Comparison of Intraoral External Oblique Ridge Fixation and Transbuccal Lateral Cortical Plate Fixation for Mandibular Angle Fracture – A Randomized Control Trial

Background/objectives: Mandibular fractures account for almost half of all the fractures occurring in the maxillofacial region. Among mandibular fractures, angle fracture has a highest rate of post-operative complications (0-32%). This study compared the fixation of mandibular angle fracture with intra-oral external oblique ridge fixation versus transbuccal lateral cortical plate fixation using a single miniplate. Post-operative complications especially infection was noted and compared. Methods: A randomized controlled trial was done to compare the outcome of the two procedures. A total of 120 mandibular angle fracture patients were randomly allocated into Group A and Group B, 60 in each group. Group A underwent ORIF with intraoral approach and Group B underwent open reduction Internal fixation (ORIF) with transbuccal lateral cortical plate fixation for mandibular angle fractures. Patients of both groups were reviewed on 1st week, 1st month and third month for clinical signs of infection. Results: In group A, 10 (16.66%) patients suffered from infection and in group B, 4 (6.66%) of patients reported with infection at the last follow up visit that is at the end 3 months. No statistically significant p value after application of ‘Chi square test’ was noted for infection at the end of the third month review. Conclusion: Mandibular angle fractures can be effectively treated with transbuccal lateral cortical plate fixation as ease of plate adaptation, placement of plate in mid neutral area and less chance of infection.

[1]  P. Patil Lower third molar in the line of mandibular angle fractures treated with stable internal fixation: To remove or retain? , 2013 .

[2]  R. Sader,et al.  Treatment of mandibular angle fractures - linea obliqua plate versus grid plate. , 2012, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[3]  D. C. Jones,et al.  Intraoral external oblique ridge compared with transbuccal lateral cortical plate fixation for the treatment of fractures of the mandibular angle: prospective randomised trial. , 2012, The British journal of oral & maxillofacial surgery.

[4]  A. Rahim,et al.  MANDIBULAR FRACTURE OSTEOSYNTHESIS : A COMPARISON OF THREE TECHNIQUES , 2010 .

[5]  M. Orafi,et al.  Incidence of mandibular fractures in Eastern part of Libya. , 2009, Medicina oral, patologia oral y cirugia bucal.

[6]  H. Snooks,et al.  A randomised controlled trial comparing fixation of mandibular angle fractures with a single miniplate placed either transbuccally and intra-orally, or intra-orally alone. , 2009, International journal of oral and maxillofacial surgery.

[7]  P. Mehra,et al.  Internal fixation of mandibular angle fractures: a comparison of 2 techniques. , 2008, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[8]  T. Kofod,et al.  Open or closed repositioning of mandibular fractures: is there a difference in healing outcome? A systematic review. , 2008, Dental traumatology : official publication of International Association for Dental Traumatology.

[9]  M. Mushtaq,et al.  FREQUENCY OF MANDIBULAR FRACTURES AT THE ANGLE AS A RESULT OF MAXILLOFACIAL TRAUMA , 2008 .

[10]  D. Duan,et al.  Does the presence of mandibular third molars increase the risk of angle fracture and simultaneously decrease the risk of condylar fracture? , 2008, International journal of oral and maxillofacial surgery.

[11]  B. Baş,et al.  Biomechanical comparison of different plating techniques in repair of mandibular angle fractures. , 2007, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[12]  B. Chrcanovic,et al.  Facial fractures: a 1-year retrospective study in a hospital in Belo Horizonte. , 2004, Brazilian oral research.

[13]  R. Kellman,et al.  Mandibular angle fractures: two-miniplate fixation and complications. , 2003, Archives of facial plastic surgery.

[14]  K. Ali,et al.  Spectrum of mandibular fractures at a tertiary care dental hospital in Lahore. , 2003, Journal of Ayub Medical College, Abbottabad : JAMC.

[15]  J. C. Moreno,et al.  Complication rates associated with different treatments for mandibular fractures. , 2000, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[16]  J. Giglio Oral and Maxillofacial Trauma , 1997 .

[17]  H. Harnisch,et al.  [Mandibular fractures]. , 1974, Die Quintessenz.

[18]  J. Halazonetis The 'weak' regions of the mandible. , 1968, The British journal of oral surgery.