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The effects of molar tooth involvement in mandibular angle fractures treated with rigid fixation
Jeevan Ramakrishnan1, Alexander Shingleton, Dawn Reeves
1Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Objective:
To determine whether the presence of a tooth in the line of mandibular angle fracture increases the incidence of complications and whether removing these teeth has an effect on complication rates.
Design:
Case series with chart review.
Subjects And Methods:
The analysis was performed on 83 patients who underwent open reduction and internal fixation for mandibular angle fractures. Lower molar teeth involved in the fracture line were extracted if they were loose, fractured, or grossly infected or prevented satisfactory reduction. Data regarding demographics, involvement of a molar tooth, management of the involved tooth, and postoperative outcome were analyzed. Statistical analysis was performed by using likelihood ratio chi(2) and logistic regression.
Results:
The revision surgery in fractures with molar tooth involvement was 28.9 percent, compared to 12.9 percent when no tooth was involved (P = 0.084). When a tooth was involved in the fracture, the revision surgery rate was 25 percent when it was removed and 30% when it was preserved (P = 0.734).
Conclusion:
Postoperative complications, especially the revision surgery rates, may not increase by involvement of lower molar teeth in the fracture line and selective removal of these teeth by using commonly accepted guidelines may not decrease complication rates in angle fractures.
