{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:59:44Z","timestamp":1790963984256,"version":"4.1.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Ulm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Head Face Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>The treatment of mandibular angle fractures remains controversial, particularly regarding the method of fixation. The primary aim of this study was to compare surgical outcomes following treatment with 1-plate versus 2-plate fixation across two oral and maxillofacial surgery clinics. The secondary aim was to evaluate associations between patient-, trauma-, and procedure-specific factors with postoperative complications and to identify high-risk patients for secondary osteosynthesis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In this retrospective two-center cohort study, patients who underwent surgical treatment for mandibular angle fractures via a transoral approach using either 1-plate or 2-plate fixation over a 10-year period were included. Clinic A exclusively performed 1-plate fixation, while clinic B used 2-plate fixation. Demographic, clinical, radiological, and treatment data were analysed. Multivariable analyses were conducted to identify predictors of postoperative complications and secondary osteosynthesis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 253 patients with 264 mandibular angle fractures were included. Violence was the most common mechanism of injury (<jats:italic>n<\/jats:italic>\u2009=\u2009131; 49.6%). Postoperative complications occurred in 34.6% of the cases at clinic A and 26.8% at clinic B (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Secondary osteosynthesis was required in 9.4% at clinic A and 7.6% of the cases at clinic B, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.6547). Multinomial regression analysis identified smoking, diabetes mellitus, patient noncompliance, left-sided mandibular angle fractures, presence of a third molar (M3), partial M3 eruption, vertical depth A of M3 and horizontal impaction class II (Pell and Gregory) as significant predictors of postoperative complications. Logistic regression analysis identified smoking, diabetes mellitus, patient noncompliance, left mandibular angle fractures, mandibular angle und body fractures and presence of third molars as significant predictors of secondary osteosynthesis. As patient age there is an increased tendency for wound infection and plate\/screw loosening (<jats:italic>p<\/jats:italic>\u2009=\u20090.06). A longer interval between trauma and surgery was associated with a higher risk of postoperative occlusal disturbances (<jats:italic>p<\/jats:italic>\u2009=\u20090.06). Patients with a longer duration of postoperative IMF were significantly associated with a higher rate of wound infection and secondary osteosynthesis (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Both 1-plate and 2-plate fixation techniques demonstrated acceptable outcomes. Single-plate fixation offers sufficient stability for most mandibular angle fractures with fewer complications, supporting its use in uncomplicated cases. Double-plate fixation may be reserved for complex cases. Higher complication rates were associated with patient-related and anatomical risk factors. Individualized treatment and further prospective studies are needed to refine surgical strategies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s13005-025-00540-7","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T05:00:01Z","timestamp":1757394001000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["One-plate versus two-plate fixation in the treatment of mandibular angle fractures: a retrospective two-centre comparative study"],"prefix":"10.1186","volume":"21","author":[{"given":"Andreas","family":"Sakkas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Scheurer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Kasper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Ebeling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Schramm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Wilde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Lethaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"H\u00e4fner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fcdiger","family":"Zimmerer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Naros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"issue":"4","key":"540_CR1","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1007\/s10006-024-01275-6","volume":"28","author":"J Pfister","year":"2024","unstructured":"Pfister J, Shazwani FN, M\u00fcller M, Burkhard JP. 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Int J Surg Dezember. 2014;12(12):1500\u201324.","journal-title":"Int J Surg Dezember"}],"container-title":["Head &amp; Face Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13005-025-00540-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13005-025-00540-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13005-025-00540-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T06:49:00Z","timestamp":1757486940000},"score":1,"resource":{"primary":{"URL":"https:\/\/head-face-med.biomedcentral.com\/articles\/10.1186\/s13005-025-00540-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,9]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["540"],"URL":"https:\/\/doi.org\/10.1186\/s13005-025-00540-7","relation":{},"ISSN":["1746-160X"],"issn-type":[{"value":"1746-160X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,9]]},"assertion":[{"value":"9 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial number"}},{"value":"The authors declare that they have no competing or financial interests, either directly or indirectly, in the products listed in the study. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"Results of this study will be presented as an oral presentation at the 4. national congress of Oral and Maxillofacial Surgery, 30.10.-01.11.2025, Berlin, Germany.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Presentation"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human ethics and consent to participate declarations"}},{"value":"Ethical approval for this study was obtained from the ethics committee of the University of Ulm (approval reference: 102\/23, approval date: 05.04.2023) and University of T\u00fcbingen (approval reference: 537\/2019BO2, approval date: 30.07.2019). The study is based on a retrospective analysis of anonymized, routinely collected clinical data. As such, the data were already available in institutional records prior to the study initiation, and no interventions or additional data collection outside routine care were performed. Both ethics committees explicitly waived the requirement for informed consent and approved the use of historical data without restrictions on the date range of the data included. Thus, neither additional IRB waivers are required nor is exclusion of data collected prior to the approval dates necessary. No data beyond the cut-off date of September 2024 were included in the analysis. All data were fully collected and finalized prior to manuscript submission. This research was conducted in full accordance with the ethical standards of the institutional research committee as well as with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this non-interventional observational retrospective study, all data were also anonymized and de-identified prior to analysis. Full compliance with data protection and safeguarding of data was ensured and no information which could identify the patients was collected. Reporting was based on the recommendations of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative [].","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}],"article-number":"62"}}