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Introduction <p>Maxillofacial fractures invariably affect the stomatognathic system. Mandible being one of the anatomic elements of the stomatognathic system is bounded by the strong elevator muscles. Fracture of the mandible angle region and injuries to the associated muscles either traumatic or operative due to surgical approach can therefore result in considerable dysfunction and pain. As a result of these injuries, masticatory efficiency gets affected.</p> Objective <p>To analyse the masticatory efficiency after open reduction &amp; internal fixation of mandible angle fracture treated by two different surgical approach.</p> Materials and Method <p>The study included 20 patients who sustained unilateral non comminuted mandible angle fracture and they were divided into two groups based upon the surgical approach used. Evaluation of masticatory efficiency was done by assessing Bite force, range of mandibular movements and masticatory satisfaction. These parameters were recorded preoperative and post operative at a specified period of time i.e. 7th day, 14th, 28th and 90th day. Readings were noted and data was statistically analyzed.</p> Result <p>Result of the study showed that the bite force values in mandible angle fracture site at different time intervals between two groups found statistically significant at 28th and 90th day postoperative using t-test (p-value &lt; 0.05). On comparison between two groups, trismus index and lateral excursion (left side) showed no statistically significant difference whereas lateral excursion (right side) was found statistically significant at 14th day postoperative. In protrusion movement between two groups, no statistically significant difference was observed at any postoperative time interval. However the mean values of lateral excursion, protrusion and trismus were found comparatively more in group B i.e. treated through transoral approach.</p> Conclusions <p> On the basis of the results and observation of the study, it can be concluded that either of the approach (extra-oral versus trans-oral) used for the treatment of mandible angle fracture affects the stomatognathic system and the masticatory efficiency regained gradually during postoperative phase. However in this study, transoral approach which has less hardware implanted showed more promising results for early functional recovery. Furthermore randomized studies on larger scale with standardized fixation protocol and assessment of strength of masticatory muscles by surface electromyography are needed to confirm this.</p>

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Does the Surgical Approach of Open Reduction and Internal Fixation of Mandibular Angle Fracture Affect the Masticatory Efficiency: a Comparative Study

  • 期刊论文

  • 发表日期：

    2026年2月21日

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  • Dinesh Chand Patidar,
  • Ramesh Ram Fry,
  • Atul Sharma,
  • Aayush Malhotra,
  • Deepika Patidar,
  • Pavneet Kaur Pandher

摘要

Introduction

Maxillofacial fractures invariably affect the stomatognathic system. Mandible being one of the anatomic elements of the stomatognathic system is bounded by the strong elevator muscles. Fracture of the mandible angle region and injuries to the associated muscles either traumatic or operative due to surgical approach can therefore result in considerable dysfunction and pain. As a result of these injuries, masticatory efficiency gets affected.

Objective

To analyse the masticatory efficiency after open reduction & internal fixation of mandible angle fracture treated by two different surgical approach.

Materials and Method

The study included 20 patients who sustained unilateral non comminuted mandible angle fracture and they were divided into two groups based upon the surgical approach used. Evaluation of masticatory efficiency was done by assessing Bite force, range of mandibular movements and masticatory satisfaction. These parameters were recorded preoperative and post operative at a specified period of time i.e. 7th day, 14th, 28th and 90th day. Readings were noted and data was statistically analyzed.

Result

Result of the study showed that the bite force values in mandible angle fracture site at different time intervals between two groups found statistically significant at 28th and 90th day postoperative using t-test (p-value < 0.05). On comparison between two groups, trismus index and lateral excursion (left side) showed no statistically significant difference whereas lateral excursion (right side) was found statistically significant at 14th day postoperative. In protrusion movement between two groups, no statistically significant difference was observed at any postoperative time interval. However the mean values of lateral excursion, protrusion and trismus were found comparatively more in group B i.e. treated through transoral approach.

Conclusions

On the basis of the results and observation of the study, it can be concluded that either of the approach (extra-oral versus trans-oral) used for the treatment of mandible angle fracture affects the stomatognathic system and the masticatory efficiency regained gradually during postoperative phase. However in this study, transoral approach which has less hardware implanted showed more promising results for early functional recovery. Furthermore randomized studies on larger scale with standardized fixation protocol and assessment of strength of masticatory muscles by surface electromyography are needed to confirm this.