Comparative Analysis of Outcomes: Intra-Oral and Transbuccal Approach Using Trocar for Fixation of Mandibular Fractures

Mandibular fractures are frequent maxillofacial injuries. Open reduction and internal fixation may be intraoral or transbuccal, with each having varying access, visualization, and aesthetic effects. Objectives: To compare intraoral and transbuccal methods of fixation of mandibular fractures. Methods: It was a prospective interventional study among 70 patients with unilateral displaced fracture of the mandible, who were divided into intraoral (n=35) and transbuccal (n=35) groups. All cases were subjected to standard intraoral access. The fixation was done intraorally & using a transbuccal trocar. They were assessed in relation to surgical time, ease of accessibility (VAS 13), post-operative occlusion, and radiographic fracture reduction (adequate 3 mm gap or below). The continuous variables were evaluated using the Mann-Whitney U test, and the chi-square test was applied to the categorical variables with a level of significance at p<0.050. Results: Fracture reduction (82.9 vs. 80.0; p=0.759) and post-operative occlusion (both 88.6; p<0.001) did not reveal any significant difference. The transbuccal group had better access to surgery. The intraoral method was shorter in terms of the time of operations (median 45 vs. 70 minutes; p<0.001). Conclusions: The transbuccal method enhances the accessibility of the surgery, and the intraoral method is faster. The choice of approach must take into account the position of fractures and the experience of the surgeon.