Surgical management of bilateral mandibular angle fractures: A systematic review

Bilateral mandibular angle fractures (BMAF) are rare and complex maxillofacial injuries. This review describes the patient factors, procedural factors and post-procedural outcomes of BMAF management. PubMed and Scopus were searched for English papers from 1993 to 2023 using the strategy: (bilateral AND angle) AND (mandib* OR bmaf) AND fracture AND (management OR repair OR surgery). Four papers were eligible for inclusion, representing 198 cases. The mean age of patients was 25 years, with 94.9% of cases male. Interpersonal violence was the leading cause of injury (76.8%). Transbuccal approach was the most common incision (53.2%). Non-rigid/rigid fixation was the most common approach to fixation (55.4%). Impacted lower third molars were present in 91.6% of cases and were extracted in 36.7% of these cases. The most common complications were infection (n = 11) and malocclusion (n = 9), with similar rates between rigid and non-rigid plates. Further studies are needed to address the scarcity of research. Standardised approaches to classifying fixation, injuries, fracture displacement and imaging protocols are needed.