Effect of third molars in the line of mandibular angle fractures on postoperative complications: systematic review and meta-analysis

Fernandes, Ighor Andrade; Souza, Glaciele Maria de; Rezende, Vanessa Silva de; Al-Sharani, Hesham Mohammed; Oliveira, Dhelfeson Willya Douglas de; Galvão, Endi Lanza; Falci, Saulo Gabriel Moreira

doi:10.1016/j.ijom.2019.09.017

Cited by 13 publications

(13 citation statements)

References 48 publications

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“…Finally, conclusions about third molar retaining or removing are still controversial. Although some studies suggest that the third molar can cause complications after mandibular angle fracture treatment 27,28 , prophylactic extraction of the lower M3 is a questionable matter. There is no reliable proof of whether to advocate or reject the prophylactic removal of the lower M3 11 .…”

Section: Discussionmentioning

confidence: 99%

The influence of wisdom tooth impaction and occlusal support on mandibular angle and condyle fractures

Al-Sharani

Zhang

Mashrah

et al. 2021

Sci Rep

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This study aimed to analyze the relationship of the occlusal support together with the lower third molars to the mandibular fractures of the angle and condyle among patients in our medical institutions. This was a retrospective study that reviewed the medical records and radiographs of all patients treated for mandibular fractures from 2015 to 2019. The data collected by using picture archiving and communicating system. Only records with mandibular angle or condyle fractures were included. The dependent variable was the presence of the fractures of the mandibular angle or condyle. The independent variables were epidemiological data, third molar characteristics, existence or absence of occlusal support. The data was analyzed through Univariate logistic regression and multivariate logistic regression. From a total of 187 mandibular fractures, 44 presented mandibular angle fracture and 29 shown condyle fractures. The average age was 40.34 ± 13.47 years. The absence of occlusal support increased the chance of condyle fractures by 5.1 times (95% CI 1.61–17.29). The lack of occlusal support is more associated with condyle fractures than the presence of occlusal support, regardless of third molar presence and characteristics and other variables evaluated.

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Section: Discussionmentioning

confidence: 99%

The influence of wisdom tooth impaction and occlusal support on mandibular angle and condyle fractures

Al-Sharani

Zhang

Mashrah

et al. 2021

Sci Rep

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“…14 The post-op infection rate in the absence of a third molar in the mandibular angle fracture line (when it is missing preoperatively or extracted during fracture treatment) has been reported to be lower than that in angle fractures with a third molar present. 15 The incidence of complications has been found to be higher if the third molars in the line of a fracture have caries, are fractured, show signs of pericoronitis, are periodontally involved, are interfering with the occlusion, are extracted at the time of fixation. 16 In the current study, the regions of the mandible were found to have no effect on the condition of the teeth at the first post-op year.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Prognosis of the Teeth in the Mandibular Fracture Line

Hoşgör

Coşkunses

Akin

2020

Craniomaxillofacial Trauma & Reconstruction

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Objective: The aim of this study was to evaluate the prognosis of the teeth in the mandibular fracture line and to analyze the relationship between the degree of displacement of fracture fragments, the relationship of the fracture line to the periodontium, and the relationship between the condition of the teeth at the first postoperative (post-op) year. Methods: A total of 60 teeth from 38 patients (11 female and 27 male) who had erupted teeth in the line of mandibular fracture and were treated with open reduction were examined. The data were collected from the patients’ clinical records and radiographs. Age at the time of injury, gender, cause of trauma, site of fracture, the relationship of the fracture line to the periodontium, the degree of displacement of fracture fragments, and the condition of the teeth in the line of the fracture at the first post-op year were evaluated. Results: The degree of displacement of fracture fragments had an effect on the condition of the teeth at the first post-op year ( P = .036) and the regions of the mandible had an effect on the degree of displacement of the fracture fragments ( P = .000). The survival rate of the pulp of the teeth was 69.8%. Conclusions: A preventive approach should be preferred for teeth in the mandibular fracture line. Retained teeth in the fracture line should be monitored clinically and radiologically for at least 1 year, and unnecessary endodontic treatments should be avoided.

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“…A large prospective study of 253 patients with 422 mandibular fractures found a postoperative infection rate of 6.95% and found no association between the rate of infection and whether the tooth in the line of fracture was removed or not. [59][60][61] A systematic review by Fernandes et al similarly failed to show any statistically significant difference in complication rates. 62 When teeth in the line of the fracture impair adequate reduction of the bony segments, are involved in an infected fracture, are mobile due to fracture or periodontal disease, have associated drainage, periapical radiolucency, or are themselves fractured, they should be removed.…”

Section: Special Considerationsmentioning

confidence: 99%

“…62 When teeth in the line of the fracture impair adequate reduction of the bony segments, are involved in an infected fracture, are mobile due to fracture or periodontal disease, have associated drainage, periapical radiolucency, or are themselves fractured, they should be removed. [61][62][63][64] For teeth otherwise involved in the lines of fractures, recent recommendations advise clinical and radiographic monitoring for at least 1 year and avoid unnecessary, costly endodontic procedures. 63 When a symptomatic tooth needs to be removed, it should ideally be removed once an adequate healing period has occurred, typically at a minimum of 3 months following reduction.…”

Section: Special Considerationsmentioning

confidence: 99%

“…[59][60][61] A systematic review by Fernandes et al similarly failed to show any statistically significant difference in complication rates. 62 When teeth in the line of the fracture impair adequate reduction of the bony segments, are involved in an infected fracture, are mobile due to fracture or periodontal disease, have associated drainage, periapical radiolucency, or are themselves fractured, they should be removed. [61][62][63][64] For teeth otherwise involved in the lines of fractures, recent recommendations advise clinical and radiographic monitoring for at least 1 year and avoid unnecessary, costly endodontic procedures.…”

Section: Special Considerationsmentioning

confidence: 99%

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Mandibular Fractures: Diagnosis and Management

Panesar

Susarla

2021

Semin Plast Surg

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Accurate evaluation, diagnosis, and management of mandibular fractures is essential to effectively restore an individual's facial esthetics and function. Understanding of surgical anatomy, fracture fixation principles, and the nuances of specific fractures with respect to various patient populations can aid in adequately avoiding complications such as malocclusion, non-union, paresthesia, and revision procedures. This article reviews comprehensive mandibular fracture assessment, mandibular surgical anatomy, fracture fixation principles, management considerations, and commonly encountered complications. In addition, this article reviews emerging literature examining 3-dimensional printing and intraoperative imaging.

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Effect of third molars in the line of mandibular angle fractures on postoperative complications: systematic review and meta-analysis

Cited by 13 publications

References 48 publications

The influence of wisdom tooth impaction and occlusal support on mandibular angle and condyle fractures

The influence of wisdom tooth impaction and occlusal support on mandibular angle and condyle fractures

Evaluation of the Prognosis of the Teeth in the Mandibular Fracture Line

Mandibular Fractures: Diagnosis and Management

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