Clinical and anatomical characteristics of mandibular angle fractures: a 10-year retrospective monocentric cohort study.

INTRODUCTION

Mandibular angle fractures represent a distinct subgroup of mandibular fractures with unique anatomical and biomechanical characteristics. However, factors influencing fracture patterns and treatment complexity remain incompletely understood. This study aimed to characterize the clinical, anatomical, and morphological features of mandibular angle fractures and to identify factors associated with fracture behavior.

METHODS

This retrospective monocentric cohort study included 115 patients treated for mandibular angle fractures at a tertiary referral center between January 2015 and December 2025. Demographic, fracture related, radiological, morphological, dental, and treatment variables were retrospectively collected and analyzed to evaluate factors associated with fracture patterns, treatment complexity, and clinical outcomes.

RESULTS

Of 115 patients, 104 (90.4%) were male and 11 (9.6%) were female. Female patients were significantly older than male patients (p < 0.001). Contralateral fracture patterns predominated among multiple fractures, most commonly involving the paramedian region. Pathological fractures were significantly associated with isolated fractures (p = 0.020) and occurred exclusively in patients aged ≥30 years (p < 0.001). Dentition status differed significantly between isolated and multiple fractures (p = 0.031). Morphological parameters, particularly anterior facial height and the posterior to anterior facial height (PFH/AFH) ratio, were significantly associated with fracture multiplicity and treatment complexity. Third molar status was significantly associated with treatment complexity (p = 0.010), whereas treatment modality differed significantly between age groups (p = 0.020). No significant association was observed between trauma mechanism and fracture pattern or treatment complexity.

CONCLUSION

Mandibular angle fractures appear to be primarily influenced by anatomical and biomechanical characteristics rather than trauma mechanism alone. Craniofacial morphology, age, and dental status may contribute to fracture patterns and treatment complexity, supporting a more individualized assessment of mandibular angle fractures.