Objective: To evaluate and compare the treatment outcomes of isolated mandibular angle fractures managed by open reduction and internal fixation using intra oral and extra oral approaches. Study Design: Randomized control trial. Place and duration of Study: Department of oral and maxillofacial surgery, Liaquat University Hospital Hyderabad, from May 2011 to Nov 2011. Patients and Methods: The patients who presented with isolated mandibular fracture were selected according to inclusion criteria.

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... The diagnosis was made by standard history, clinical examination and radiographic investigations. The patients were randomly divided into two groups, A and B. Group A patients were managed by extra oral approach and group B patients were managed using intra oral approach. The patients were prescribed antibiotics for one week and follow up was carried for four weeks. Nerve damage, limited mouth opening, infection, mal-occlusion, hypertrophic scar and aesthetic dissatisfaction were immediate and late post operative complications observed and documented. Results: Road traffic accident (RTA) was the main etiologic factor (66.66%). Marginal mandibular nerve damage was noted in 20% cases treated with extra oral approach (group A). Post operative esthetic dissatisfaction was present in 60% patients (group A) as compared to 6.66% of the patients (group B). The rate of mouth opening compromise and mal-occlusion were also higher in the patients treated with extra oral approach compared with intra oral approach, although statistically not significant. Conclusion: The intra oral approach for mandibular angle fracture management is an effective and comparatively better technique as compare to the extra oral approach.