Fixation Of Mandibular Angle Fractures Research Articles

The necessity of removal of third molars involved in mandibular fractures: A retrospective study

This retrospective analysis aimed to investigate the necessity of removing the wisdom tooth in cases of angle fractures of the mandible. The study retrieved 595 mandible fractures from January 2006 to December 2021 through the Hospital Inpatient Enquiry System, of which 303 involved a fracture through the angle of the mandible, including the wisdom tooth socket. Of these, 203 (66.9%) underwent open reduction and internal fixation with retention of the third molar. The authors found that only four (2%) patients returned for the removal of plates and the retained third molar during the follow-up period. Therefore, the authors concluded that wisdom teeth removal should remain an exception during open reduction and internal fixation of mandibular angle fractures unless they hinder fracture reduction, pose a potential infection risk, or interfere with occlusal stability.

Comparison of Conventional Versus Right Angled Fixation Technique in Management of Mandibular Angle Fractures – A Prospective Randomized Clinical Study

The treatment of mandibular angle fractures ranges from observation to closed reduction with maxillomandibular fixation to open reduction and internal fixation. The study aims to compare the effectiveness of three different techniques (transoral, transbuccal, and right-angled fixation technique) for single adaptational monocortical upper border plating in mandibular angle fracture. The study conducted at our center was a prospective randomized study. The study duration was from November 2019 to August 2021. The three groups included in our study were transoral, transbuccal, and transoral approach using the right-angled drill. Patients who required open reduction and internal fixation of mandibular angle fracture were included in the study. Computer-generated randomization method was used to assign the participants among the 3 groups, ie, transoral, transbuccal, or right-angled fixation technique. The primary outcome clinical variables were mouth opening (MO), occlusion stability, scar or laceration, facial nerve weakness, infection, and the radiological variables were gap between the fracture segments and displacement of the fracture segment. The secondary outcome of our study is a comparison of the perioperative complications including plate exposure during the entire fracture healing period. The covariates of the study were age, sex, etiology, and tooth in line of fracture. Statistical analysis was done using ANOVA, post hoc Tukey test, and Pearson χ2 test. A P value less than 0.05 was considered statistically significant. A total of 48 patients were included in our study. According to randomization, each group was allotted 16 patients. In the study, 66.7% of the study population were male and 33.3% were female; 75% of the study population were victims of road traffic accidents, and 25% were injured due to assault. The mean and standard deviation for MO at 1month were 31.3±2.9 for the transoral group, 35.8±1.7 for the transbuccal group, and 35.5±1.3 for the right-angled fixation group. On intergroup comparison, statistically significant results were seen at the 1-month postoperative MO clinical parameter. The P value here was 0.02 which was statistically significant. The comparison of the right-angled fixation technique to transoral and transbuccal fixation methods have not been documented. Our study is the first of its kind to compare the right-angled fixation technique to various other approaches. Our study showed that the MO was better postoperatively with the transbuccal approach. The other variables showed no difference among the three techniques.

Does a Short Period of Maxillomandibular Fixation Decrease Complications in Open Reduction Internal Fixation of Mandibular Angle Fractures?

A short duration of postoperative maxillomandibular fixation (MMF) has the potential to reduce complications following open reduction and internal fixation (ORIF) of mandibular angle fractures. The purpose of this study was to determine if a short duration of MMF is associated with a reduced rate of postoperative inflammatory complications (POICs) in patients with mandibular angle fractures undergoing ORIF. The authors conducted a retrospective cohort study consisting of patients treated with ORIF for mandibular angle fractures from August 1, 2015 to May 31, 2020 at an urban, level 1 trauma center. Patients under the age of 18 years, bilateral angle fractures, those with MMF periods of more than 3weeks, and those patients without documentation of the duration of MMF were excluded from the study. The primary predictor variable was the use of a short duration (less than 2weeks) of postoperative MMF. The outcome variable of interest was the presence of POICs. Categorical covariates were compared using Fisher's exact tests, while continuous variables were compared using Wilcox rank-sum tests. Multivariable logistic regression adjustment was also performed. There were 307 patients included in the study, 84.4% of which were men. The average age was 32.5years. Patients with a short duration of MMF had a POIC rate of 8.3% compared to 18.2% for no MMF (P=.08). In the adjusted analysis, patients with a short duration of MMF time had a significant decrease in POIC risk compared to no MMF (adjusted odds ratio [aOR]=0.32, 95% confidence interval [CI]=0.11 to 0.97). Other significant variables in the regression analysis included plating type and noncompliance. Inferior border rigid fixation was associated with decreased POIC risk compared to ladder plates and lateral border plates (aOR 5.8, 95% CI=1.8 to 18.4 and aOR 5.1, 95% CI=1.4 to 18.7, respectively). The findings from our study suggest that a short duration of postoperative MMF may reduce POICs following ORIF of mandibular angle fractures.

