1
|
A retrospective analysis of the impaction status of mandibular third molars as a risk factor for fractures of angle or condylar region of the mandible. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [DOI: 10.1016/j.adoms.2021.100018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
2
|
Kandel L, Mishra R, Yadav D, Tripathi S, Shubham S, Chhetri P. Impact of mandibular third molars on angle fractures: A retrospective study. Dent Traumatol 2020; 37:103-107. [PMID: 32946680 DOI: 10.1111/edt.12608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous studies have shown that the position and presence of mandibular third molars is associated with a high risk of mandibular angle fractures. The aim of this study was to assess the relationship between the position and presence of mandibular third molars and mandibular angle fractures. MATERIAL AND METHODS A retrospective study consisting of 256 patients who were admitted for treatment of mandibular fractures between January 2016 and January 2018 was undertaken. Patients' data and orthopantomogram radiographs were obtained from their medical record. The predictor variable was the presence and position of mandibular third molars. The position of the third molars was grouped based on the Pell and Gregory classification. The outcome variable was the presence of an angle fracture. Other study variables included age, gender, mechanism of injury, and fracture location. RESULTS Patients with mandibular third molars had a 2.7 times greater chance of an angle fracture than patients without third molars. Patients with their third molars present at occlusal position C and ramus position level 3 had a higher risk of angle fracture in comparison with other groups. There was a statistically significant variation in the risk of an angle fracture, depending on mandibular third molar position (P < .001). CONCLUSION Patients with mandibular third molars have an increased risk of angle fractures. The risk for an angle fracture varied depending on the third molar position.
Collapse
Affiliation(s)
- Laxmi Kandel
- Department of Oral and Maxillofacial Surgery, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Ravish Mishra
- Department of Oral and Maxillofacial Surgery, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Deepak Yadav
- Department of Oral and Maxillofacial Surgery, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Shashank Tripathi
- Department of Oral and Maxillofacial Surgery, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Snigdha Shubham
- Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa, Nepal
| | - Pradip Chhetri
- Department of Community Medicine and Public Health, Universal College of Medical Sciences, Bhairahawa, Nepal
| |
Collapse
|
3
|
Soós B, Janovics K, Tóth Á, Di Nardo MD, Szalma J. Association Between Third Molar Impaction Status and Angle or Condylar Fractures of the Mandible: A Retrospective Analysis. J Oral Maxillofac Surg 2020; 78:1162.e1-1162.e8. [PMID: 32151652 DOI: 10.1016/j.joms.2020.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/05/2020] [Accepted: 02/05/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of our study was to evaluate the correlations between mandibular third molar impaction status and mandibular angle and condylar fractures. MATERIALS AND METHODS This retrospective cross-sectional study included patients with unilateral and isolated angle or condylar fractures. Patient records and panoramic radiographs were evaluated. The predictor variables included the presence, impaction status (Pell and Gregory [P&G] classification), and angulation (Winter classification) of the third molar. The outcome variable was the type of fracture, whereas other predictor variables included demographic factors such as age, gender, and fracture etiology. Bivariate (χ2 test) and logistic regression analyses were conducted to estimate the associations between variables and the outcome. RESULTS The sample was composed of 164 angle fracture (mean age, 31.6 ± 12.3 years; 83.5% male) and 115 condylar fracture (mean age, 41.9 ± 16.8 years; 76.5% male) patients. A third molar was present in 72.6% of the angle fracture group and 54.8% of the condylar fracture group (P = .002). Deep impactions (classes IC, IIC, IIIB, and IIIC) exhibited an odds ratio (OR) of 3.60 for angle fractures (P < .001). No association was found between tooth angulations and the type of fracture. According to logistic regression analysis, older age (adjusted OR, 1.05; 95% confidence interval [CI], 1.03 to 1.07), P&G class I impaction (OR, 1.86; 95% CI, 1.09 to 3.20), and P&G class A impaction (OR, 1.91; 95% CI, 1.12 to 3.24) were significantly associated with condylar fractures whereas the presence of a third molar (OR, 0.46; 95% CI, 0.28 to 0.76) or P&G class B impaction (OR, 0.287; 95% CI, 0.12 to 0.69) was associated with angular fractures. CONCLUSIONS P&G class II or III and class B impaction status was significantly associated with angle fractures, whereas missing or fully erupted (class IA) third molars significantly correlated with condylar fractures.
