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Craniomaxillofac Trauma Reconstr. 2021 Dec;14(4):284-288. doi: 10.1177/1943387520983118. Epub 2020 Dec 24.

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

Craniomaxillofacial trauma & reconstruction

Steven G Press, Andrew J Miller, Michelle Campbell Luschen

Affiliations

  1. Envison Physician Services, Department of Facial Trauma, TriStar Skyline Medical Center, Nashville, TN, USA.
  2. SSM Health Dean Medical Group, Madison, WI, USA.
  3. Department of Radiology, TriStar Skyline Medical Center, Nashville, TN, USA.

PMID: 34707788 PMCID: PMC8543591 DOI: 10.1177/1943387520983118

Abstract

STUDY DESIGN: Cross-sectional study design.

OBJECTIVE: 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.

METHODS: 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.

RESULTS: 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).

CONCLUSION: 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.

© The Author(s) 2020.

Keywords: facial trauma; mandible; mandible angle fracture; open fracture reduction; trauma

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

  1. J Oral Maxillofac Surg. 2010 Jul;68(7):1565-7 - PubMed
  2. J Oral Maxillofac Surg. 2008 Nov;66(11):2254-60 - PubMed
  3. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Jun;113(6):817-26 - PubMed
  4. Int J Oral Maxillofac Surg. 2018 Mar;47(3):330-338 - PubMed
  5. J Oral Maxillofac Surg. 2010 Dec;68(12):2980-5 - PubMed
  6. Am J Orthod Dentofacial Orthop. 2011 Apr;139(4):495-503 - PubMed
  7. Dentomaxillofac Radiol. 1999 May;28(3):137-40 - PubMed
  8. Int J Oral Maxillofac Surg. 1999 Aug;28(4):243-52 - PubMed
  9. J Orofac Orthop. 2019 May;80(3):144-158 - PubMed
  10. J Oral Maxillofac Surg. 2005 Feb;63(2):209-14 - PubMed
  11. J Maxillofac Oral Surg. 2017 Dec;16(4):453-464 - PubMed
  12. Craniomaxillofac Trauma Reconstr. 2019 Jun;12(2):122-127 - PubMed

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