Evaluation of customized plate in mandibular angle fracture

Background: A customized plate design is an appropriate plate structure for mandibular angle fracture using the minimum output values for stress of plate. Methods: To evaluate the effect of customized plate fixation versus a conventional superior-inferior miniplates fixation of mandibular angle fracture on patient satisfaction. Results: Most patients were males (92%) while (8%) were females. (69 %) of patients’ age ranged from 17-35 years old, and (31%) patients were aged between 35.1-45 years old. There was a statistical difference (p=0.000) in the postoperative sensory dysfunction in both groups. Conclusion: Customized plate is a proper plate structure for mandibular angle fracture, it ensured a proper alignment of the fracture with good fixation without any post-operative sensory dysfunction.

Does a Short Period of Maxillomandibular Fixation Decrease Complications in Open Reduction Internal Fixation of Mandibular Angle Fractures?

Postoperative maxillomandibular fixation (MMF) has the potential to reduce complications following open reduction and internal fixation (ORIF) of mandibular angle fractures. The purpose of this study is to determine if a short duration of MMF is associated with a reduced rate of postoperative inflammatory complications (POICs) in patients with mandibular angle fractures.

An In vitro study of biomechanical comparison between titanium 4-hole 3D plates and titanium conventional 4-hole miniplates for internal fixation of mandibular angle fractures.

Fracture fixation, in the present times, is classically done using mini plates. The position and number of plates to fixate a mandibular angle fracture have been and are still extensively researched and reported in the literature. A more recent addition is 3D mini plates. To compare and evaluate the biomechanical behavior of one 2.0mm titanium 3D miniplate fixation plate (4- hole) and one 2.0mm titanium 4-hole miniplate in internal fixation of mandibular angle fractures. To measure load at break, maximum load, and displacement at maximal load for internal fixation done with 3D mini plates and conventional mini plates respectively. Five dry cadaveric mandibles were sectioned into 10 hemi-mandibles. Each cadaveric mandible was sectioned at the angle of mandible to simulate unfavorable mandibular angle fracture. The obtained hemimandible were divided into experimental groups (GROUP 1 and GROUP 2) with 5 samples in each group, plated with a linear miniplate and 3D miniplate respectively. Maximal load, Load at break, and displacement at maximum load were the only obtained parameters for comparison. Conventional miniplate showed greater mean maximum load values of 174.93N±54.45 compared to 3D mini plates which recorded a mean maximum load value of 106.96N±23.86. Load at break and displacement at maximum load were found to be both insignificant. The results in this study showed statistically no significant difference with any of the above parameters except maximal load, between the two groups evaluated. Conventional linear miniplate according to Champy's lines of osteosynthesis can be used successfully for providing satisfactory osteosynthesis with the definitive advantage of cost-effectiveness.

Outcome of Transbuccal and Transoral Technique in Open Reduction and Internal Fixation of Mandibular Angle Fractures

Background: Angle fractures have the highest percentage among mandibular fractures. It has many reasons like thinner cross section area, presence of third molar, muscle forces acting at the angle area and abrupt change of shape from horizontal to vertical rami. Aim: To determine the outcomes of trans-buccal and trans-oral technique in open reduction and internal fixation of mandibular angle fractures. Study Design: Randomized control trial. Methodology: Total of 194 patients were recruited and divided in two groups. All patients underwent general anesthesia. In trans-oral group incision line was on external oblique ridge, exposing the ridge, the 5 holes mono-cortical plate were twisted and adapted to the ridge contour and fixed with 4 mono-cortical 2mm diameter screws. While in transbuccal approach, the angle region was exposed trans-orally. Statistical analysis: The collected data was analyzed by using SPSS version 25. Chi square was applied with p-value of less than 0.05 as significant. Results: The result showed infection in trans-buccal group was 5.4% and in transoral group was 17.4%. Wound dehiscence in trans-buccal group was 2.2% while in transoral group was 10.9%. Plate or screw loosening in trans-buccal group was 1.1% and transoral group was 7.6%. Mal-union in trans-buccal group was 1.1% and in trans-oral group, it was 7.6%. Conclusion: It was concluded that the trans-buccal is an effective procedure in terms of infection, wound dehiscence, mal-union and plate/screw loosening in comparison to trans-oral approach. Keywords: Trans-buccal, Trans-oral, Infection and Wound Dehiscence.

