The literature revealed that the angle of mandible
may be an accurate cephalometric tool for population-specific age and sex identification (Singh et al., 2015).
We realised that inferior and anterior relocation was much easier by holding at the angle of mandible
and retracting forward.
For this, fixed bony landmarks like angle of mandible
, symphysis menti and thyroid notch are used to take measurements.
The angle of mandible
is more prone to complications among all the mandibular fractures.4 Many treatment options are suggested in literature but still the treatment of angle of mandible
is subject to many controversies.2
Incision was made from right angle of mandible
to the left angle of mandible
Risdon incision was made extraorally distractor was oriented at the angle of mandible
. Mandibular osteotomy was done.
On clinical examination diffuse swelling was present on right side of the face at the angle of mandible
. Swelling was 5 x 4 cm in size.
The anterior branch joins with the facial vein slightly inferior and anterior to the angle of mandible
to form common facial vein that drains into internal jugular vein.
CASE HISTORY: A 12 year old boy presented with the defect over right angle of mandible
Buccal cortices were fractured on both sides at anterior limit of angle of mandible
. Distractors were fixed at pre-decided positions keeping the vector of growth in mind.
Fracture at the angle of the mandible with a tooth in the line of fracture are more likely to become infected than at other sites4.The relation of the third molar with weakening of angle mandible has been proved by the study of Ueno et al.5 Rietzik et al in comparative study conclude that unerupted third molars are more signifi- cant in fracture of angle of mandible
than the erupted third molar.6
The angle of mandible
varies with age and state of dentition (Zivanovich, 1970).
On extra oral examination, a swelling of size 4x5 centimeters cm was seen extending anteroposteriorly from the right lower border of mandible till the right angle of mandible
. The swelling was hard in consistency, surface was smooth and tender on palpation.