Treatment of Mandibular Angle Fractures

Jung-Ho Lee, Jung-Ho Lee

Abstract

The management of mandibular angle fractures is often challenging and results in the highest complication rate among fractures of the mandible. In addition, the optimal treatment modality for angle fractures remains controversial. Traditional treatment protocols for angle fractures have involved rigid fixation with intraoperative maxillomandibular fixation (MMF) to ensure absolute stability. However, more recently, non-compression miniplates have gained in popularity and the use of absolute intraoperative MMF as an adjunct to internal fixation has become controversial. In this article, the history of, and current trends in, the treatment of mandibular angle fractures will be briefly reviewed. In addition, issues regarding the management of the third molar tooth will be discussed.

Keywords: Fracture fixation, internal; Mandibular fractures; Molar, third.

References

    1. Allareddy V, Allareddy V, Nalliah RP. Epidemiology of facial fracture injuries. J Oral Maxillofac Surg. 2011;69:2613–2618.
    1. Haug RH, Prather J, Indresano AT. An epidemiologic survey of facial fractures and concomitant injuries. J Oral Maxillofac Surg. 1990;48:926–932.
    1. Wagner WF, Neal DC, Alpert B. Morbidity associated with extraoral open reduction of mandibular fractures. J Oral Surg. 1979;37:97–100.
    1. Chuong R, Donoff RB, Guralnick WC. A retrospective analysis of 327 mandibular fractures. J Oral Maxillofac Surg. 1983;41:305–309.
    1. Iizuka T, Lindqvist C. Rigid internal fixation of fractures in the angular region of the mandible: an analysis of factors contributing to different complications. Plast Reconstr Surg. 1993;91:265–271.
    1. Ellis E, 3rd, Walker L. Treatment of mandibular angle fractures using two noncompression miniplates. J Oral Maxillofac Surg. 1994;52:1032–1036.
    1. Ellis E., 3rd Treatment methods for fractures of the mandibular angle. Int J Oral Maxillofac Surg. 1999;28:243–252.
    1. James RB, Fredrickson C, Kent JN. Prospective study of mandibular fractures. J Oral Surg. 1981;39:275–281.
    1. Schmelzeisen R, McIff T, Rahn B. Further development of titanium miniplate fixation for mandibular fractures: experience gained and questions raised from a prospective clinical pilot study with 2.0 mm fixation plates. J Craniomaxillofac Surg. 1992;20:251–256.
    1. Ellis E, 3rd, Walker LR. Treatment of mandibular angle fractures using one noncompression miniplate. J Oral Maxillofac Surg. 1996;54:864–871.
    1. Gear AJ, Apasova E, Schmitz JP, Schubert W. Treatment modalities for mandibular angle fractures. J Oral Maxillofac Surg. 2005;63:655–663.
    1. Luhr HG. Vitallium Luhr systems for reconstructive surgery of the facial skeleton. Otolaryngol Clin North Am. 1987;20:573–606.
    1. Schierle HP, Schmelzeisen R, Rahn B, Pytlik C. One- or two-plate fixation of mandibular angle fractures? J Craniomaxillofac Surg. 1997;25:162–168.
    1. Michelet FX, Deymes J, Dessus B. Osteosynthesis with miniaturized screwed plates in maxillo-facial surgery. J Maxillofac Surg. 1973;1:79–84.
    1. Champy M, Lodde JP, Schmitt R, Jaeger JH, Muster D. Mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg. 1978;6:14–21.
    1. Mehra P, Murad H. Internal fixation of mandibular angle fractures: a comparison of 2 techniques. J Oral Maxillofac Surg. 2008;66:2254–2260.
    1. Al-Moraissi EA, Ellis E., 3rd What method for management of unilateral mandibular angle fractures has the lowest rate of postoperative complications? A systematic review and meta-analysis. J Oral Maxillofac Surg. 2014;72:2197–2211.
    1. Choi BH, Kim KN, Kang HS. Clinical and in vitro evaluation of mandibular angle fracture fixation with the two-miniplate system. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79:692–695.
    1. Dichard A, Klotch DW. Testing biomechanical strength of repairs for the mandibular angle fracture. Laryngoscope. 1994;104:201–208.
    1. Levy FE, Smith RW, Odland RM, Marentette LJ. Monocortical miniplate fixation of mandibular angle fractures. Arch Otolaryngol Head Neck Surg. 1991;117:149–154.
    1. Valentino J, Marentette LJ. Supplemental maxillomandibular fixation with miniplate osteosynthesis. Otolaryngol Head Neck Surg. 1995;112:215–220.
    1. Kumar I, Singh V, Bhagol A, Goel M, Gandhi S. Supplemental maxillomandibular fixation with miniplate osteosynthesis-required or not? Oral Maxillofac Surg. 2011;15:27–30.
    1. Ellis E., 3rd Outcomes of patients with teeth in the line of mandibular angle fractures treated with stable internal fixation. J Oral Maxillofac Surg. 2002;60:863–865.
    1. Tate GS, Ellis E, 3rd, Throckmorton G. Bite forces in patients treated for mandibular angle fractures: implications for fixation recommendations. J Oral Maxillofac Surg. 1994;52:734–736.
    1. Rai S, Pradhan R. Tooth in the line of fracture: its prognosis and its effects on healing. Indian J Dent Res. 2011;22:495–496.
    1. Bobrowski AN, Sonego CL, Chagas Junior OL. Postoperative infection associated with mandibular angle fracture treatment in the presence of teeth on the fracture line: a systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2013;42:1041–1048.

Source: PubMed

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