A Retrospective Cohort Outcome Study Comparing Gingival Margin and Buccal Sulcus Incisions for Mandibular Fracture Access.

(1) Background: The main intraoral incisions used in the operative management of mandibular fractures are gingival margin incisions and buccal sulcus incisions. The aim of this retrospective cohort study was to compare postoperative outcomes between incision types and guide future operative protocols. (2) Methods: Data was collected from Queen's Medical Centre in Nottingham, a level I major trauma centre. BlueSpier was used to identify mandibular fracture patients operated on between January 2023 and January 2025. Digital health records were used to obtain patient demographics and postoperative outcomes. Primary outcome measures were postoperative infection and wound dehiscence. Secondary outcome measures were return to theatre and new numbness or paraesthesia. (3) Results: In this cohort, 138 patients underwent operative management for a mandibular fracture through an intraoral incision; 60 patients had a gingival margin incision and 78 patients had a buccal sulcus incision. No statistically significant difference was found between the gingival margin and buccal sulcus incision groups for the primary and secondary outcome measures. (4) Conclusions: Incision choice is dependent on mandibular fracture location and surgeon preference. Both incisions were used by most of the operating surgeons. This study was not designed as an equivalence or non-inferiority study. Further larger-scale studies are needed to identify superior outcomes of one approach.