title: Iatrogenic mandibular fractures following removal of impacted third molars: an analysis of 130 cases.
abstract: Immediate and late mandibular fractures are a rare complication of third molar removal. We analysed 130 cases of mandibular fractures following removal of impacted third molars reported in the literature, including four managed in the maxillofacial unit and identified potential risk factors. Its occurrence is likely to be multi-factorial, with age, gender, angulation, laterality, extent and degree of impaction and associated pathologies contributing to the risk of fracture. Postoperative fractures were more common than intra-operative fractures (2.7:1) and occurred most frequently in the second and third weeks (57%). A 'cracking' noise was the most frequent presentation (77%). Intra-operative fractures were more frequent among females (M:F - 1:1.3), and differed from postoperative fractures (M:F - 3.9:1). This study analyses the results, providing suggestions to minimise the risk and to manage a mandibular fracture following removal of a third molar.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Western Sussex Hospitals NHS Trust, Chichester, UK. mgethu@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Ethunandan
authors.forename: D
authors.initials: D
authors.lastname: Shanahan
authors.forename: M
authors.initials: M
authors.lastname: Patel
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D008337:Mandibular Fractures / Q000209:etiology*; D008875:Middle Aged; D008964:Molar, Third / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D012737:Sex Factors; D014081:Tooth Extraction; D014095:Tooth, Impacted / Q000601:surgery*