A Comparative Study of Transbuccal and Extraoral Approaches in the Management of Mandibular Angle Fractures: A Systematic Review
DOI:
https://doi.org/10.3889/oamjms.2016.096Keywords:
extraoral approach, transbuccal approach, mandibular angle fracture, trocar canula, internal fixation, postoperative complicationsAbstract
AIM: The aim of the present study was to compare the extraoral and transbuccal approaches for the treatment of mandibular angle fractures with regard to postoperative complications.
PATIENTS AND METHODS: An electronic search for relevant articles without language and date restrictions was performed in July 2016. Inclusion criteria were studies in humans including randomised controlled trials (RCTs), controlled clinical trials (CCTs), prospective studies (PS), and retrospective studies (RS). In total, 107 patients were included from four studies (transbuccal = 48, extraoral = 59). The follow-up period varied from 3 months to 24 months.
RESULTS: In extraoral group the average of unsightly scar, facial nerve weakness, infection, malocclusion, plate removal were found to be 55% (range,10% -100%), 26.5% (range, 0%-53%), 11.7% (range, 0% - 20%), 22.5% (range, 0% -50%), 6.7% (range, 3.3% - 10%) respectively while these parameters in the transbuccal approach were found to be no obvious unsightly scar, 6.6 % (range, 0%-13.3%), 8.1% (range, 0% - 20%), 4.8% (range, 0% - 12.5%), 0%. The incidence of postoperative trismus and nonunion/malunion were 0% in both groups.
CONCLUSION: The results of this study suggest that transbuccal approach shows fewer complications than extraoral approach when used for the treatment of mandibular angle fractures.Downloads
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References
Booth PW, Schendel SA, Hausamen JE. Maxillofacial surgery, 2nd ed, vol. 1. London, UK: Churchill Livingstone, 2007; p. 74–76.
Gear AJ, Apasova E, Schmitz JP, Schubert W. Treatment modalities for mandibular angle fractures. J Oral Maxillofac Surg. 2005;63(5):655-63. http://dx.doi.org/10.1016/j.joms.2004.02.016 PMid:15883941
Zix J, Lieger O, Iizuka T. Use of straight and curved 3- dimensional titanium miniplates for fracture fixation at the mandibular angle. J Oral Maxillofac Surg. 2007;65(9):1758-63. http://dx.doi.org/10.1016/j.joms.2007.03.013 PMid:17719394
Iizuka T, Lindqvist C, Hallikainen D, Paukku P. Infection after rigid internal fixation of mandibular fractures: A clinical and radiologic study. J Oral Maxillofac Surg. 1991; 49(6):585-93. http://dx.doi.org/10.1016/0278-2391(91)90340-R
Lamphier J, Ziccardi V, Ruvo A, Janel M. Complications of mandibular fractures in an urban teaching center. J Oral Maxillofac Surg. 2003;61(7):745-9. http://dx.doi.org/10.1016/S0278-2391(03)00147-2
Ellis E 3rd. Treatment methods for fractures of the mandibular angle. J Craniomaxillofac Trauma. 1996; 2(1):28-36. PMid:11951472
Guimond C, Johnson JV, Marchena JM. Fixation of mandibular angle fractures with a 2.0-mm 3- dimensional curved angle strut plate. J Oral Maxillofac Surg. 2005;63(2):209-14. http://dx.doi.org/10.1016/j.joms.2004.03.018 PMid:15690289
Toma VS, Mathog RH, Toma RS, Meleca RJ. Transoral versus extra-oral reduction of mandible fractures: A comparison of complication rates and other factors. Otolaryngol Head Neck Surg. 2003;128(2): 215–19. http://dx.doi.org/10.1067/mhn.2003.59 PMid:12601317
Sudhakar GV, Rajasekhar G, Dhanala S, Vura N, Ramisetty S. Comparison of Management of Mandibular Angle Fractures by Three Approaches. J Maxillofac Oral Surg. 2015;14(4):979-85. http://dx.doi.org/10.1007/s12663-015-0779-0 PMid:26604473
Pattar P, Shetty S, Degala S. A Prospective Study on Management of Mandibular Angle Fracture. J Maxillofac Oral Surg. 2014;13 (4): 592-8. http://dx.doi.org/10.1007/s12663-013-0542-3 PMid:26225033 PMCid:PMC4518788
Gulses A, Kilic C, Sencimen M. Determination of a safety zone for transbuccal trocar placement: an anatomical study. Int J Oral Maxillofac Surg. 2012;41(8):930-33. http://dx.doi.org/10.1016/j.ijom.2012.02.013