One miniplate versus two miniplates in the fixation of mandibular angle fractures. An updated systematic review and meta-analysis

PurposeThe aim of this study is to compare the outcomes after using one miniplate fixation in the external oblique ridge versus two miniplate fixation for mandibular angle fractures. MethodsA systematic review of MEDLINE (via PubMed), Scopus and Cochrane Library database was performed (last search date: 04 February 2022) according to the PRISMA guidelines. The research question was addressed using the PICO criteria. Only comparative studies between the two techniques were included. Random-effects model meta-analyses were performed. ResultsSeventeen studies, comprising a total of 1667 patients, 846 undergoing one miniplate fixation and 854 undergoing two miniplate fixation for mandibular angle fractures were identified. No statistically significant differences were observed regarding surgical site infection (odds ratio [OR]= 0.94, 95% confidence interval [CI]: [0.69] – [1.28], p = 0.68, I2=0.00%), post-operative malocclusion (OR= 0.97, 95% CI: [0.53] – [1.18], p = 0.25, I2=0.00%), post-operative neurosensory dysfunction (OR= 0.67, 95% CI: [0.37] – [1.22], p = 0.19, I2=73.93%), pseudoarthrosis formation (OR=0.90, 95% CI: [0.58] – [(1.39], p = 0.63, I2=0.00%). Wound dehiscence was marginally less common in the one miniplate group (OR=0.52, 95% CI: [0.28] – [0.98], p = 0.04, I2=54.34%). The probability of scarring formation (OR=0.13, 95% CI: [0.05] – [0.32], p = 0.00, I2=0.00%) and hardware failure (OR=0.36, 95% CI [0.21] – [0.62], p = 0.00, I2=29.33%) were statistically significantly higher in the two miniplates arm. ConclusionOne miniplate fixation and two miniplates fixation of mandibular angle fractures have similar results regarding post operative infection, malocclusion, neurosensory dysfunction and pseudoarthrosis formation while wound dehiscence, hardware failure and scarring seem to be more common when two miniplates are used as a fixation technique.

Is a Tooth Extraction Required If Dentition Lies Within a Mandible Fracture?

Is a Tooth Extraction Required If Dentition Lies Within a Mandible Fracture?

Is Screw-Fracture Proximity or Residual Fracture Displacement Correlated to Outcomes After Open Reduction and Internal Fixation of Mandibular Angle Fractures?

Computed tomography (CT) imaging is commonly obtained following open reduction and internal fixation (ORIF) of mandibular fractures but the significance of common findings is unknown. The purpose of this study is to examine the relationship of screw-to-fracture proximity and residual fracture displacement to post-operative complications following ORIF of mandibular angle fractures treated with monocortical fixation techniques. The authors conducted a retrospective cohort study consisting of all patients with mandibular angle fractures treated with ORIF using monocortical fixation at the lateral surface of the mandible from the dates August 1, 2015 to May 31, 2020. The predictor variables were the distance measurements between the 2 closest screws to the fracture and the fracture line and the amount of residual fracture displacement, both measured on postoperative CT. The primary outcome variable was the presence of postoperative inflammatory complications (POICs). Statistical analysis was performed using logistic regression and Bayesian variable selection to calculate posterior probability of importance for the variables of interest. Of the 285 patients included in the study, 84.6% were men and the average age was 30.8 years. POICs occurred in 22.1% of the patients. Age, smoking, homelessness, noncompliance and drug use were associated with POICs. However, none of the screw-to-fracture distances were associated with POICs, including linear, dichotomous or polynomial transformations of these variables. Additionally, the residual fracture displacement distances and transformations of these distances were also not associated with POICs. The present study did not find any evidence to suggest that a closer screw-fracture distance or increased residual fracture displacement on postoperative CT imaging increased the risk of POICs for mandibular angle fractures treated with ORIF using monocortical fixation at the lateral border.

