title: Transbuccal versus transoral approach for management of mandibular angle fractures: a prospective, clinical and radiographic study.
abstract: OBJECTIVE
  We compared the transbuccal and transoral approaches in the management of mandibular angle fractures.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospicio District Hospital, Margao, India.
authors.forename: Purva Vijay Sinai
authors.identifier: 0000-0001-7789-3773
authors.initials: PV
authors.lastname: Khandeparker
authors.affiliation: Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, India.
authors.forename: Vikas
authors.identifier: 0000-0002-8208-1056
authors.initials: V
authors.lastname: Dhupar
authors.affiliation: Oral and Maxillofacial Surgery, Richardsons Dental and Craniofacial Hospital, Nagercoil, India.
authors.forename: Rakshit Vijay Sinai
authors.identifier: 0000-0003-0809-792X
authors.initials: RV
authors.lastname: Khandeparker
authors.affiliation: Department of Oral and Maxillofacial Surgery, Yogitha Dental College, Ratnagiri, India.
authors.forename: Hunny
authors.identifier: 0000-0002-4206-3902
authors.initials: H
authors.lastname: Jain
authors.affiliation: Oral and Maxillofacial Surgery, Private Practitioner, Bengaluru, India.
authors.forename: Kiran
authors.identifier: 0000-0003-0867-5523
authors.initials: K
authors.lastname: Savant
authors.affiliation: Department of Oral and Maxillofacial Surgery, Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, India.
authors.forename: Vikas
authors.identifier: 0000-0002-7121-1986
authors.initials: V
authors.lastname: Berwal
keywords: Mandibular angle fracture; Single miniplate; Transbuccal approach; Transoral approach