Kale TP, Baliga SD, Ahuja N, Kotrashetti SM. A comparative study between transbuccal and extra-oral approaches in treatment of mandibular fractures. J Maxillofac Oral Surg. 2010;9(1):9-12. http://dx.doi.org/10.1007/s12663-010-0026-7 PMid:23139558 PMCid:PMC3453684
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? J Oral Maxillofac Surg. 2012; 70(11):2620-8. http://dx.doi.org/10.1016/j.joms.2012.07.051 PMid:22959879
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, for the STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007; 370(9596):1453–7. http://dx.doi.org/10.1016/S0140-6736(07)61602-X
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000; 283(15):2008–12. http://dx.doi.org/10.1001/jama.283.15.2008 PMid:10789670
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7): e1000097. http://dx.doi.org/10.1371/journal.pmed.1000097 PMid:19621072 PMCid:PMC2707599
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 J Otolaryngol Head Neck Surg. 2011 ;63(2):190-2. http://dx.doi.org/10.1007/s12070-011-0236-4 PMid:22468259 PMCid:PMC3102161
Singh V, Khatana S, Bhagol A. Superior border versus inferior border fixation in displaced mandibular angle fractures: prospective randomized comparative study. Int J Oral Maxillofac Surg. 2014; 43(7):834-40. http://dx.doi.org/10.1016/j.ijom.2013.09.009 PMid:24636170
Cillo JE Jr, Ellis E 3rd. Treatment of patients with double unilateral fractures of the mandible. J Oral Maxillofac Surg. 2007;65(8):1461-9. http://dx.doi.org/10.1016/j.joms.2006.08.013 PMid:17656269
Wales CJ, Carter LM. A safe and accurate technique for transbuccal incision. Br J Oral Maxillfac Surg. 2007; 45(2):177. http://dx.doi.org/10.1016/j.bjoms.2006.03.004 PMid:16621207
Cole P, Rottgers SA, Cameron H, HollierJr LH. Improving the minimally invasive approach to mandible angle repair. J Craniofac Surg. 2008;19(2):525–7. http://dx.doi.org/10.1097/SCS.0b013e3180a77340 PMid:18362737
Zide MF, Kent JN. Indications for open reduction of mandibular condyle fractures. J Oral Maxillofac Surg. 1983;41(2):89–98. http://dx.doi.org/10.1016/0278-2391(83)90214-8
Shetty V, Bertolami CN. Wound Healing. In Peterson's Principles Of Oral and Maxillofacial Surgery: Second Edition, Chapter 1, 2004; 1: 9.
Vineeth K, Lalitha RM, Prasad K, Ranganath K, Shwetha V, Singh J. A comparative evaluation between single noncompression titanium miniplate and three dimensional titanium miniplate in treatment of mandibular angle fracture - a randomized prospective study. J Craniomaxillofac Surg. 2013;41(2):103-9. http://dx.doi.org/10.1016/j.jcms.2012.05.015 PMid:22809633
Siddiqui A, Markose G, Moos KF, McMahon J, Ayoub AF. One miniplate versus two in the management of mandibular angle fractures: a prospective randomised study. Br J Oral Maxillofac Surg. 2007;45(3):223-5. http://dx.doi.org/10.1016/j.bjoms.2006.08.016 PMid:17110006
Mendonca D, Kenkere D. Avoiding occlusal derangement in facial fractures: An evidence based approach. Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India. 2013;46(2):215-20. http://dx.doi.org/10.4103/0970-0358.118596 PMid:24501457 PMCid:PMC3901902
Singh V, Puri P, Arya S, Malik S, Bhagol A. Conventional versus 3- dimensional miniplate in management of mandibular fracture: a prospective randomized study. Otolaryngol Head Neck Surg. 2012;147(3):450–5. http://dx.doi.org/10.1177/0194599812449437 PMid:22647925
Levy FE, Smith RW, Odland RM, Marentette LJ. Monocortical miniplate fixation of mandibular fractures. Arch Otolaryngol Head Neck Surg. 1991;117 (2):149-54. http://dx.doi.org/10.1001/archotol.1991.01870140037002 PMid:1991053
Valentino J, Levy FE, Marentette LJ. Intraoral Monocortical miniplating of mandible fractures. Arch Otolaryngol Head Neck Surg. 1994;120(6):605-12. http://dx.doi.org/10.1001/archotol.1994.01880300021003 PMid:8198783
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