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Transbuccal versus transoral approach for management of mandibular angle fractures: a prospective, clinical and radiographic study.

Khandeparker PV, Dhupar V, Khandeparker RV, Jain H, Savant K, Berwal V - J Korean Assoc Oral Maxillofac Surg (2016)

Bottom Line: A P-value less than 0.05 was considered significant.Infection was noted in 2 patients in group B compared 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Hospicio District Hospital, Margao, India.

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. Intraoperatively, the surgical time and the ease of surgical assess for fixation were noted. Patients were followed at 1 week, 3 months, and 6 months postoperatively 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 compared 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, inconspicuous 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.

No MeSH data available.


Related in: MedlinePlus

Postoperative radiographic interpretation of fracture reduction (group B).
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Figure 4: Postoperative radiographic interpretation of fracture reduction (group B).

Mentions: Radiographic evaluation of fracture reduction between the two groups was done by measuring the gap between the fractured segments of the mandible in postoperative OPG radiographs. These radiographs were taken within 1 day after surgery. All radiographs were performed using the Orthophos XG Machine (Sirona Dental Systems, Bensheim, Germany) with similar exposure parameters. On the radiographs, a line was drawn along the fracture and divided into three equal parts. Perpendicular lines were projected onto the fracture line to create reproducible measuring points. Measurements of the fracture gap were conducted on these 4 defined points with a digital caliper6.(Fig. 3, 4)


Transbuccal versus transoral approach for management of mandibular angle fractures: a prospective, clinical and radiographic study.

Khandeparker PV, Dhupar V, Khandeparker RV, Jain H, Savant K, Berwal V - J Korean Assoc Oral Maxillofac Surg (2016)

Postoperative radiographic interpretation of fracture reduction (group B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940199&req=5

Figure 4: Postoperative radiographic interpretation of fracture reduction (group B).
Mentions: Radiographic evaluation of fracture reduction between the two groups was done by measuring the gap between the fractured segments of the mandible in postoperative OPG radiographs. These radiographs were taken within 1 day after surgery. All radiographs were performed using the Orthophos XG Machine (Sirona Dental Systems, Bensheim, Germany) with similar exposure parameters. On the radiographs, a line was drawn along the fracture and divided into three equal parts. Perpendicular lines were projected onto the fracture line to create reproducible measuring points. Measurements of the fracture gap were conducted on these 4 defined points with a digital caliper6.(Fig. 3, 4)

Bottom Line: A P-value less than 0.05 was considered significant.Infection was noted in 2 patients in group B compared 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Hospicio District Hospital, Margao, India.

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. Intraoperatively, the surgical time and the ease of surgical assess for fixation were noted. Patients were followed at 1 week, 3 months, and 6 months postoperatively 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 compared 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, inconspicuous 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.

No MeSH data available.


Related in: MedlinePlus