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. (c) 2025 The Author(s). Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).