Late mandibular fracture occurring in the postoperative period after third molar removal: systematic review and analysis of 124 cases.
Factors associated with the diagnosis, aetiology, and treatment of mandibular fractures occurring during the postoperative period following the removal of a lower third molar are discussed. The following databases were searched using specific key words: PubMed/MEDLINE, LILACS, Embase, and Scopus. The search yielded 124 cases. Sex, age, side, tooth position and angulation, bone impaction, relationship between the tooth and the inferior alveolar nerve, local pathological conditions, aetiology of the fracture, symptomatology, and time between surgery and fracture, as well as any displacement of the fracture and the treatment of the fracture, were evaluated. Data were tabulated and the χ2statistical test was applied (P<0.05). Male patients aged >35 years, with teeth in positions II/III and B/C, complete bony impaction, and local bone-like alterations, were found to have a higher frequency of fracture and pericoronitis (P<0.05). Late fractures generally occurred between the second and fourth postoperative weeks (P<0.05). They were generally not displaced and the typical treatment was the non-surgical approach (P<0.05). It is concluded that the risk of mandibular fracture after extraction is associated with excessive ostectomy and/or local alterations. At-risk patients should be thoroughly briefed on the importance of a proper postoperative diet.
Department of Surgery and Integrated Clinic, Araçatuba Dental School, UNESP, Araçatuba, São Paulo, Brazil.
W R
WR
Pires
Department of Surgery and Integrated Clinic, Araçatuba Dental School, UNESP, Araçatuba, São Paulo, Brazil. Electronic address: joao_bonardi@hotmail.com.
J P
JP
Bonardi
Department of Surgery and Integrated Clinic, Araçatuba Dental School, UNESP, Araçatuba, São Paulo, Brazil.
L P
LP
Faverani
Department of Surgery and Integrated Clinic, Araçatuba Dental School, UNESP, Araçatuba, São Paulo, Brazil.
G A C
GA
Momesso
Department of Surgery and Integrated Clinic, Araçatuba Dental School, UNESP, Araçatuba, São Paulo, Brazil.
X M J P
XM
Muñoz
Department of Surgery and Integrated Clinic, Araçatuba Dental School, UNESP, Araçatuba, São Paulo, Brazil.
A F M
AF
Silva
Department of Surgery and Integrated Clinic, Araçatuba Dental School, UNESP, Araçatuba, São Paulo, Brazil.
S R
SR
Panzarini
Department of Surgery and Integrated Clinic, Araçatuba Dental School, UNESP, Araçatuba, São Paulo, Brazil.
A P F
AP
Bassi
Department of Surgery and Integrated Clinic, Araçatuba Dental School, UNESP, Araçatuba, São Paulo, Brazil.
D
D
Ponzoni
D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D008337:Mandibular Fractures / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy*; D008964:Molar, Third / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy*; D012307:Risk Factors; D014081:Tooth Extraction; D014095:Tooth, Impacted / Q000601:surgery*
fractures; mandibular fractures; spontaneous; third molar