125 The Fate of The Third Molar in The Line of a Mandibular Angle Fracture: A Retrospective Study at A Tertiary Centre

Abstract Aim: To evaluate the risk of complications associated with retaining or extracting an asymptomatic third molar in the line of an angle fracture. Aiming to seek a consensus whether third molars should be extracted or retained during surgical repair of mandibular angle fractures. Method A retrospective study was undertaken at the Queen Elizabeth Hospital, Birmingham. 150 patients across a span of three years underwent open reduction and internal fixation of mandibular angle fractures with third molar involvement. Patients were classified into two groups, tooth retention during angle fracture and tooth removal during angle fracture repair. Hospital records were evaluated to seek the rate of post-operative complications at follow-up Results 162 angle fractures were identified with ipsilateral wisdom teeth present. In 37 cases the wisdom tooth was removed during surgery. 6 complications (16.2%) occurred in this group necessitating a return to theatre. In 125 cases the wisdom tooth was left in-situ. Complications necessitating a return to theatre occurred in 14 cases (11.1%). Conclusions This study indicates that retention of wisdom tooth overall did not significantly increase the risk of complications associated with angle fractures (p = 0.42). Where wisdom tooth pathology was noted its retention was associated with complications requiring a return to theatre (X2=4.40, p = 0.036).

Is There a Safe Zone for Lateral Border Fixation of Mandibular Angle Fractures?

Cross-sectional study design. There are multiple accepted treatment options for internal fixation of mandibular angle fractures. The purpose of this study was to determine if there is a safe zone for lateral border fixation of mandibular angle fractures. One hundred coronal images of facial computed tomography (CT) scans were reviewed on patients between the ages of 18 to 48. Measurements were taken in the area of the second and third molar region related to the inferior border to the superior extent of the inferior alveolar canal and apex of the second molar root, along with buccal cortical measurements to the inferior alveolar canal and apical third of the second molar root. The average measurement of the inferior border in the second molar area to the inferior alveolar canal and apex of the root was 1.12 cm (0.70-1.77) and 1.39 cm (0.91-2.30), respectively. The average measurement of the inferior border of the third molar to the inferior alveolar canal was 1.26 cm (0.78-1.83). The average measurement of the buccal cortex of the second molar to the inferior alveolar canal and apical one-third of the root was 0.64 cm (0.34-1.25) and 0.59 cm (0.33-0.98), respectively. The average measurement of the third molar buccal cortex to the inferior alveolar canal was 0.45 cm (0.18-0.98). In the area of the second molar region, there is no ubiquitous safe zone for screw placement, cortical bone thickness is more critical than vertical placement of the fixation plate and screws. In the third molar region, cortical bone thickness and vertical orientation may provide a safe zone for screw placement.

Comparing treatment outcomes of external oblique ridge plating and lateral cortical plating for mandibular angle fractures

Aim: The aim of this study was to compare the outcomes of external oblique ridge platting and lateral cortical plating for mandibular angle fractures. Materials and Methods: A retrospective study was performed of patient’s data, who underwent open reduction and internal fixation of mandibular angle fractures. Inpatient and outpatient records were reviewed for pertinent data including age, gender, presence of other fractures, type of plating, operative time, and post-operative complications. Results: 40 patients with angle fracture were included in the study, 60% of them were treated with external oblique ridge plating and the rest 40% with lateral cortical plating. The mean age of the patients were 32.40 years. Main etiology of injury was road traffic accident (RTA). Post-op infection and wound dehiscence was observed in 12.5% and 10% of cases respectively in the external oblique plating group and 2.5% and 5% cases respectively in the lateral cortical plating group. Nonunion was not seen in any of the cases. Implant retrieval was performed in 5% of the external oblique ridge plating group and none in the other group. (p value 0.21). Conclusion: Lateral cortical plate fixation for angle fracture is a better and simple method when compared to external oblique ridge fixation. It is safe and reliable with minimal complications. Hence this technique is recommended for the fixation of mandibular angle fractures for better stability and outcome. Keywords: Mandibular angle fracture, External oblique ridge plating, Lateral cortical plate plating, Postop infection, Breakage of plate, Implant retrieval.

Patient End of Endotracheal Tube as Gateway for Transbuccal Approach in Internal Fixation of Mandibular Angle Fracture: A Technical Note.

Patient End of Endotracheal Tube as Gateway for Transbuccal Approach in Internal Fixation of Mandibular Angle Fracture: A Technical Note.

