The goal of this clinical trial is to learn if transbuccal technique for mandibular angle fracture is better than transoral technique. The main questions it aims to answer are:
* Does transbuccal technique provide better mouth opening than transoral technique * Radiographic gap and displacement between fracture lines is more prevalent in transoral technique than transbuccal technique postoperatively Researcher will compare both the techniques to see if transbuccal technique works better than transoral technique
Participants will:
* Be assessed 1 week , 1 month and 3 months postoperatively * Their mouth opening will be assessed by measuring interincisal opening with ruler * Radiographic gap between fracture segments and displacement of fractured segments will be measured on OPG through ruler
1.All dentate and partially dentate patients with unilateral mandibular angle fracture.
2. Both isolated mandibular angle fractures and mandibular angle fractures associated with other facial fractures will be included
1.Comminuted mandibular angle fractures.
2.Edentulous patients.
3. Gross external laceration in submandibular region.
4.Presence of local bone pathology alongwith fracture will be excluded from study.
Parallel
Transoral technique for mandibular angle fracture reduction
Procedure/SurgeryIn transoral technique approach inferior alveolar nerve block and buccal nerve block will be given by 2% xylocaine with 1:100000 adrenaline. Incision will be made with surgical blade no 15 from gingival crevices of molars to ascending ramus. Fracture segments will be reduced alongwith MMF. A 5-hole 2mm miniplate with 2 holes anterior and 2 holes posterior to fracture line will be screwed to external oblique ridge and MMF will be removed and incision line will be closed.
Transbuccal technique for mandibular angle fracture reduction
Procedure/SurgeryIn transbuccal technique inferior alveolar nerve block and buccal nerve block will be given by 2% xylocaine with 1:100000 adrenaline. Incision will be made with surgical blade no 15 from gingival crevices of molars to ascending ramus. Fracture segments will be reduced alongwith MMF. extraorally a stab incision will be made with scalpel blade parallel to relaxed resting skin tension lines through which the cannula with a trocar will be inserted through facial tissue down to bone. Transbuccal instrument system will cionsist of transbuccal guide, mountable retractor, drill sleeve, drill guide, and 2mm drill bit. A 2mm titanium miniplate will be placed along buccal cortex and screwed through trocar system. MMF will be removed and incision line closed
Mean of mouth opening
Mouth opening will be defined as maximum interincisal distance measured in millimeters through ruler.
MEAN OF GAP BETWEEN FRACTURE SEGMENTS
Gap between proximal and distal fracture lines measured in millimeters in OPG with ruler.
MEAN OF DISPLACEMENT OF FRACTURE SEGMENTS:
Presence of step between distal and proximal segments in vertical plane at the lower border on OPG.
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