Collapse
Affiliation(s)
- Balázs Soós
- PhD Student and Assistant Lecturer, Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, Pécs, Hungary
| | - Kata Janovics
- Assistant Lecturer, Department of Conservative Dentistry and Periodontology, University of Pécs, Pécs, Hungary
| | - Ákos Tóth
- Assistant Professor, Institute of Sport Sciences and Physical Education, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | | | - József Szalma
- Associate Professor and Department Head, Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, Pécs, Hungary.
| |
Collapse
|
4
|
Lee Y, Kim J, Lee M, Shin D, Choi H. Relationship between mandible fractures and third molars. Arch Craniofac Surg 2020; 20:376-381. [PMID: 31914492 PMCID: PMC6949500 DOI: 10.7181/acfs.2019.00493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 11/10/2019] [Indexed: 11/11/2022] Open
Abstract
Background This study was conducted to determine the relationship between third molar (M3) and mandibular fracture. Methods Patients with unilateral mandibular angle or condyle fractures between 2008 and 2018 were evaluated retrospectively. Medical records were reviewed regarding the location of fractures, and panoramic radiographs were reviewed to discern the presence and position of ipsilateral mandibular third molars (M3). We measured the bony area of the mandibular angle (area A) and the bony area occupied by the M3 (area B) to calculate the true mandibular angle bony area ratio (area A–B/area A× 100). Results The study consisted of 129 patients, of which 60 (46.5%) had angle fractures and 69 (53.5%) had condyle fractures. The risk of angle fracture was higher in the presence of M3 (odds ratio [OR], 2.2; p< 0.05) and the risk of condyle fracture was lower in the presence of M3 (OR, 0.45; p< 0.05), than in the absence of M3. The risk of angle fracture was higher in the presence of an impacted M3 (OR, 0.3; p< 0.001) and the risk of condyle fracture was lower in the presence of an impacted M3 (OR, 3.32; p< 0.001), than in the presence of a fully erupted M3. True mandibular angle bony area ratio was significantly lower in the angle fractures than in the condyle fractures (p= 0.003). Conclusion Angle fractures had significantly lower true mandibular angle bony area ratios than condyle fractures. True mandibular angle bony area ratio, a simple and inexpensive method, could be an option to predict the mandibular fracture patterns.
Collapse
Affiliation(s)
- Yunhae Lee
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Jeenam Kim
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Myungchul Lee
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Donghyeok Shin
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Hyungon Choi
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| |
Collapse
|
5
|
Mehra A, Anehosur V, Kumar N. Impacted Mandibular Third Molars and Their Influence on Mandibular Angle and Condyle Fractures. Craniomaxillofac Trauma Reconstr 2019; 12:291-300. [PMID: 31719954 DOI: 10.1055/s-0039-1685459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 02/07/2019] [Indexed: 10/27/2022] Open
Abstract
The aim of this study is to retrospectively analyze the effect unerupted or partially erupted third molars have on the angle and condyle fracture patterns of the mandible. It also focuses on evaluating the type of impaction that causes angle fracture and the level at which the condyle most commonly fractures. The study involves all the patients who had undergone treatment for condylar and angle of the mandible fractures from 2010 to 2017 in our craniofacial center. The case records and orthopantomograms of each patient were taken into consideration and a correlation was established based on gender, age, etiology, presence of third molars, position of third molars, angulation, and root development of third molars. Of the 150 angle fracture patients, 146 had third molars and 4 did not, whereas of the 130 condyle fractures, third molar was present in 54 patients and absent in 76. The prevalence of angle fractures was statistically significant when a third molar was present, whereas the prevalence of condyle fractures was higher when third molar was absent. The results of age, etiology, angulation, position, and root development of third molars were also statistically significant. However, sex of the patient did not influence the fracture pattern. The presence of an impacted third molar or a completely erupted one has a definite influence on the fracture pattern of the mandible. The occurrence of angle and condyle fractures was mostly affected by the continuity of the cortical bone at the angle of the mandible. Hence, prophylactic removal of mandibular third molars does increase the risk of condyle fractures.
