Mandibular fracture 2 weeks after third molar extraction

Abstract

This case report describes mandibular fracture after the surgical extraction of fully erupted lower third molar of a 53-year-old healthy male patient. The fracture occurred 15 days after the extraction while chewing. The fracture line extended from the apex of the mesiobuccal root socket to the inferior border of the mandible. Follow-up of the patient was agreed as the patient was not willing to carry on further treatment. Bony union was observed radiologically 3 months later.

Pathological mandibular fractures: a review of the literature of the last two decades

“…In the recent literature (Table ), increased rates of fractures were observed in patients over 40 years of age . In particular, many studies report values of mean age ranging from 22 to 53 . However, most of the case series showed a mean age ≥39 years (Iizuka et al.…”

“…Pathological mandibular fracture associated with the removal of teeth can occur either during the procedure or in the immediately postoperative weeks. It can be considered a rare event with a reported incidence between 0.0034% and 0.0075% (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) (Table 1).…”

“…In the recent literature review, almost all pathological mandibular fractures following tooth removal were due to third molar removal (1,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)). This appears to be related to the particular characteristics of third molar extraction that often require higher forces or more extensive ostectomy than other extractions, weakening the mandible for a period of time (24,25,(110)(111)(112)(113).…”

“…In the recent literature (Table 1), increased rates of fractures were observed in patients over 40 years of age (1,14,21,27). In particular, many studies report values of mean age ranging from 22 to 53 (1,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). However, most of the case series showed a mean age 39 Reasons for this finding could be a decrease in elasticity of the mandibular bone during advancing age, an increase in narrowing of the periodontal ligament and the increased ankylosis of third molars in older patients that may require extensive osteotomy (1,14,21).…”

“…Pathological fractures usually may be determined by surgical interventions (third molar removal and implant placement), result from regions of osteomyelitis, osteoradionecrosis (ORN), and bisphosphonate‐related osteonecrosis of the jaw (BRONJ), occur because of idiopathic reasons or be facilitated by cystic lesions, benign, malignant, or metastatic tumors .…”