A Comparative Study of Transbuccal and Extraoral Approaches in the Management of Mandibular Angle Fractures: A Systematic Review

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.