Collapse
Affiliation(s)
- Anhad Mehra
- Department of Oral and Maxillofacial Surgery, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
| | - Venkatesh Anehosur
- Department of Oral and Maxillofacial Surgery, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
| | - Niranjan Kumar
- SDM Craniofacial Unit and Research Centre, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India
| |
Collapse
|
6
|
Brasil DM, Nascimento EH, Gaêta-Araujo H, Oliveira-Santos C, Maria de Almeida S. Is Panoramic Imaging Equivalent to Cone-Beam Computed Tomography for Classifying Impacted Lower Third Molars? J Oral Maxillofac Surg 2019; 77:1968-1974. [DOI: 10.1016/j.joms.2019.03.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/27/2019] [Accepted: 03/29/2019] [Indexed: 11/30/2022]
|
7
|
Samieirad S, Eshghpour M, Dashti R, Tohidi E, Javan AR, Mianbandi V. Correlation Between Lower Third Molar Impaction Types and Mandibular Angle and Condylar Fractures: A Retrospective Study. J Oral Maxillofac Surg 2019; 77:556-564. [DOI: 10.1016/j.joms.2018.09.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/01/2018] [Accepted: 09/19/2018] [Indexed: 11/29/2022]
|
8
|
Do Mandibular Third Molars Play a Role in Fractures of the Mandibular Angle and Condyle? J Craniofac Surg 2018; 29:e713-e717. [PMID: 30192292 DOI: 10.1097/scs.0000000000004961] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The relationship between impacted mandibular third molars with angle and condylar fractures is subject of many publications, yet their conclusions differ widely, hence the authors wanted to investigate this topic in their patients. METHODS The authors designed a retrospective study including 241 patients who presented with angle and/or mandibular condyle fractures over a 13-year period at the authors' institution. The study variable was the presence/absence of third molars. The authors used the Pell and Gregory system to classify their position, whereas the angulation was classified using Archer classification. The outcome variables were the presence of angle and condylar fractures. Other study variables included fracture etiology. RESULTS Assaults were the most frequent cause of angle fractures (62.7%), whereas falls were mostly responsible for condylar fractures (79.6%). Angle fractures were mostly isolated (66.3%), whereas condylar fractures were mostly associated with other fractures (62.6%). The majority of the angle fractures occurred in patients with third molars (63.6%), on the contrary the majority of the condylar fractures occurred in patients without mandibular third molars (78.3%). Angle fractures were mostly associated with fully erupted or superficially impacted third molars (90,9%). Finally in the presence of mesioangulated third molars, condylar fractures did not happen in 83.8% of patients. CONCLUSIONS According to the authors' findings, fully erupted or superficially impacted mandibular third molars are a risk factor for angle fractures but at the same time a protective factor for the condyle. On the contrary, the absence of mandibular third molars "strengthens" the angle and represents a risk factor for condylar fractures.
Collapse
|
9
|
Kılınç Y, Zor ZF, Tümer MK, Erkmen E, Kurt A. Does the angulation of the mandibular third molar influence the fragility of the mandibular angle after trauma to the mandibular body? A three-dimensional finite-element study. Comput Methods Biomech Biomed Engin 2018; 21:488-497. [PMID: 29969292 DOI: 10.1080/10255842.2018.1482282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The relationship between mandibular third molar (M3) angulation and mandibular angle fragility is not well established. The aim of this study was to evaluate the impact of M3 angulation on the mandibular angle fragility when submitted to a trauma to the mandibular body region. A three-dimensional (3D) mandibular model without M3 (Model 0) was obtained by means of finite-element analysis (FEA). Four models were generated from the initial model, representing distoangular (Model D), horizontal (Model H), mesioangular (Model M) and vertical (Model V) angulations. A blunt trauma with a magnitude of 2000 N was applied perpendicularly to the sagittal plane in the mandibular body. Maximum principal stress (Pmax) (tensile stress) values were calculated in the bone. The lowest Pmax stress values were noted in Model 0. When the M3 was present extra stress fields were found around marginal bone of second molar and M3. Comparative analysis of the models with M3 revealed that the highest level of stress was found in Model V, whereas Model D showed the lowest stress values. The angulation of M3 affects the stress levels in the mandibular angle and has an impact on mandibular fragility. The mandibular angle becomes more fragile in case of vertical impaction when submitted to a trauma to the mandibular body region.
