Abstract

Background: Maximum bite force quantifies force generation, but absolute values do not indicate whether masticatory loading is balanced between sides. This study described bilateral bite-force balance over six months after surgical treatment of Le Fort II maxillary fractures and explored differences between fixation groups.

Methods: This prospective, non-randomised controlled clinical study included 68 adults, with 34 receiving bioresorbable plate-and-screw fixation and 34 receiving titanium alloy fixation. Bite force was measured with the byte force device at the bilateral second molars at 1, 2 and 4 weeks and 3 and 6 months. Each site was measured three times with 2-minute intervals and the mean was used. The asymmetry index was the absolute right-left difference divided by their mean, multiplied by 100, and classified as Good (≤10%), Fair (>10-20%) or Poor (>20%).

Results: Median bilateral asymmetry decreased from 5.5% at week 1 to 2.9% at month 6. The proportion classified as Good increased from 69.1% to 89.7%, and no Poor classifications remained from month 3 onward. No statistically significant between-group differences were detected in the asymmetry index or categorical balance distribution at any follow-up.

Conclusion: Bilateral bite-force balance improved during follow-up and was classified as Good in nearly 90% of patients at six months. These findings are descriptive and do not establish equivalence or non-inferiority between fixation systems.