Transbuccal versus transoral approach for management of mandibular angle fractures: a prospective, clinical and radiographic study
Khandeparker Purva Vijay Sinai, Dhupar Vikas, Khandeparker Rakshit Vijay Sinai, Jain Hunny, Savant Kiran, Berwal Vikas,
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( Khandeparker Purva Vijay Sinai ) - Hospicio District Hospital Department of Oral and Maxillofacial Surgery
( Dhupar Vikas ) - Goa Dental College and Hospital Department of Oral and Maxillofacial Surgery
( Khandeparker Rakshit Vijay Sinai ) - Richardsons Dental and Craniofacial Hospital Oral and Maxillofacial Surgery
( Jain Hunny ) - Yogitha Dental College Department of Oral and Maxillofacial Surgery
( Savant Kiran ) - Private Practitioner Oral and Maxillofacial Surgery
( Berwal Vikas ) - Post Graduate Institute of Medical Sciences Department of Oral and Maxillofacial Surgery
KMID : 0355620160420030144
Abstract
Objectives: We compared the transbuccal and transoral approaches in the management of mandibular angle fractures.
Materials and Methods: Sixty patients with mandibular angle fractures were randomly divided into two equal groups (A, transoral approach; group B, transbuccal approach) who received fracture reduction using a single 2.5 mm 4 holed miniplate with a bar using either of the two approaches. Intra-operatively, the surgical time and the ease of surgical assess for fixation were noted. Patients were followed at 1 week, 3 months, and 6 months postop-eratively and evaluated clinically for post-surgical complications like scarring, infection, postoperative occlusal discrepancy, malunion, and non-union. Radiographically, the interpretation of fracture reduction was also performed by studying the fracture gap following reduction using orthopantomogram tracing. The data was tabulated and subjected to statistical analysis. A P-value less than 0.05 was considered significant.
Results: No significant difference was seen between the two groups for variables like surgical time and ease of fixation. Radiographic interpretation of fracture reduction revealed statistical significance for group B from points B to D as compared to group A. No cases of malunion/non-union were noted. A single case of hypertrophic scar formation was noted in group B at 6 months postsurgery. Infection was noted in 2 patients in group B com-pared to 6 patients in group A. There was significantly more occlusal discrepancy in group A compared to group B at 1 week postoperatively, but no long standing discrepancy was noted in either group at the 6 months follow-up.
Conclusion: The transbuccal approach was superior to the transoral approach with regard to radiographic reduction of the fracture gap, inconspicu-ous external scarring, and fewer postoperative complications. We preferred the transbuccal approach due to ease of use, minimal requirement for plate bending, and facilitation of plate placement in the neutral mid-point area of the mandible.
키워드
Mandibular angle fracture; Transoral approach; Transbuccal approach; Single miniplate
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