Collapse
Affiliation(s)
- Yeliz Kılınç
- a Department of Oral and Maxillofacial Surgery, Faculty of Dentistry , Gazi University , Ankara , Turkey
| | - Zeynep Fatma Zor
- a Department of Oral and Maxillofacial Surgery, Faculty of Dentistry , Gazi University , Ankara , Turkey
| | - Mehmet Kemal Tümer
- b Department of Oral and Maxillofacial Surgery, Faculty of Dentistry , Gaziosmanpaşa University , Tokat , Turkey
| | - Erkan Erkmen
- a Department of Oral and Maxillofacial Surgery, Faculty of Dentistry , Gazi University , Ankara , Turkey
| | - Ahmet Kurt
- c Department of Manufacturing Engineering, Faculty of Engineering , Atılım University , Ankara , Turkey
| |
Collapse
|
10
|
Giovacchini F, Paradiso D, Bensi C, Belli S, Lomurno G, Tullio A. Association between third molar and mandibular angle fracture: A systematic review and meta-analysis. J Craniomaxillofac Surg 2018; 46:558-565. [DOI: 10.1016/j.jcms.2017.12.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 12/02/2017] [Accepted: 12/14/2017] [Indexed: 10/18/2022] Open
|
11
|
Xu S, Huang JJ, Xiong Y, Tan YH. How Is Third Molar Status Associated With the Occurrence of Mandibular Angle and Condyle Fractures? J Oral Maxillofac Surg 2017; 75:1476.e1-1476.e15. [PMID: 28412268 DOI: 10.1016/j.joms.2017.03.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 03/14/2017] [Accepted: 03/14/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE Third molars (M3s) have been hypothesized to be associated with the risk of mandibular angle fracture and mandibular condylar fracture. The authors systematically estimated the relative risk (RR) of M3 status for the development of mandibular angle fracture and mandibular condylar fracture through a meta-analysis of cohort studies. MATERIALS AND METHODS In this systematic review, the PubMed, EMBASE, and Cochrane Library databases were searched from inception to October 2016. The predictor of risk was the presence or absence of M3s. The primary outcome was the RR of mandibular angle or condylar fracture. A fixed- or a random-effects model was applied to evaluate the pooled risk estimates. Sensitivity analysis also was performed to identify the potential sources of heterogeneity. Publication bias was assessed by the Begg and Egger tests. RESULTS Overall, 13 retrospective cohort studies were included. Of these, 13 reported the association between M3s and mandibular angle fracture, and 5 reported the association with mandibular condylar fracture. Patients with M3s had an increased risk of mandibular angle fractures (RR = 2.63; 95% confidence interval [CI], 2.15-3.21) but a decreased risk of mandibular condylar fractures (RR = 0.47; 95% CI, 0.25-0.86). Substantial heterogeneity in the risk estimates was found. No evidence of publication bias was found. CONCLUSION The present meta-analysis provides further evidence associating the presence of M3s with an increased risk of mandibular angle fractures and a simultaneously decreased risk of mandibular condylar fracture. Because of potentially more serious complications associated with condylar fracture, clinicians should carefully consider the decision to remove M3s to decrease the risk of mandibular angle fracture.
Collapse
Affiliation(s)
- Shuai Xu
- Resident, Department of Stomatology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Jun-Jie Huang
- Resident, Department of Stomatology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Yu Xiong
- Associate Professor, Department of Stomatology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Ying-Hui Tan
- Professor, Department of Stomatology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
| |
Collapse
|
12
|
Influence of third molars in mandibular fractures. Part 1: mandibular angle-a meta-analysis. Int J Oral Maxillofac Surg 2017; 46:716-729. [PMID: 28291569 DOI: 10.1016/j.ijom.2017.02.1264] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 01/25/2017] [Accepted: 02/13/2017] [Indexed: 11/21/2022]
Abstract
The aim of this systematic review was to investigate the influence of the presence and position of mandibular third molars on angle fractures. An electronic search was conducted in the PubMed, Scopus, Web of Science, Cochrane Library, and VHL databases, through January 2016. The eligibility criteria included observational studies. The search strategy resulted in 704 articles. Following the selection process, 35 studies were included in the systematic review and 28 in the meta-analysis. Twenty studies presented a score of ≤6 stars in the Newcastle-Ottawa scale assessment, indicating a risk of bias in the analysis. The presence of a mandibular third molar increases the chance of an angle fracture (case-control and cross-sectional studies: odds ratio (OR) 3.83, 95% confidence interval (CI) 3.02-4.85, I2=83.1%; case-control studies: OR 3.27, 95% CI 2.57-4.16, I2=81.3%). The third molar positions most favourable to angle fracture according to the Pell and Gregory classification are class B (OR 1.44, 95% CI 1.06-1.96, I2=87.2%) and class II (OR 1.67, 95% CI 1.36-2.04, I2=72.4%). Class A (OR 0.60, 95% CI 0.45-0.81, I2=87.1%) and class I (OR 0.51, 95% CI 0.37-0.71, I2=89.4%) act as protective factors for angle fracture. The results suggest that the presence of the third molar increases the chance of angle fracture by 3.27 times and that the most favourable positions of the third molar for angle fracture are classes B and II, whilst classes A and I act as protective factors.
