Considerations of mandibular angle fractures during and after surgery for removal of third molars: a review of the literature (original) (raw)

A Study on the Impact of Mandibular Third Molars on Angle Fractures

Purpose: This study evaluated the relationship between the status and position of mandibular third molars and angle fractures. Materials and Methods: In a total of 2,033 patients with a mandibular fracture, 532 (26%) had angle fractures, and 1,466 (72%) had retained their lower third molars. The most frequent cause for mandibular fracture was road traffic accident (64%), followed by assault (19%). Results: Of 341 patients with an unerupted third molar, mandibular angle fracture was evident in 249 patients (73%). Only 62 patients (9.4%) with a completely erupted third molar had angle fractures, whereas 83 patients (17.6%) with partially erupted third molars had angle fractures. Conclusions: Our study confirmed an increased risk of angle fractures in the presence of a lower third molar, as well as a variable risk for angle fracture, depending on the third molar's position.

Mandibular Angle Fracture after Third Molar Extraction: A Case Report and Review of the Literature

2020

The extraction of third molar teeth is one of the most common procedures in the specialty of oral and maxillofacial surgery. On some occasions, the extraction results in complications, including less serious ones, such as infection, alveolar osteitis, bleeding and hemorrhage, and paresthesia. In some cases, fracture of the mandible can be observed and is classified as a severe form of these complications. The following case present a fracture of the angle of the mandible as a complication of the extraction of the lower wisdom tooth.

Late mandibular fracture after attempted third molar surgery: case report

ARCHIVES OF HEALTH INVESTIGATION, 2020

Removal of lower third molar corresponds to one of the most common procedures in oral surgery. The extraction can result in several intraoperative or postoperative complications, especially when fully impacted molars are involved. This case report describes a mandibular angle fracture following removal of a fully impacted lower third molar of a 41 years old male patient. The fracture occurred 3 days after the attempt to extract the tooth 38 by a dentist surgeon. Several factors influencing the possibility of fracture including gender, age, dental position, and angulation were reviewed and associated with the injury. A fracture line in the angular region of the jaw was observed in radiological and tomographic analysis, both essential to perform the diagnosis. Open reduction internal fixation treatment approach was realized to ensure the best patient’s recovery. We conclude that the difficult to maintain a soft diet and the complete dentition factor could have been determinant to caus...

Relationship between Fractures of Mandibular Angle and the Presence of a Lower Third Molar

Objectives: In this retrospective study, we measured the relationship between the presences of a lower third molar and mandibular angle fractures. Patients &Methods: The records and radiographs of 50 patients with mandibular angle fracture were examined. The presence of a lower third molar were assessed for each patient and related to the occurrence of mandibular angle fracture. Results: Patients with presence of a lower third molar exhibited three times greater chance of a mandibular angle fracture than patients with absent lower third molar. There was a major variation in the risk for a mandibular angle fracture depending on presence of a lower third molar. Conclusion: The presence of third molar teeth provides an area of potential weakness of the mandible and predisposes the angle region to fracture & difficulty to achieve good reduction and exposes the fracture for many complications like postoperative infections and delayed healing. Fights accounted for the largest number of fr...

Impact of mandibular third molars on angle fractures: A retrospective study

Dental Traumatology, 2020

BackgroundPrevious studies have shown that the position and presence of mandibular third molars is associated with a high risk of mandibular angle fractures. The aim of this study was to assess the relationship between the position and presence of mandibular third molars and mandibular angle fractures.Material and MethodsA retrospective study consisting of 256 patients who were admitted for treatment of mandibular fractures between January 2016 and January 2018 was undertaken. Patients' data and orthopantomogram radiographs were obtained from their medical record. The predictor variable was the presence and position of mandibular third molars. The position of the third molars was grouped based on the Pell and Gregory classification. The outcome variable was the presence of an angle fracture. Other study variables included age, gender, mechanism of injury, and fracture location.ResultsPatients with mandibular third molars had a 2.7 times greater chance of an angle fracture than p...

Impacted Third Molars and Associated Risk of Mandibular Angle Fracture - a Cross Sectional Study

Journal of Khyber College of Dentistry

Objective: To determine frequency of impacted third molar in mandibular angle fracture. Materials and Methods: This descriptive, cross sectional study was carried out in the Oral & Maxillofacial Surgery Department, Khyber College of Dentistry Peshawar from April 2016 to March 2017. 216 patients with mandible angle fractures were included in the study. Data regarding gender, age, angle fracture and impacted mandibular third molar were collected through history, clinical examination and was confirmed by orthopentomogram (OPG). Impacted third molar in mandibular angle fracture was stratified using chi square test among gender and age. P<0.05 was considered significant. Results: Among 216 patients presenting with angle fractures , impacted lower third molar was present in 179 patients (82.9%) and absent in 37 patients (17.1%).Amongst them 181 (83.8%) were males and 35 (16.2%) females. Mandibular angle fracture was predominant in male gender with male to female ratio of 5.17:1. The me...