Comparison of Intraoral External Oblique Ridge Fixation and Transbuccal Lateral Cortical Plate Fixation for Mandibular Angle Fracture – A Randomized Control Trial

Background/objectives: Mandibular fractures account for almost half of all the fractures occurring in the maxillofacial region. Among mandibular fractures, angle fracture has a highest rate of post-operative complications (0-32%). This study compared the fixation of mandibular angle fracture with intra-oral external oblique ridge fixation versus transbuccal lateral cortical plate fixation using a single miniplate. Post-operative complications especially infection was noted and compared. Methods: A randomized controlled trial was done to compare the outcome of the two procedures. A total of 120 mandibular angle fracture patients were randomly allocated into Group A and Group B, 60 in each group. Group A underwent ORIF with intraoral approach and Group B underwent open reduction Internal fixation (ORIF) with transbuccal lateral cortical plate fixation for mandibular angle fractures. Patients of both groups were reviewed on 1st week, 1st month and third month for clinical signs of infection. Results: In group A, 10 (16.66%) patients suffered from infection and in group B, 4 (6.66%) of patients reported with infection at the last follow up visit that is at the end 3 months. No statistically significant p value after application of ‘Chi square test’ was noted for infection at the end of the third month review. Conclusion: Mandibular angle fractures can be effectively treated with transbuccal lateral cortical plate fixation as ease of plate adaptation, placement of plate in mid neutral area and less chance of infection.

Effect of chewing and cutting condition for V-shape three-dimensional titanium miniplate for fixation of mandibular angle fractures (MAFs)

PurposeMiniplate shapes determine the fixation stability to promote best healing and osseointegration process of mandibular fracture. In clinical treatment, the common method used two straight-type miniplate or I-shape miniplate; sometimes this method is not stable enough or limited by the fracture geometry and caused high risk of failure due to screw loosening. This paper aims to investigate a new type of miniplate called V-shape miniplate design as an alternative to the standard straight plate based on total displacement, von Mises stress, stress transfer parameter (STP) and strain energy density transfer parameters (SEDPTs) for two types of bite force condition, which is cutting and chewing condition.Design/methodology/approachThe 3D fixation models were constructed and the finite element (FE) simulation is based on the two-bite force load that ranges from 50 to 700 N based on cutting and chewing bite force condition using ANSYS Workbench 19.2.FindingsIn result comparison, the maximum loading of the V-shape miniplate can reduce deformation by 5.9%, reduce stress by 0.58% reduce strain by 8.1% in cutting condition while reducing deformation by 6.43%, reduce stress by 15.25%, reduce strain by 10.1% in chewing condition. To assess the stress transfer behavior of miniplates fixations to the mandibular bone, the STP and SEDPT were evaluated at the normal cortex screw and the locking head screw. In the simulation, the locking head screw is vertical to the bone structure while the cortex screw is 95 degrees to the bone structure, as a result, the STP value for locking head screw is 1.0073 while in cortex screw is 0.7408.Research limitations/implicationsMeanwhile, the SEDPT value for locking head screw is 2.7574 and 1.8412 for cortex screw.Practical implicationsClinically, V-shape miniplate has shown factual data that can be used for prototyping. STP and SEDTP values provide evidence of how fixation stability is better than I-shape miniplate.Originality/valueIn conclusion, the newly designed V-shape miniplate has overall better stability than the standard I-shape miniplate, and the locking head screw has the STP value closer to 1 than the standard cortex screw; it means the locking screw is better in reducing the stress shielding.

The Use of a Novel CAD-CAM Splint to Simplify Open Reduction and Internal Fixation of Mandibular Angle Fracture: A Technical Note

Mandibular angle fractures are frequently encountered as they constitute an area of weakness. Complications after open reduction and internal fixation (ORIF) of angle fractures commonly arise due to improper reduction and fixation methods that fail to counteract the dynamic muscle forces present in this region. Conventional reduction methods such as digital manipulation, intermaxillary fixation, towel clip traction, and wiring are associated with various limitations. This technical note highlights the fabrication and use of a computer-aided designing/computer-aided manufacturing-generated splint for ORIF of a superiorly displaced mandibular angle fracture. The splint consisted of 2 components: (1) a distal tooth-borne component to guide the teeth into maximum intercuspation and (2) a proximal bone-borne component to reduce the angle fracture. This composite splint facilitates simultaneous restoration of occlusion as well as reduction of mandibular angle fractures. The advantages of this technique include the following: (1) easy fabrication of splint, (2) easy and precise anatomical reduction of angle fracture, and (3) less operative time.

