"Z-plate for mandibular fractures"- Design patent for Dr Kende & team (OMFS), GDCH Mumbai

What inspired you to come up with this idea?

The face is an anatomically complex region which is vital in terms of aesthetics as well as function. Any injury to the face can impair the person’s ability to eat, speak, interact with others, and perform other important functions. Out of these injuries, mandibular fractures are the most common owing to its anatomic position with less support from the cranium. These fractures are either managed by open reduction or closed reduction. Out of which open reduction is carried out by rigid or semi-rigid fixation which is promoted by the AO/ASIF. In this concept, compression, tension, torsion and shearing forces which develop under functional loading, are neutralized by thick solid plates fixed by bicortical screws. The success of this approach not only depends on the surgeon’s clinical expertise but also on the efficiency of the plate systems that are used which still has a lot of scope for improvement. Therefore, we thought of coming up with an innovation pertaining to this field for the betterment of patients.

Can you brief us about the different plate systems currently available in the market?

There are different kinds of plate systems currently available in the market. The most basic being mini-plates which provide semi-rigid fixation. There are also newer categories of plates made available as of today such as the 3D mini-plates by Framed and Dupoirieux where its shape is based on the principle of the quadrangle as a geometrically stable configuration for support.

Why did you feel there was a need for innovation in this field?

We found that the currently available plates have a few shortcomings which hamper the post-operative results in the patient. In the conventional mini-plates, a doubt arises whether its fixation is sufficiently stable for fractures that cannot be adequately reduced. Even the newer variety of 3D mini-plates have a few drawbacks such as being difficult to adapt, difficult to use in fractures involving important structures like the mental nerve and has to be bent in 3 dimensions. Looking at these shortcomings we thought of developing a plate system which can overcome these issues while maintaining the same level of efficiency.

What makes your Z plate different than others?

In our Z plate, instead of two vertical bars connecting the two horizontal bars, we have provided a single oblique bar connecting the two horizontal bars thus reducing the material, providing inter-plate stabilization and for easy adaptation in the region of the mental nerve. The plate has also shown better stability and strength compared to other conventional plate systems based on Finite Element Analysis results.

What are your expectations with this design?

We expect that this Z plate can be easily adapted in the transition zone of Parasymphysis and body of mandible without damaging the mental nerve & it can also be adapted in symphysis, the body of mandible & angle region. Thus reducing time & material and providing better strength & stability in fracture immobilization.

What are your future plans pertaining to this innovation?

We have already completed a finite element analysis on this plate and received promising data. Along with this, we have recently acquired its design patent from the authorities. Also, we are conducting a Randomized Controlled Trial (RCT) where we will compare our Z plate with the conventional 3D miniplate. We hope on achieving positive results which can help us in promoting our Z plate for routine use thus improving the overall efficiency of mandibular fracture management.

Dr Prajwalit Kende

Post-Graduate Teacher, Dept of Oral & Maxillofacial Surgery, Govt Dental College & Hospital, Mumbai. Fellow AOCMF - Morriston Hospital, Swansea, United Kingdom. Trainee - Surgical Oncology, Head & Neck, Tata Hospital, Mumbai.
1. Copyright granted for the work on “Temporomandibular Joint Hematoma Nerve Block” in May-2020 (Diary No- 4741/2020-CO/L)
2. Design patent granted with number 327731-001 on 02/10/2020 for “Z plate for management of mandibular fracture”.
3. Patent application filled with BR no- 24735 (patent numbered- 201921046736 dated 15/11/2019) for Mobile Dental Vehicle with a solar-powered portable dental treatment unit & portable dental chair.