Management of Mandibular angle fractures using three-dimensional strut plate: A comparison between transoral and transbuccal approaches

Aim: To compare between transoral and transbuccal approaches in the management of mandibular angle fractures using 3d-strut plates.
Materials and methods: Ten patients with unilateral mandibular angle fracture with an age range 18-56 years were included in our study. The patients were divided into two groups based on the approach for the 3d strut plate placement and fixation. Group A included 5 patients undergoing open reduction and internal fixation (ORIF) via transoral approach and group B included 5 patients undergoing ORIF via transbuccal approach. Patients were followed up clinically at 1 week, 1 month and 3 months postoperatively and radiographically at 1 week and 3 months postoperatively.
Results: In the transbuccal group patients, extraoral scar evaluation revealed 3 patients (60%) with invisible scar, 2 patients (40%) with barely visible scar after 3 months postoperatively. The mean time of the surgical procedure starting from the first incision till the last suture was 38.4±6.5 minutes for group A and 41.1±5.2 minutes for group B patients. None of the patients in both groups was introduced with malocclusion, facial nerve affection, segmental mobility, wound dehiscence, infections or parathesia during different follow up periods. Radiographic evaluation didn’t reveal any kind of hardware failures in the terms of plate fracturing or screws loosening and there was no statistically significant difference in the mean bone density along the fracture line between both groups.
Conclusion: The use of 3d strut plates in angle fractures through transoral or transbuccal approaches resulted in excellent results with no significant difference clinically or radiographically between both approaches. However, The transbuccal approach was our preferred technique due to ease of use, negligible necessity for plate bending and easy placement of the plate in the neutral mid-point region.