Mandibular angle fractures- intra oral and extra oral approaches – A comparative study

Aim: The aim of this study was to analyze outcomes of intra-oral and extra-oral approaches to mandibular angle fractures. Materials and Methods: a retrospective study was performed of patients who underwent open reduction and internal fixation of mandibular angle fractures. Inpatient and outpatient records were reviewed for pertinent data including age, gender, presence of other fractures, surgical approach, operative time, and post-operative complications. Results: The 40 patients with angle fracture, 60% were treated vis intra-oral approach and the rest 40% via extra-oral approach. The mean age of the patients were 30.87 years in the intra-oral group and 34.13 years in the extra-oral group. Main etiology of injury was RTA. The mean operating time for the intra-oral group was 95.63 minutes and 100.43 minutes for the extra-oral group. There was not much of difference in length of hospital stay for both the groups the mean being 2 days. Malocclusion was seen in 17.4% of extra-oral cases and 12.5% of intra-oral group. Re-surgery was performed in 12.5% of the extra-oral cases. Post-op infection was observed in 13% of intra-oral cases and 31.3% of extra-oral cases. Neurosensory disturbance occurred in 30% of extra-oral cases, and none in the intra-oral group, which is statistically significant. (p-0.017). Conclusion: Both methods of fixation for angle fractures are useful in the treatment. On the basis of our results we recommend using intra-oral approach while clinically favorable with single miniplate along superior border. Keywords: Mandbular angle fracture, Intraoral versus extra oral approach.

Effects of polymethylmethacrylate on the stability of screw fixation in mandibular angle fractures: A study on sheep mandibles.

Aim: Malfixed miniplates can impair fracture healing, and the screw pilot holes may widen during repeated fixation trials. This in vitro study explored the extent to which screw fixation of mandibular angle fractures could be improved by augmenting the drilling holes with polymethylmethacrylate (PMMA).Materials and Methods: We measured stabilization by recording specimen displacement under a vertical force of 50 N applied using a hydraulic tester. We included 20 hemimandibles from sheep (average weight 40 kg). The specimens were randomly divided into two groups of 10 and pilot holes were created in the angulus region using a drill 1.2 mm in diameter. Next, we performed osteotomies simulating angulus fracture repair. In group 1, the fracture site was fixed using non-compression miniplates and four screws were inserted to the maximal possible extent employing a mechanical screwdriver. In group 2, the pilot drill holes were filled with PMMA prior to miniplate fixation. Then vertical forces of 50 N were applied to the molar region and the displacements were measured. The Shapiro-Wilks test was used to compare the two groups.Result: The maximum average displacement in the experimental group was significantly lower than that in the control group (p=0.026). Thus, PMMA-augmented screws better stabilized bone, affording reliable fixation.

Management of Mandibular Angle Fractures by Two Conventional 2.0-mm Miniplates: A Retrospective Study of 389 Patients.

Fractures of the mandibular angle account for 23 to 42% of all facial fractures with a high complication rate (0-32%). Although the ideal treatment remains debatable, two main procedures are commonly used to manage the majority of mandibular angle fractures that are open reduction and internal fixation by a noncompression miniplate placed on the external oblique ridge with or without a second miniplate on the outer cortex. The purpose of this study was to describe our management of mandibular angle fractures by two noncompression miniplates placed on the outer cortex via a transbuccal approach. Medical records and radiographic examination of 389 patients (258 males [66.3%] and 131 females [33.7%]) operated from January 2000 to December 2012 were retrospectively reviewed. Postoperative complications including malocclusion, infection, wound dehiscence, nonunion, and reoperative surgery were recorded and analyzed. Fifty-three patients developed postoperative complications (overall complication rate: 13.6%). No significant difference was found in the complication rate by age and gender variables and regarding the interval between the trauma and the operation and the presence of the teeth in the line of fracture. A higher rate of complications was found among patients with alcohol/drug addiction and in patients with multiple-site involvement. The findings of this study suggest that the use of two transbuccal miniplates placed on the outer cortex for the internal fixation of mandibular angle fracture provided a low rate of complications. The global incidence of screw loosening, wound dehiscence, plate exposure, infection, reoperation, and plate removal were similar with the data reported in the literature with improved health outcomes, lower postoperative morbidity, and a faster return to normal life.