Complication rates in angle fractures with or without retaining third molars: A comparative study (original) (raw)
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Annals of King Edward Medical University, 2013
Objective: To determine the frequency of post-ope-rative infection in patients with mandibular angle fra-ctures treated with rigid fixation after extraction of in-volved third molar. Materials and Methods: In a total of 100 patients undergoing open reduction and internal fixation of mandibular angle fractures in which involved third molar will be extracted were included from Depart-ment of Oral and Maxillofacial Surgery, Mayo Hos-pital, Lahore. Procedure was performed by the same consultant and post operatively patients were assessed by two post graduate trainees who were trained previously to check Infection, on 1 st , 2 nd ,4 th and 6 th weeks post operatively. All the observations were entered on preformed proforma. Data was entered & analyzed by using SPSS version 10.0 Results: According to this study, the mean age of patients was 33.22 + 9.155 years. Minimum and maxi-mum age of patients was 18 years and 50 years with range of 32 years. There were 83 (83.0%) male pati-ents...
Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology, 2013
To evaluate whether the retention of lower third molars in the line of fracture of mandibular angle fractures adversely affects treatment outcomes. Methods: Data were collected on patients treated by intraoral open reduction and stable internal fixation for fractures of the mandibular angle during a 6-year period. 75% of patients had a third molar tooth in the line of fracture. Outcome variables were postoperative infection, delayed healing, nonunion, malunion, osteomyelitis, malocclusion and need for removal of bone plates. Data regarding patient demographics, cause of injury, associated fractures, time of treatment after injury, management of the third molar and postoperative complications were statistically analyzed. Results: Seventy five patients had sufficient follow-up for inclusion in the study. A tooth was present in the fracture line in 75% of the cases. Teeth in the fracture were removed in 34.6% of the cases. Postoperative complications occurred in 8% of the sample. Fractures not containing teeth at the time of fracture had a 10.5% rate of postoperative complication compared with 7.1% for patients who had teeth in the fracture (p = NS). For angle fractures with a tooth retained in the fracture line, the incidence of postoperative complications was 5.2%. When the tooth was removed, the incidence was 11.1% (p = NS). Conclusions: There is no statistically significant increase in risk for postoperative complications when a tooth is present in the line of fracture at the mandibular angle. Selective removal of these teeth may not decrease complication rates in angle fractures.
Oral and Maxillofacial Surgery, 2010
Background Angle fractures are quite common considering that the angle of the mandible forms an area of lower resistance which contains a thicker upper border, a thin basilar bone, and the presence of an impacted mandibular third molar. Common complications of mandibular third molar surgery include alveolar osteitis (dry socket), secondary infection, nerve dysfunction, and hemorrhage. Reports of mandibular fracture during and after third molar removal are uncommon. Purpose The purpose of this paper is to discuss the risk and predisposing factors that should be analyzed regarding the possibility of immediate and late mandibular angle fractures and their need for surgical treatment as a means through which to remove impacted molars. This study is based on a thorough review of the literature as well as on one immediate and one late mandibular angle fracture as described by the authors' own personal experience.
Craniomaxillofacial Trauma and Reconstruction, 2012
The objective of this study is to discuss problems associated with dental retention through three clinical cases of mandible fractures related to the presence of retained lower third molars, emphasizing the possibility of mandible fractures resulting from this or from the extraction procedure. The three evaluated patients had a fracture in the mandible angle. The third molars were present in all the cases, as was the relationship of the fracture with the teeth. After evaluating the three cases and reviewing literature, it is believed that the presence of the retained lower third molars and the surgical procedures for their extraction increase the risk of mandible angle fractures.
Annals of Maxillofacial Surgery, 2015
The purpose was to analyze the clinical course of surgically treated mandibular angle fractures from the viewpoint of routine removal of the plate because these fractures are associated with high rates of complications and plate removal. Subjects and Methods: The subjects were 40 patients with unilateral mandibular angle fracture, which was intraorally reduced and principally fixed with a single miniplate on the external oblique ridge. The third molar in relation to the fracture line was extracted in seven patients during the surgery. Clinical course was evaluated in terms of removal of the plate, preservation of the third molar and complications. Results: One patient showed a wound infection postoperatively, and two patients developed pericoronitis during the follow-up. These were managed with medication and local irrigation. One patient with a preserved third molar did not make a required visit and was lost from the follow-up. Removal of the plates was performed in 39 patients after confirmation of good fracture healing, mostly within a year. Twenty-four of 32 preserved third molars were simultaneously extracted. These procedures were generally performed under local anesthesia on an outpatient basis, and they did not cause any complications. Conclusions: Routine removal of the plate after surgical treatment for mandibular angle fractures, simultaneously with extraction of the third molar if indicated, may be beneficial to avoid complications related to the plate and the third molar later in life.
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...
Frequency of Mandibular 3rd Molar Presence and Position on Risk of Mandibular Angle Fracture
Journal of Medicine, Physiology and Biophysics
Objective of study was to determine the frequency of mandibular third molar presence and position in mandibular angle fractures. Study Design: Cross Sectional Study Setting: This study was carried out in department of dentistry, Nishtar institute of dentistry, Multan. Duration of Study: This study was conducted from 1 st July 2016 to 31 st January 2017. Methadology: Study was started after taking informed consent from the patients and approval of ethical committee. Fracture side was diagnosed by history and examination. Status of mandibular third molar (erupted, un-erupted and impacted) on the side of fracture was evaluated through clinical and radio-graphical examination. Data was collected for basic demographics (Age, Sex and side of fracture).Patients from both gender with age range of 25-40 years having mandibular angle fracture of any side of < one month duration were included in this study. Patients with history of extraction of mandibular third molar and those with history of fracture from gunshot injury were excluded from the study.Data was collected for mandibular third molar presence and position and noted in especially designed proforma. Results: A total of 158 patients of both gender with mandibular angle fracture of any side were included. Age range in this study was from 25 to 40 years with mean age of 32.689 ± 3.28 years, mean height 1.612 ± 0.04 meters, mean BMI 23.929 ± 2.08 Kg/m 2 and mean duration of fracture was 11.354 ± 6.08 days. Majority of the patients (55.7%) belongs to 25-33 years age groups. While males were 90.5% as compare to females 9.5%. UnErupted Mandibular third molar was seen in 12.7% patients, Erupted 44.3% and Impacted was 43%. Conclusion: Conclusion of this study is that the absence of an impacted third molar decrease the prevalence of mandibular angle fractures.
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...
Frequency of unerupted mandibular third molar in mandibular angle fractures
Journal of Ayub Medical College, Abbottabad : JAMC
Fractures of the mandibular angle are common and comprise 31% of all mandibular fractures. Multiple recent studies report a 2-3 fold increased risk for mandibular angle fractures when un-erupted mandibular third molars are present. The objective of this study was to assess the frequency of un-erupted mandibular third molar in mandibular angle fractures. This cross-sectional study was conducted at the Department of Oral and Maxillofacial Surgery, Ayub Medical College, Abbottabad from April to October 2009. One hundred and two patients were included both from the outdoor and ward on consecutive non-probability sampling base. Data were recorded on a structured Performa and analysed using SPSS-16. A hemi-mandible containing un-erupted mandibular third molar was seen to have a 1.41 times the risk of mandibular angle fracture then a hemi-mandible containing an erupted mandibular third molar. The presence of unerupted mandibular third molar is associated with an increased risk for mandibul...
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...