Collapse
|
13
|
Armond ACV, Martins CC, Glória JCR, Galvão EL, Dos Santos CRR, Falci SGM. Influence of third molars in mandibular fractures. Part 2: mandibular condyle-a meta-analysis. Int J Oral Maxillofac Surg 2017; 46:730-739. [PMID: 28259600 DOI: 10.1016/j.ijom.2017.02.1265] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 01/25/2017] [Accepted: 02/14/2017] [Indexed: 10/20/2022]
Abstract
The aim of this systematic review was to investigate the influence of the presence and position of mandibular third molars in mandibular condyle fractures. An electronic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, and VHL, through January 2016. The eligibility criteria included observational studies. The search strategy resulted in 704 articles. Following the selection process, 13 studies were included in the systematic review and 11 in the meta-analysis. In terms of the risk of bias analysis, six studies presented ≤6 stars in the Newcastle-Ottawa scale assessment. The presence of a mandibular third molar decreased the probability of condylar fracture (cross-sectional and case-control studies: odds ratio (OR) 0.26, 95% confidence interval (CI) 0.17-0.40, I2=87.8%; case-control studies: OR 0.30, 95% CI 0.16-0.58, I2=91.6%). The third molar positions most favourable to condylar fracture according to the Pell and Gregory classification are class A (OR 1.32, 95% CI 1.09-1.61, I2=0%) and class I (OR 1.37, 95% CI 1.05-1.77, I2=32.8%). Class B (OR 0.69, 95% CI 0.49-0.97, I2=56.0%) and class II (OR 0.71, 95% CI 0.57-0.87, I2=0%) act as protective factors for condylar fracture. The results suggest that the presence of a mandibular third molar decreases the chance of condylar fracture and that the positions of the third molar most favourable for condylar fracture are classes A and I, with classes B and II acting as protective factors.
Collapse
Affiliation(s)
- A C V Armond
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhona e Mucuri (UFVJM), Diamantina, MG, Brazil
| | - C C Martins
- Department of Paediatric Dentistry and Orthodontics, Universidade Federal de Minas Gerais (UFMG), Pampulha, Belo Horizonte, MG, Brazil
| | - J C R Glória
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhona e Mucuri (UFVJM), Diamantina, MG, Brazil
| | - E L Galvão
- Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil
| | - C R R Dos Santos
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhona e Mucuri (UFVJM), Diamantina, MG, Brazil
| | - S G M Falci
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhona e Mucuri (UFVJM), Diamantina, MG, Brazil.
| |
Collapse
|
14
|
Menon S, Kumar V, V S, Priyadarshini Y. Correlation of Third Molar Status with Incidence of Condylar and Angle Fractures. Craniomaxillofac Trauma Reconstr 2016; 9:224-8. [PMID: 27516837 DOI: 10.1055/s-0036-1584400] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 02/20/2016] [Indexed: 10/21/2022] Open
Abstract
The mandibular angle and condylar regions are most prone to fractures and this has been attributed to the presence/absence or the position of the third molars. This retrospective study was undertaken to analyze the correlation between the third molars and incidence of condylar and angle fractures in 104 patients treated for these fractures during the period from June 2009 to December 2013. Clinical and radiographic records of these patients were studied to look for the presence and position of third molars and their relation to incidence of condylar or angle fractures. There was a definite positive relation to impacted third molars and increased incidence of angle fractures. The condylar fractures were more commonly seen when the third molars were fully erupted or missing. Third molar impactions predispose to angle fractures and missing or fully erupted third molars predispose to condylar fractures.
