Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb;43(1):37-41.
doi: 10.5125/jkaoms.2017.43.1.37. Epub 2017 Feb 20.

Evaluation of postoperative complications according to treatment of third molars in mandibular angle fracture

Hye-Youn Lim  1 , Tae-Young Jung  1 , Sang-Jun Park  1
Affiliations

Evaluation of postoperative complications according to treatment of third molars in mandibular angle fracture

Hye-Youn Lim et al. J Korean Assoc Oral Maxillofac Surg. 2017 Feb.

Abstract

Objectives: The aim of this study was to evaluate the implication of third molars in postoperative complications of mandibular angle fracture with open reduction and internal fixation (ORIF).

Materials and methods: Data were collected on patients who presented with mandibular angle fracture at our Department of Oral and Maxillofacial Surgery between January 2011 and December 2015. Of the 63 total patients who underwent ORIF and perioperative intermaxillary fixation (IMF) with an arch bar, 49 patients were identified as having third molars in the fracture line and were followed up with until plate removal. The complications of postoperative infection, postoperative nerve injury, bone healing, and changes in occlusion and temporomandibular joint were evaluated and analyzed using statistical methods.

Results: In total, 49 patients had third molars in the fracture line and underwent ORIF surgery and perioperative IMF with an arch bar. The third molar in the fracture line was retained during ORIF in 39 patients. Several patients complained of nerve injury, temporomandibular disorder (TMD), change of occlusion, and postoperative infection around the retained third molar. The third molars were removed during ORIF surgery in 10 patients. Some of these patients complained of nerve injury, but no other complications, such as TMD, change in occlusion, or postoperative infection, were observed. There was no delayed union or nonunion in either of the groups. No statistically significant difference was found between the non-extraction group and the retained teeth group regarding complications after ORIF.

Conclusion: If the third molar is partially impacted or completely nonfunctional, likely to be involved in pathologic conditions later in life, or possible to remove with the plate simultaneously, extraction of the third molar in the fracture line should be considered during ORIF surgery of the mandible angle fracture.

Keywords: Mandibular fracture; Open reduction; Third molar.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Postoperative panoramic radiographs. A. Non-extraction case. B. Extraction case.
Fig. 2
Fig. 2. Mandible series+modified towne's view.
See this image and copyright information in PMC

References

    1. Hanson BP, Cummings P, Rivara FP, John MT. The association of third molars with mandibular angle fractures: a meta-analysis. J Can Dent Assoc. 2004;70:39–43. - PubMed
    1. Al-Moraissi EA, Ellis E., 3rd What method for management of unilateral mandibular angle fractures has the lowest rate of postoperative complications? A systematic review and meta-analysis. J Oral Maxillofac Surg. 2014;72:2197–2211. - PubMed
    1. Patel N, Kim B, Zaid W. A detailed analysis of mandibular angle fractures: epidemiology, patterns, treatments, and outcomes. J Oral Maxillofac Surg. 2016;74:1792–1799. - PubMed
    1. Rajandram RK, Nabil S, Shareif MS, Ishak I, Marhazlinda J, Nordin R, et al. Mandibular third molar and angle of mandible fractures: an unsolved clinical dilemma. Sains Malaysiana. 2013;42:39–43.
    1. McNamara Z, Findlay G, O'Rourke P, Batstone M. Removal versus retention of asymptomatic third molars in mandibular angle fractures: a randomized controlled trial. Int J Oral Maxillofac Surg. 2016;45:571–574. - PubMed