Risk Factors for Postoperative Complications in Isolated Mandibular Angle Fractures Within a North African Population

Background: Mandibular angle fractures are associated with a relatively high incidence of postoperative complications despite standardized surgical protocols. Identifying reliable predictive factors is essential to optimize therapeutic strategies and enhance patient outcomes. This study aimed to evaluate the risk factors for postoperative complications in surgically managed, isolated, unifocal mandibular angle fractures. Materials and Methods: We conducted a retrospective monocentric study including patients surgically treated for isolated mandibular angle fractures over a 4-year period. Data regarding demographic characteristics, fracture displacement, mandibular third molar status (presence and eruption stage), surgical approach (intraoral vs trans buccal), timing of intervention, and postoperative outcomes were analyzed. Results: A total of 86 patients were included. Postoperative complications occurred in 22 patients (26%). These complications were significantly associated with fracture displacement ( P = .011), complete eruption of the mandibular third molar ( P = .005), an intraoral surgical approach ( P = .003), and delayed surgical management ( P = .042). Specifically, hardware exposure was significantly more frequent following an intraoral approach compared with a trans buccal approach ( P = .043). Furthermore, preoperative inferior alveolar nerve hypoesthesia was strongly predictive of persistent postoperative neurosensory deficits ( P < .001), and smoking was significantly linked to hardware exposure ( P = .047). Conclusion: Postoperative outcomes in isolated mandibular angle fractures are primarily determined by injury characteristics and therapeutic choices. Prompt intervention, careful assessment of third molar status, and the strategic use of a trans buccal approach are essential to minimize complications and enhance clinical recovery.