Collapse
Affiliation(s)
- Suresh Menon
- Department of Oral and Maxillofacial Surgery, Vydehi Institute of Dental Sciences, Bangalore, Karnataka, India
| | - Veerendra Kumar
- Department of Oral and Maxillofacial Surgery, Vydehi Institute of Dental Sciences, Bangalore, Karnataka, India
| | - Srihari V
- Department of Oral and Maxillofacial Surgery, Vydehi Institute of Dental Sciences, Bangalore, Karnataka, India
| | - Yogitha Priyadarshini
- Department of Oral and Maxillofacial Surgery, Vydehi Institute of Dental Sciences, Bangalore, Karnataka, India
| |
Collapse
|
15
|
Hasegawa T, Sadakane H, Kobayashi M, Tachibana A, Oko T, Ishida Y, Fujita T, Takenono I, Komatsubara H, Takeuchi J, Ichiki K, Miyai D, Komori T. A multi-centre retrospective study of mandibular fractures: do occlusal support and the mandibular third molar affect mandibular angle and condylar fractures? Int J Oral Maxillofac Surg 2016; 45:1095-9. [PMID: 27134046 DOI: 10.1016/j.ijom.2016.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 12/30/2015] [Accepted: 04/07/2016] [Indexed: 11/17/2022]
Abstract
This retrospective study was performed to investigate the influence of occlusal support and the presence, state, and position of mandibular third molars on the incidence of mandibular angle and condylar fractures. The following variables were investigated: age, sex, cause of fracture, presence and state (impaction, angulation, and the number of roots) of the mandibular third molars, site of the mandibular fracture, presence of occlusal support, duration of intermaxillary fixation, and postoperative complications. Various risk factors for mandibular angle and condylar fractures were investigated by univariate analysis. The risk of mandibular angle fracture was significantly higher in patients with occlusal support and mandibular third molars. The risk of condylar fracture was significantly higher in patients without occlusal support or mandibular third molars. The position and angulation of the mandibular third molars were not significant risk factors in mandibular angle and condylar fractures. This study demonstrated the influence of occlusal support and the presence of mandibular third molars on the incidence of mandibular angle and condylar fractures. The presence of occlusal support may be a more important factor affecting mandibular angle or condylar fractures than the position of the mandibular third molars.
Collapse
Affiliation(s)
- T Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - H Sadakane
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - M Kobayashi
- Department of Oral and Maxillofacial Surgery, Shin-Suma General Hospital, Kobe, Japan
| | - A Tachibana
- Department of Oral and Maxillofacial Surgery, Kakogawa East City Hospital, Kakogawa, Japan
| | - T Oko
- Department of Oral and Maxillofacial Surgery, Saiseikai Hyogo-ken Hospital, Kobe, Japan
| | - Y Ishida
- Department of Oral and Maxillofacial Surgery, Hyogo Prefectural Awaji Medical Center, Hyogo, Japan
| | - T Fujita
- Department of Oral and Maxillofacial Surgery, Mitsubishi Kobe Hospital, Kobe, Japan
| | - I Takenono
- Department of Oral and Maxillofacial Surgery, Kawasaki Hospital, Kobe, Japan
| | - H Komatsubara
- Department of Oral and Maxillofacial Surgery, Kobe Central Hospital, Kobe, Japan
| | - J Takeuchi
- Department of Oral and Maxillofacial Surgery, Kita-Harima Medical Center, Ono, Japan
| | - K Ichiki
- Department of Oral and Maxillofacial Surgery, Fujii Masao Memorial Hospital, Kurayoshi, Japan
| | - D Miyai
- Department of Oral and Maxillofacial Surgery, Hirono-Kogen Hospital, Kobe, Japan
| | - T Komori
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
16
|
Antic S, Milicic B, Jelovac DB, Djuric M. Impact of the lower third molar and injury mechanism on the risk of mandibular angle and condylar fractures. Dent Traumatol 2016; 32:286-95. [PMID: 26821987 DOI: 10.1111/edt.12259] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous studies have shown the influence of the mandibular third molar on mandibular angle and condylar fractures, but have not comparatively analyzed the impact of the injury mechanism on these fractures. The purpose of this study was to evaluate the influence of the lower third molar (M3) and injury-related factors (fracture etiology and site of impact of the traumatic force) on the risk of mandibular angle and condylar fractures. MATERIAL AND METHODS The study included 615 patients who sustained a mandibular fracture in a 13-year period (from January 2000 to December 2013). The independent variables were presence, position and the root number of the M3, fracture etiology, and site of impact of the force. The outcome variables were mandibular angle and condylar fractures. Other variables included in the study were patients' gender and age. The data were analyzed using the chi-square test. Univariate and multivariate binary logistic regression analyses were used to evaluate the relationship between angle and condylar fractures and to show potential determinants. RESULTS Angle fractures were significantly influenced by the M3, site of impact, and age, but the main predictors were the eruption status and vertical position of the M3 (classified by Pell and Gregory) and site of impact of the force. Condylar fractures were significantly influenced by the M3 and site of impact of the force, but only the last showed as a predictor. CONCLUSIONS Factors related to the M3 showed more significant influence on angle fractures than on condylar fractures.
