RESEARCH ARTICLE


Transbuccal vs. Intraoral Approach using an Angulated Screwdriver in Fixation of a Mandibular Angle Fracture



Shadia Abdel-Hameed Elsayed1, *, Hanan Mohamed Reda1, 5, Maiada Mohammed Awadd1, Samah Ibrahim Mourad2, Hanan MR Shokeir1, 5, Emad Hussein Elsayed3, Essam A Al-Moraissi4
1 Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
3 Department of Plastic Surgery, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
4 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Dhamar, Yemen
5 Department of Oral and Maxillofacial Surgery and Rehabilitation, Faculty of Dentistry, UMM-Al Qura University, Makkah, KSA


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Creative Commons License
© 2022 Elsayed et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt; E-mail address: shadiaelsayed25@gmail.com


Abstract

Objectives:

This study aimed to evaluate surgical stability and cosmetic outcomes in patients with mandibular angle fractures (MAFs) using an angled screwdriver (ASD) versus transbuccal trocar (TBT) for single locking plate fixation.

Methods:

A prospective cohort clinical study was done on 44 male patients (88%) and 6 (12% females patients with MAFs, categorized into 2 groups. Group A patients were treated with strictly intraoral vestibular incision using an angulated screwdriver; group B was treated with TBT. Both groups placed a single locking 2.0 mm mini-plates at the inferior border. The main outcome variables were the perioperative complication rate.

Results:

There were no statistical differences between both groups regarding postoperative wound dehiscence, screw or/and plate looseness, infection rate, and inferior dental nerve injury. The study (ASD) approach took 28.10±3.3minutes, while the TBT approach took 37.40±1.75minutes, indicating a highly significant difference in operating time (P=0.001). Post-operative edema had decreased significantly in the ASD group.

Conclusion:

According to the present results, a strictly intraoral approach for ASD enabled stable fixation of MAFs using a single mini-locking plate. This can significantly reduce operation time and postoperative edema and prevent extraoral scarring.

Keywords: Angulated drills, Mandible, Fracture, Mandible, Angle, Intraoral.