A Comparative Evaluation of Conventional and Staircase Modification of the Intraoral Mandibular Vestibular Incision Approach in Symphysis and Parasymphysis Fractures.

The aim of this study was therefore to evaluate the conventional intraoral mandibular vestibular incision approach in symphysis and parasymphysis fractures and compare prognosis of the incision site, fracture healing, and associated complications with the staircase modification of the intraoral mandibular vestibular incision approach for symphysis and parasymphysis fractures. This study was conducted on 34 healthy individual of age 18-60 years, reporting to the department with a history of trauma having mandibular symphysis or parasymphysis fractures and underwent open reduction and internal fixation under either local or general anesthesia. The treated patients were prospectively followed and examined for the postoperative complications such as pain, swelling, infection, dehiscence, sensory disturbances, and nonunion/malunion of the fracture site. Patients were followed up at the intervals of 2nd postoperative day, 1 week, 2 weeks, and 6 weeks postoperatively and were evaluated for any of the above complications. There was no statistically significant difference in the assessment parameters between the conventional intraoral mandibular vestibular approach and the staircase modification of the same. The conventional method and the staircase modification of the intraoral mandibular vestibular approach have similar treatment outcomes in terms of osteosynthesis and soft tissue healing but the staircase modification fairs better in terms of healing till the 6th week. This study contributes to the understanding of the comparatively treatment outcomes of the conventional and staircase modification of the intraoral mandibular vestibular approach with respect to postoperative complications such as pain, swelling, infection, dehiscence, sensory disturbances, and nonunion/malunion of the fracture site, which may influence the choice by the dental surgeon.