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Dr Syed Abdul Rauf Shah
Dr Abdul Samad Gichki
Dr Aysha Sadaf
Dr Anosha Mujtaba
Dr Hamid Rahman Tipuo
Dr Muhammad Umair


Transbuccal, Transoral approaches, Mandibular Angle Fracture.


Objectives: To comparison the outcomes of Transbuccal versus Transoral approaches for Management of Mandibular Angle Fracture.

Materials and Methods:  This comparative observational study was conducted at Shifa College of Dentistry Islamabad, Pakistan. The study duration was 6 month from Nov 2023 to April 2024. A total of 62 patients who met the inclusion criteria were enrolled in the study. These patients were divided into two groups: Group A underwent the transoral approach, while Group B underwent the transbuccal approach. Radiographs were utilized to evaluate fracture displacement and type, and blood tests were conducted as part of preoperative assessment. Prior to surgery, patients received antibiotics to prevent infection. Erich's arch bars were placed one day before surgery to ensure occlusal stability. Following surgery, thorough follow-up was conducted, and patients were given postoperative instructions to aid in their recovery process.

Results: In this study, a total of 62 patients were enrolled, divided into two groups, with a mean age of 30.90 ± 7.68 years. The number of male patients in Group A and Group B were 14 (45.2%) and 19 (61.3%), respectively, while the number of female patients were 17 (54.8%) and 12 (38.7%), respectively, with a P-value of 0.20. Surgical access ease was found to be insignificant between both groups. The gap between fracture segments was smaller in the transbuccal group than in the transoral group, with a p-value of 0.00. The mean surgical times for Group A and Group B were 51.29 ± 1.79 and 59.19 ± 2.35, respectively. Scarring was observed in the transbuccal group.

Conclusion: Even though both methods were similar in many aspects, the transbuccal approach proved to be more effective for treating mandibular angular fractures.

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1. Patel N, Kim B, Zaid W. A detailed analysis of mandibular angle fractures: epidemiology, patterns, treatments, and outcomes. Journal of Oral and Maxillofacial Surgery. 2016;74(9):1792-9.
2. Panesar K, Susarla SM, editors. Mandibular fractures: Diagnosis and management. Seminars in Plastic Surgery; 2021: Thieme Medical Publishers, Inc.
3. Meram AT, Woo BM. Oral Cancer Management. Peterson’s Principles of Oral and Maxillofacial Surgery. 2022:1009-55.
4. Panneerselvam E, Prasad PJ, Balasubramaniam S, Somasundaram S, Raja KV, Srinivasan D. The influence of the mandibular gonial angle on the incidence of mandibular angle fracture—A radiomorphometric study. Journal of Oral and Maxillofacial Surgery. 2017;75(1):153-9.
5. Seeley-Hacker BL, Holmgren EP, Harper CW, Lauer CS, Van Citters DW. An anatomic predisposition to mandibular angle fractures. Journal of Oral and Maxillofacial Surgery. 2020;78(12):2279. e1-. e12.
6. Fox AJ, Kellman RM. Mandibular angle fractures: two-miniplate fixation and complications. Archives of facial plastic surgery. 2003;5(6):464-9.
7. Beza SA, Attia S, Ellis E, Omara L. A comparative study of transbuccal and extraoral approaches in the management of mandibular angle fractures: A systematic review. Open access Macedonian journal of medical sciences. 2016;4(3):482.
8. Sudhakar GV, Rajasekhar G, Dhanala S, Vura N, Ramisetty S. Comparison of management of mandibular angle fractures by three approaches. Journal of maxillofacial and oral surgery. 2015;14:979-85.
9. Chinnaiah R. A Comparative study between Transbuccal and Transoral Approaches for Management of Mandibular Angle Fractures using Single Miniplates: Adhiparasakthi Dental College and Hospital, Melmaruvathur; 2020.
10. Sehrawat K, Malik B, Vallabha H, Vaishnavi AB, Pendyala SK, Ibrahim M, et al. A comparative evaluation of transbuccal versus transoral approach for the management of mandibular angle fractures: A prospective, clinical, and radiographic study. Journal of Pharmacy and Bioallied Sciences. 2021;13(Suppl 2):S1295-S9.
11. Kumar S, Prabhakar V, Rao K, Brar R. A comparative review of treatment of 80 mandibular angle fracture fixation with miniplates using three different techniques. Indian Journal of Otolaryngology and Head & Neck Surgery. 2011;63:190-2.
12. Sugar A, Gibbons A, Patton D, Silvester K, Hodder S, Gray M, 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. International journal of oral and maxillofacial surgery. 2009;38(3):241-5.
13. Devireddy SK, Kumar RK, Gali R, Kanubaddy SR, Dasari MR, Akheel M. Transoral versus extraoral approach for mandibular angle fractures: A comparative study. Indian Journal of Plastic Surgery. 2014;47(03):354-61.
14. Pattar P, Shetty S, Degala S. A prospective study on management of mandibular angle fracture. Journal of maxillofacial and oral surgery. 2014;13:592-8.
15. Wan K, Williamson RA, Gebauer D, Hird K. Open reduction and internal fixation of mandibular angle fractures: does the transbuccal technique produce fewer complications after treatment than the transoral technique? Journal of oral and maxillofacial surgery. 2012;70(11):2620-8.
17. Khan A, Khitab U, Khan MT. A comparative analysis of rigid and non rigid fixation in mandibular fractures: A prospective study. Pakistan Oral & Dental Journal. 2010;30(1).
18. Khandeparker PVS, Dhupar V, Khandeparker RVS, Jain H, Savant K, Berwal V. Transbuccal versus transoral approach for management of mandibular angle fractures: a prospective, clinical and radiographic study. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 2016;42(3):144.

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