Collapse
Affiliation(s)
- Svetlana Antic
- Center for Radiological Diagnostics, School of Dentistry, University of Belgrade, Belgrade, Serbia.,Laboratory for Anthropology, School of Medicine, Institute of Anatomy, University of Belgrade, Belgrade, Serbia
| | - Biljana Milicic
- Department of Statistics, School of Dentistry, University of Belgrade, Belgrade, Serbia.,Department of Anesthesiology, Clinical Center of Serbia, Belgrade, Serbia
| | - Drago B Jelovac
- Clinic of Maxillofacial Surgery, School of Dentistry, University of Belgrade, Belgrade, Serbia
| | - Marija Djuric
- Laboratory for Anthropology, School of Medicine, Institute of Anatomy, University of Belgrade, Belgrade, Serbia
| |
Collapse
|
17
|
Rahimi-Nedjat RK, Sagheb K, Jacobs C, Walter C. Association between eruption state of the third molar and the occurrence of mandibular angle fractures. Dent Traumatol 2016; 32:347-52. [DOI: 10.1111/edt.12260] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Roman K. Rahimi-Nedjat
- Department of Oral and Maxillofacial Surgery; University Medical Center of the Johannes Gutenberg University; Mainz Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery; University Medical Center of the Johannes Gutenberg University; Mainz Germany
| | - Collin Jacobs
- Department of Orthodontics; University Medical Center of the Johannes Gutenberg University; Mainz Germany
| | - Christian Walter
- Department of Oral and Maxillofacial Surgery; University Medical Center of the Johannes Gutenberg University; Mainz Germany
| |
Collapse
|
18
|
Recent advances in the management of oral and maxillofacial trauma. Br J Oral Maxillofac Surg 2015; 53:913-21. [DOI: 10.1016/j.bjoms.2015.08.261] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 08/20/2015] [Indexed: 11/17/2022]
|
19
|
Impact of the lower third molar presence and position on the fragility of mandibular angle and condyle: A Three-dimensional finite element study. J Craniomaxillofac Surg 2015; 43:870-8. [PMID: 25939313 DOI: 10.1016/j.jcms.2015.03.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 02/10/2015] [Accepted: 03/23/2015] [Indexed: 11/20/2022] Open
Abstract
The aim of the present study was to investigate the influences of the presence and position of a lower third molar (M3) on the fragility of mandibular angle and condyle, using finite element analysis. From computed tomographic scans of a human mandible with normally erupted M3, two additional virtual models were generated: a mandibular model with partially impacted M3 and a model without M3. Two cases of impact were considered: a frontal and a lateral blow. The results are based on the chromatic analysis of the distributed von Mises and principal stresses, and calculation of their failure indices. In the frontal blow, the angle region showed the highest stress in the case with partially impacted M3, and the condylar region in the case without M3. Compressive stresses were dominant but caused no failure. Tensile stresses were recorded in the retromolar areas, but caused failure only in the case with partially impacted M3. In the lateral blow, the stress concentrated at the point of impact, in the ipsilateral and contralateral angle and condylar regions. The highest stresses were recorded in the case with partially impacted M3. Tensile stresses caused the failure on the ipsilateral side, whereas compressive stresses on the contralateral side.
