Does the presence of an unerupted lower third molar influence the risk of mandibular angle and condylar fractures?

Antic, Svetlana; Šaveljić, Igor; Nikolić, Dalibor; Jovičić, Gordana; Filipović, Nenad; Rakocevic, Zoran; Djurić, Marija

doi:10.1016/j.ijom.2014.09.018

Cited by 20 publications

(25 citation statements)

References 19 publications

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“…In a later finite element analysis, they found that a blow directed at the symphyseal region caused a stress concentration in the region of the condyle, irrespective of the presence of a third molar. 52 In our study, no significant association was found between the fracture pattern and Winter third molar classification. Some previous studies found similar results.…”

Section: E5contrasting

confidence: 63%

“…[22][23][24] However, on the basis of our results, which are similar to those of several studies, the extraction of unerupted third molars also can influence the risk of different mandibular fractures. 6,8,10,13-15 Antic et al 52 stated that the extraction of unerupted lower third molars to prevent angle fractures is not recommended. According to Iida et al, 33 the removal of third molars in young athletes decreases the risk of angle fractures but increases the risk of condylar fractures, which are associated with the most severe complications among mandible fractures.…”

Section: E5mentioning

confidence: 99%

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Association Between Third Molar Impaction Status and Angle or Condylar Fractures of the Mandible: A Retrospective Analysis

Soós

Janovics

Tóth

et al. 2020

Journal of Oral and Maxillofacial Surgery

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The aim of our study was to evaluate the correlations between mandibular third molar impaction status and mandibular angle and condylar fractures.Materials and Methods: This retrospective cross-sectional study included patients with unilateral and isolated angle or condylar fractures. Patient records and panoramic radiographs were evaluated. The predictor variables included the presence, impaction status (Pell and Gregory [P&G] classification), and angulation (Winter classification) of the third molar. The outcome variable was the type of fracture, whereas other predictor variables included demographic factors such as age, gender, and fracture etiology. Bivariate (c 2 test) and logistic regression analyses were conducted to estimate the associations between variables and the outcome.Results: The sample was composed of 164 angle fracture (mean age, 31.6 AE 12.3 years; 83.5% male) and 115 condylar fracture (mean age, 41.9 AE 16.8 years; 76.5% male) patients. A third molar was present in 72.6% of the angle fracture group and 54.8% of the condylar fracture group (P = .002). Deep impactions (classes IC, IIC, IIIB, and IIIC) exhibited an odds ratio (OR) of 3.60 for angle fractures (P < .001). No association was found between tooth angulations and the type of fracture. According to logistic regression analysis, older age (adjusted OR, 1.05; 95% confidence interval [CI], 1.03 to 1.07), P&G class I impaction (OR, 1.86; 95% CI, 1.09 to 3.20), and P&G class A impaction (OR, 1.91; 95% CI, 1.12 to 3.24) were significantly associated with condylar fractures whereas the presence of a third molar (OR, 0.46; 95% CI, 0.28 to 0.76) or P&G class B impaction (OR, 0.287; 95% CI, 0.12 to 0.69) was associated with angular fractures.Conclusions: P&G class II or III and class B impaction status was significantly associated with angle fractures, whereas missing or fully erupted (class IA) third molars significantly correlated with condylar fractures.

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Section: E5contrasting

confidence: 63%

Section: E5mentioning

confidence: 99%

Association Between Third Molar Impaction Status and Angle or Condylar Fractures of the Mandible: A Retrospective Analysis

Soós

Janovics

Tóth

et al. 2020

Journal of Oral and Maxillofacial Surgery

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“…There are studies that suggest that unerupted lower third molars (M3) increase the fragility of the mandibular angle and simultaneously decrease the risk of condylar fracture. [ 23 ] In this thesis, there was no significant difference between the presence of unerupted lower third molar teeth and the angular fracture.…”

Section: Discussionmentioning

confidence: 73%

Condylar fractures: Review of 40 cases

Mahgoub

El-Sabbagh

El-Latif

et al. 2018

Ann Maxillofac Surg

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Purpose:To put an algorithmic approach for the treatment of condylar fractures according to the condition of occlusion.Patients and Methods:This study had been carried out between May 2016 and April 2017. Forty patients were included (6 females and 34 males) with their ages ranged between 3 and 60 years. Patients were managed through two approaches as follows: maxillomandibular fixation (MMF) only regimen and MMF with open reduction and internal fixation regimen. The operated cases were 12 with bilateral condylar/subcondylar fractures, and the rest were unilateral 28 cases.Results:Data were assessed demographically, time lapse before the intervention, surgically, functionally, and radiologically. In general, there were no significant differences between closed and open methods.Conclusion:Retromandibular approach was convenient for internal fixation of condylar fracture with a good outcome. In our work, there were no significant differences between closed and open methods in the treatment of condylar fractures.

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“…The presence of a lower third molar that has not erupted increases the chance of angle fractures; however, the avulsion of the dental element in this type of trauma is extremely rare and there are no cases reporting the displacement to deep spaces of the face associated with this injury [5,6]. The dental displacement to these anatomical cavities normally occurs during iatrogenic dental extractions and is typically caused by inexperienced professionals [3,7,8].…”

Section: Discussionmentioning

confidence: 99%

Lower third molar displaced to lateral pharyngeal space after mandibular angle fracture: a case report

Pereira

Silva

Bonardi

et al. 2018

Oral Maxillofac Surg

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The removal of displaced dental elements from deep anatomical spaces is a condition that requires the knowledge of the region and skills to perform the procedure. The lateral pharyngeal space contains important structures such as the internal carotid artery and close proximity with the cranium basis. The aim of this paper is to report a clinical case of a lower third molar displaced to the lateral pharyngeal space after a mandibular angle fracture and its treatment by surgical intervention. The tooth was removed under general anesthesia by direct approach and the fracture was reduced and fixed with a plate and screws. This case report illustrates the importance of an immediate procedure to avoiding severe complications and further damage to important anatomical structures.

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Does the presence of an unerupted lower third molar influence the risk of mandibular angle and condylar fractures?

Cited by 20 publications

References 19 publications

Association Between Third Molar Impaction Status and Angle or Condylar Fractures of the Mandible: A Retrospective Analysis

Association Between Third Molar Impaction Status and Angle or Condylar Fractures of the Mandible: A Retrospective Analysis

Condylar fractures: Review of 40 cases

Lower third molar displaced to lateral pharyngeal space after mandibular angle fracture: a case report

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