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Mandibular third molars and angle fractures.

David R Halmos1, Edward Ellis, Thomas B Dodson

  • 1University of California San Francisco School of Dentistry, USA.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|September 4, 2004
PubMed
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The presence of mandibular third molars (M3) significantly increases the risk of mandible angle fractures by 2.8 times. M3 position also influences fracture risk, though deep impactions do not elevate this risk.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Dental Traumatology
  • Anatomy

Background:

  • Mandibular third molars (M3) are frequently associated with various pathologies.
  • Understanding the relationship between M3s and mandibular fractures is crucial for patient management.

Purpose of the Study:

  • To investigate the association between the presence and position of mandibular third molars (M3) and the risk of mandible angle fractures.
  • To quantify the impact of M3 status on fracture risk.

Main Methods:

  • A multicenter retrospective cohort study involving 1,450 patients requiring operative management for mandible fractures.
  • M3 presence (present/absent) and position (Pell and Gregory classification) were analyzed as predictor variables.
  • Logistic regression models were used to determine the association with angle fractures.

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Main Results:

  • The overall risk of angle fracture was 30.1% in patients with M3s versus 13.7% in those without.
  • The presence of M3s was associated with a 2.8-fold increased risk of angle fracture (adjusted OR, 2.8; P <.001).
  • M3 position significantly influenced fracture risk (P <.001), with deep impactions showing no increased risk.

Conclusions:

  • Mandibular third molars are a significant risk factor for mandible angle fractures.
  • The specific position of M3s modifies the risk of fracture.
  • Deeply impacted M3s may not contribute to an increased risk of angle fracture.