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Late mandibular fracture after third molar extraction: a malpractice case or not?
Sara Bernardi1, Eloenora Ricciuti1, Sara Trichilo1
1Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
The Journal of Forensic Odonto-Stomatology
|August 26, 2025
Summary
Mandibular angle fractures after third molar extraction are rare, occurring in less than 0.0075% of cases. This case highlights that while extraction may cause such fractures, it is a known complication, not necessarily malpractice.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Malpractice Litigation
- Surgical Complications
Background:
- Fractures of the mandibular angle following surgical third molar extraction are infrequent, with reported incidences between 0.0034% and 0.0075%.
- Legal claims for late mandibular fractures post-third molar extraction are uncommon due to the low incidence of this clinical condition.
Purpose of the Study:
- To investigate the causal link between mandibular angle fracture and the extraction of a semi-included third molar (element 3.8).
- To evaluate potential dental malpractice in a case involving a mandibular angle fracture after third molar extraction.
Main Methods:
- Case report analysis including medical history, clinical examination, and radiological investigations.
- Medico-legal assessment of the extraction procedure and subsequent diagnosis.
Main Results:
- The patient developed a mandibular angle fracture approximately two weeks after third molar extraction, initially misdiagnosed.
- Radiological investigations confirmed a left mandibular angle fracture.
- The extraction was deemed necessary due to a periodontal lesion on the adjacent tooth (element 3.7).
Conclusions:
- While the extraction maneuvers may have caused the mandibular angle fracture, professional responsibility in the criminal field is excluded.
- The fracture is considered a known complication of mandibular third molar extraction, not indicative of malpractice in this instance.
