-logical'' plate design that allows callus to grow between t he knobs and therefore provide adequate nutritional and vascular suppl y. The plate's knobbed profile also promotes extraosseous venous drain age without impeding intraosseous fluid flow. This plate is the logica l choice for rapid fracture consolidation in the high-grade atrophied mandible.