Mandibular fracture during mandibular third molar extraction

The Internet Journal of …, 2009

Pre-operative planning for the extraction of mandibular third molars is of fundamental importance, particularly in patients over the age of 40 years, in whom osteotomies and odontotomies procedures must be included to prevent mandibular fractures Conservative treatment of the mandibular fracture has advantages and disadvantages, and can present excellent results when well indicated and performed. The main aim of this article is to relate a case of fracture of the mandibular angle in a 40-year old patient, as a result of third molar extraction on the right side. The patient had two fracture lines favourable to reduction, reported feeling a difference in dental occlusion and was treated with intermaxillary fixation with an Erich bar for 45 days. The follow-up shows complete bone consolidation of the fracture traces after four years.

Impacted third molars and risk of angle fracture

International Journal of Oral and Maxillofacial Surgery, 2002

The purpose of this study was to assess the influence of the presence, position, and severity of impaction of the mandibular third molars, on the incidence of mandibular angle fractures. A retrospective cohort study was designed for patients presenting to the Division of Oral and Maxillofacial Surgery, Toronto General Hospital (Toronto, Canada), for treatment of mandibular fractures from January 1995 to June 2000. The independent variables in this study were the presence, position and severity of impaction of third molars. The outcome variable was the incidence of mandibular angle fractures. Hospital charts and panoramic radiographs were used to determine and classify these variables. The demographic data included age, sex, mechanism of injury and number of mandibular fractures. The study sample comprised 413 mandibular fractures in 214 patients. The incidence of angle fractures was found to be significantly higher in the male population and was most commonly seen in the third decade of life. Assault remained the most significant aetiological factor. Patients with third molars had thrice the increased risk of angle fractures when compared to patients without (P<0.001). Impaction of third molars significantly increased the incidence of angle fractures (P<0.001). The severity and angulation of third molar impactions were not significantly associated with angle fractures. This study provides evidence that patients with retained impacted third molars are significantly more susceptible to angle fracture than those without. The risk for angle fracture, however, does not seem to be influenced by the severity of impaction.

Late treatment of mandible fracture after third molar removal

Research, Society and Development, 2022

Surgical management of impacted third molars is a treatment performed by dentists and its indicated for various conditions, among the indications has the prevention of mandibular fracture, but this is a factor that has been discussed and is controversial. Fractures caused by a third molar can occur, and on the other hand, the fractures after or during the management of impacted third molar are a possible complication. Surgical planning as the indication to the surgery has to be performed to avoid complications as the fracture. Thus this study aims to report a case about a mandible fracture after third molar extraction, presenting edema, pain, and restriction in mandible mobility in 01-day follow-up. A 27-year-old female was referred to the oral and maxillofacial surgery service of the Santa Casa Hospital of Araçatuba (Araçatuba, Brazil), reporting dental history of third molar removal, with immediately chief complaints. In the assessment, the patient presented edema, pain, malocclus...

Complication rates in angle fractures with or without retaining third molars: A comparative study

IP innovative publication pvt ltd, 2020

Aim: The aim of this study is to assess whether the third molar in the line of mandibular angle fracture predisposes to post-operative infection, which further may lead to implant retrieval. Materials and Methods: Surgically rehabilitated cases of mandibular angle fracture at our center Sanjay Gandhi institute of trauma and orthopedics from 2016 to 2019 were considered in the study. During this period 49 cases were followed up for over a period of 6 months at 3 moths and 6months interval. All the cases were operated by the same surgeon using universal aseptic precautions using semi- rigid fixation. Results: Out of 49 cases, 20 cases the third molar was removed and in 29 cases the third molar was retained. The mean age group of the population of the study was 33.67 (18 to 60 years), out of which majority of the cases 93.9%(46) were male patients and 6.3%(3) were female patients. The main etiology of the cases were attributed to RTA. 96.3%. At the end of the 6 months follow up it was noted that 4 plates in case of retained group and 2 plates in removed group. In the 3 month follow up in 4 cases of the retained third molar was extracted due to signs of infection. When the tooth in question was removed, infection did not occur. At the 3rd to 6 month follow another 4 retained third molars were extracted along with implant retrieval. Statistically the relationship between the two groups were analyzed using Chi-square test bivariate statistics. A P ≤ 0.05 was taken as significant. Conclusion: In our study we could not provide any concrete evidence to form a protocol for the management for the third molar in the line of mandibular angle. Retaining the third molar in the line of fracture has an increased chance of post-operative infection. We would like to conclude that partially impacted tooth are best to be removed during the procedure for better outcomes provided the fractured segments stability is maintained. Until an algorithm is set for the management of the third molar in the line of fracture, the dilemma of retaining or removing still stays and varies from case to case and on the surgeon’s experience.