clin dent res Clinical Dentistry and Research 2146-3972 Hacettepe University Oral and Maxillofacial Surgery Ağız ve Çene Cerrahisi COMPARISON OF INTERNAL FIXATION METHODS AND MINIMAL INVASIVE SURGICAL APPROACHES IN THE TREATMENT OF MANDIBULAR FRACTURES Yılmaz Utku Nezih DICLE UNIVERSITY Eriş Derkuş Fatma Gülsün Belgin DICLE UNIVERSITY Sezgin Can DICLE UNIVERSITY Yılmaz Berivan DICLE UNIVERSITY 04 24 2025 49 1 11 18 05 20 2024 03 03 2025

Background and Aim: Mandibular fractures are one of themost common fracture types in the maxillofacial region, withcondylar and angular fractures being particularly prevalent. Inrecent years, endoscopic approaches, have become increasinglywidespread as alternatives to traditional internal fixationmethods, in the treatment of maxillofacial traumas. Theendoscopic treatment of mandibular fractures is a minimallyinvasive technique. The aim of this study is to evaluate andcompare the clinical and radiological outcomes of endoscopyassistedopen reduction and internal fixation (EAORIF) andconventional open reduction and internal fixation (ORIF) in thetreatment of mandibular fractures.Materials and Methods: In this study, 18 patientsdiagnosed with mandibular fractures were randomly dividedinto two groups. Nine patients underwent EAORIF, while theremaining patients underwent ORIF under general anesthesia.Postoperative evaluations were conducted clinically andradiologically to assess the advantages and disadvantages ofboth techniques.Results: No significant difference was found in both methodsin terms of age, time between trauma and operation, andhospital stay (p>0.05). However, the surgical duration waslonger in the EAORIF group (p0.05).Conclusion: These findings suggest that EAORIF is aneffective minimally invasive alternative to conventional ORIF,offering improved postoperative recovery despite its technicalcomplexity.

 Condylar Fractures Endoscopic Approach Internal Fixation Mandible Fractures Minimally Invasive This research was supported by Dicle University Scientific Research Projects Coordination Office with project number DİŞ.20.022. Reference1. Müller R, Schmidt H, Wagner T. Soft tissue complications in open reduction techniques. Injury 2020; 51: 1011-1019. Reference2. Chen W, Zhang X, Liu Y. Minimally invasive endoscopic techniques in fracture management: a review. J Orthop Surg 2021; 29: 112- 120. Reference3. De Groen PC. History of the endoscope [scanning our past]. Proc IEEE 2017; 105: 1987-1995. Reference4. Watson SW, Niamtu J 3rd, Cunningham LL Jr. The endoscopic brow and midface lift. Atlas Oral Maxillofac Surg Clin North Am 2003; 11: 145-155. Reference5. Cunningham LL Jr, Peterson GP. Historical development of endoscopy. Atlas Oral Maxillofac Surg Clin N Am 2003; 11: 109- 127. Reference6. Bansal A, Chaudhary D, Kukreja N, Gupta NK, Kukreja U, Bansal J et al. Seeing is believing - Endoscopy in the clinical practice of dentistry: a review of literature. Indian J Dent Sci 2012; 4: 690-693. Reference7. White RD. Arthroscopy of the temporomandibular joint: technique and operative images. Atlas Oral Maxillofac Surg Clin N Am 2003; 11: 129-144. Reference8. Nahlieli O, Moshonov J, Zagury A, Michaeli E, Casap N. Endoscopic approach to dental implantology. J Oral Maxillofac Surg 2011; 69: 186-191. Reference9. Bos RR, Ward Booth RP, de Bont LG. Mandibular condyle fractures: a consensus. Br J Oral Maxillofac Surg 1999; 37: 87-89. Reference10. Shakya S, Zhang X, Liu L. Key points in surgical management of mandibular condylar fractures. Chin J Traumatol 2020; 23: 63-70. Reference11. Al-Moraissi EA, Louvrier A, Colletti G. Does the surgical approach for treating mandibular condylar fractures affect the rate of seventh cranial nerve injuries? A systematic review and metaanalysis based on a new classification for surgical approaches. J Cranio-Maxillofac Surg 2018; 46: 398-412. Reference12. Brandt MT, Haug RH. Open versus closed reduction of adult mandibular condyle fractures: a review of the literature regarding the evolution of current thoughts on management. J Oral Maxillofac Surg 2003; 61: 1324-1332. Reference13. Ellis E 3rd, Dean J. Rigid fixation of mandibular condyle fractures. Oral Surg Oral Med Oral Pathol 1993; 76: 6-15. Reference14. Schon R, Schramm A, Gellrich NC, Schmelzeisen R. Follow-up of condylar fractures of the mandible in 8 patients at 18 months after transoral endoscopic-assisted open treatment. J Oral Maxillofac Surg 2003; 61: 49-54. Reference15. Schon R, Gutwald R, Schramm A, Gellrich NC, Schmelzeisen R. Endoscopy-assisted open treatment of condylar fractures of the mandible: extraoral vs intraoral approach. Int J Oral Maxillofac Surg 2002; 31: 237-243. Reference16. Pedroletti F, McCain JP. Endoscopically assisted repair of mandibular angle fractures. J Oral Maxillofac Surg 2010; 68: 912- 914. Reference17. Kellman RM. Endoscopic approach to subcondylar mandible fractures. Facial Plast Surg 2004; 20: 239-247. Reference 18. Frake PC, Goodman JF, Joshi AS. Feasibility of purely endoscopic intramedullary fixation of mandibular condyle fractures. J Craniofac Surg 2015; 26: 91-93. Reference19. Gordon PE, Kaban LB, Tagoni JR, Troulis MJ. Minimally invasive oral and maxillofacial surgery trauma. In: Fonseca RJ, editor. Oral and maxillofacial trauma Oxford: Saunders; 2013. p. 828-843. Reference20. Williams WB, Abukawa H, Shuster V, Kaban LB. A comparison of postoperative edema after intraoral vs. endoscopic mandibular ramus osteotomy. J Oral Maxillofac Surg 2003; 61: 8. Reference21. Kumar A, Yadav N, Singh S, Chauhan N. Minimally invasive (endoscopic-computer assisted) surgery: technique and review. Ann Maxillofac Surg 2016; 6: 159-164. Reference22. Lee C, Mueller RV, Lee K, Mathes SJ. Endoscopic subcondylar repair. Functional, aesthetic and radiographic outcomes. Plast Reconstr Surg 1998; 102: 1434-1444. Reference23. Lee C, Stiebel M, Young DM. Cranial nerve VII region of the traumatized facial skeleton: optimizing fracture repair with the endoscope. J Trauma 2000; 48: 423-431. Reference24. Cavalcanti SCSXB, Taufer B, Rodrigues AF, Luz JGC. Endoscopic surgery versus open reduction treatment of mandibular condyle fractures: a meta-analysis. J Cranio-Maxillofac Surg 2021; 49: 749- 757. Reference25. Sanati-Mehrizy P, Massenburg BB, Sherif RD, Ingargiola MJ, Motakef S, Taub PJ. Review of endoscopic repair of mandible fractures. J Craniofac Surg 2019; 30: 489-492. Reference26. Haug RH, Brandt MT. Traditional versus endoscope-assisted open reduction with rigid internal fixation (ORIF) of adult mandibular condyle fractures: a review of the literature regarding current thoughts on management. J Oral Maxillofac Surg 2004; 62: 1272-1279. Reference27. Ellis E, Moss KF, El-Attar A. Ten years of mandibular fractures in analysis of 2317 cases. Oral Surg 1985 ;2: 120-129.