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Pathological mandibular fractures following third molar removal
K W Wagner1, J-E Otten, R Schoen
1Department of Oral and Maxillofacial Surgery, University Hospital Freiburg, Hugstetter Strasse 55, D-79106 Freiburg, Germany. wagner@zmk2.ukl.uni-freiburg.de
Summary
Mandibular fractures after wisdom tooth removal are more common in males over 40 undergoing difficult lower third molar extraction. Early signs include cracking sounds, with follow-up imaging recommended for suspected fractures.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Traumatology
Background:
- Mandibular fractures can occur as a complication of third molar removal.
- Risk factors and clinical presentation require further investigation.
Purpose of the Study:
- To analyze the incidence and characteristics of mandibular fractures following third molar removal.
- To identify patient demographics and surgical factors associated with increased fracture risk.
Main Methods:
- Retrospective analysis of 17 patients treated for mandibular fractures post-third molar removal.
- Review of clinical and radiological data from 2000-2004 at University Hospital Freiburg.
Main Results:
- Increased fracture rate observed in males over 40 years old.
- Fractures often followed difficult lower wisdom tooth removal requiring bone removal.
- Most fractures (14/17) were postoperative and located anterior to the mandibular angle (15/17).
- Six fractures were initially radiologically undetectable.
Conclusions:
- Inform patients about potential risks, including the possibility of fracture.
- Consider a soft diet for up to 4 weeks post-operation in select cases.
- A cracking noise is a key indicator; radiological follow-up is advised for initially undetectable fractures.