Purpose: In this retrospective study, we analyzed immediate and late mandibular fractures after impacted lower third molar surgery. Patients and Methods: One hundred fifty oral and maxillofacial surgeons in the north of-France were questioned about their experience with intraoperative and late mandibular fracture after third molar surgery. Cases were examined clinically and radiographically. Results: Thirty-seven fractures were reported in about 750,000 extractions (incidence of 0.0049%). Only 27 cases could be precisely described: 17 intraoperative and 10 late fractures. The patients were 19 to 75 years of age, with an average age of 37 years for intraoperative fractures and 47 years for late fractures. All grades of tooth impaction were included. Only 2 patients did not have full dentition. [163][164][165] 2002 The mandible is the most commonly fractured facial bone a fact directly related to its prominent and exposed location. 1 Fractures through the angle are frequent 2 because the angle of the mandible forms an area of lowered resistance with a thicker superior border, thin basilar bone, 3,4 and the presence of the impacted mandibular third molar. Reports of mandibular fracture after third molar removal are uncommon. [5][6][7] This retrospective survey of the 10-year experience of 150 oral and maxillofacial surgeons in northern France was designed to determine the occurrence of intraoperative and postoperative mandibular fracture, the incidence, and the predisposing factors. Patients and MethodsOne hundred fifty oral and maxillofacial surgeons were questioned about their experience with intraoperative and postoperative mandibular fracture after third molar removal. The survey covered the 10-year period between 1989 and 1999. The patients with immediate or late fracture were selected, and their age, gender, dentition, type of impaction, medical history, radiologic evaluation, and type of surgery were assessed. Furthermore, the surgeons specified how the fracture occurred.

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