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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Exogenous neurotrophic factors, delivered by various systems, are used to improve nerve regeneration. This study tested the effectiveness of a polymeric membrane loaded with Nerve Growth Factor (NGF) on mental nerve regeneration after a crush injury in rats. We tested NGF application, known to play a role in afferent fiber repair in dental neurobiology, to see if it could improve the regeneration. Afferent neurogram recordings and histological analyses of the trigeminal ganglion neurons were performed. One month after the crush injury, early regeneration was observed independently of exogenous NGF. However, as compared with the activity level recorded before the injury, the afferent activity was reduced by 28.5% without NGF, and the mean number of labeled neurons decreased. With NGF, activity was increased by 30.8%, with no significant histological difference compared with animals without lesions. NGF application through a polymeric membrane can influence degenerative and/or regenerative processes after a crush injury.