Collapse
|
20
|
Antic S, Saveljic I, Nikolic D, Jovicic G, Filipovic N, Rakocevic Z, Djuric M. Does the presence of an unerupted lower third molar influence the risk of mandibular angle and condylar fractures? Int J Oral Maxillofac Surg 2014; 45:588-92. [PMID: 25448405 DOI: 10.1016/j.ijom.2014.09.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 07/21/2014] [Accepted: 09/25/2014] [Indexed: 10/22/2022]
Abstract
It has been suggested that unerupted lower third molars (M3) increase the fragility of the mandibular angle and simultaneously decrease the risk of condylar fracture. However, it is unknown whether this applies regardless of the direction and point of impact of the traumatic force. The aim of this study was to investigate the impact of an unerupted M3 on the fragility of the angle and condyle in terms of a force acting from different directions and affecting different regions of the mandible. Computed tomography scans of a human mandible and finite element methodology were used to obtain two three-dimensional models: a model with, and the other without an unerupted M3. A force of 2000N was applied to three different regions of the models: the symphysis, ipsilateral body, and contralateral body, respectively. When the force was applied to the mandibular body, the results revealed increased angle fragility in cases with unerupted M3. When the force was applied to the symphysis, the condyle region showed higher fragility, irrespective of the presence of an unerupted M3. In summary, fragility of the angle and condyle regions depends on the presence of an unerupted M3 and on the direction and point of impact of the force.
Collapse
Affiliation(s)
- S Antic
- Laboratory for Anthropology, Institute of Anatomy, University of Belgrade - School of Medicine, Belgrade, Serbia
| | - I Saveljic
- Laboratory for Anthropology, Institute of Anatomy, University of Belgrade - School of Medicine, Belgrade, Serbia
| | - D Nikolic
- Laboratory for Anthropology, Institute of Anatomy, University of Belgrade - School of Medicine, Belgrade, Serbia
| | - G Jovicic
- Laboratory for Anthropology, Institute of Anatomy, University of Belgrade - School of Medicine, Belgrade, Serbia
| | - N Filipovic
- Laboratory for Anthropology, Institute of Anatomy, University of Belgrade - School of Medicine, Belgrade, Serbia
| | - Z Rakocevic
- Laboratory for Anthropology, Institute of Anatomy, University of Belgrade - School of Medicine, Belgrade, Serbia
| | - M Djuric
- Laboratory for Anthropology, Institute of Anatomy, University of Belgrade - School of Medicine, Belgrade, Serbia.
| |
Collapse
|
21
|
Kumar PP, Sridhar BS, Palle R, Singh N, Singamaneni VK, Rajesh P. Prognosis of teeth in the line of mandibular fractures. J Pharm Bioallied Sci 2014; 6:S97-S100. [PMID: 25210395 PMCID: PMC4157291 DOI: 10.4103/0975-7406.137397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 03/30/2014] [Accepted: 04/09/2014] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The purpose of this study was to evaluate teeth involved in the line of fracture, clinically and radiographically, and their associated complications so as to indicate if they should be managed conservatively or extracted. MATERIALS AND METHODS Data were collected from patients records treated of mandibular fractures. It was included pre and postoperative panoramic radiographs, information such as demographic data, age, and sex, fracture location, mobility, and vitality of teeth in the line of fracture, teeth stabilizing the fracture segment. RESULTS The sample presented 25 patients with teeth in the line of mandibular fractures. A total of 16 patients teeth in the line of fracture were vital during the 6(th) week postoperative follow-up and 9 patients with their teeth in the line of fracture were nonvital of which 4 were endodontically treated and the rest 5 patients teeth in the line of fracture were extracted as they showed signs of infection. CONCLUSION This study demonstrated that the presence of teeth in the line of fracture is not a limiting factor for the treatment. Despite the risk of complications, tooth in the fracture line should be preserved for its merits. A regular clinical and radiological follow-up should be mandatory for at least a period of 1 year.
Collapse
Affiliation(s)
- P Prasanna Kumar
- Department of Oral and Maxillofacial Surgery, BCDS, Jatkhedi, Bhopal, Madhya Pradesh, India
| | - B S Sridhar
- Department of Oral and Maxillofacial Surgery, Rama Dental College, Kanpur, Uttar Pradesh, India
| | - Ramaiah Palle
- Department of Oral and Maxillofacial Surgery, Vananchal Dental College & Hospital, Farathiyagarhwa, Jharkhand, India
| | - Nishanth Singh
- Department of Oral and Maxillofacial Surgery, Rama Dental College, Kanpur, Uttar Pradesh, India
| | - Vijay Kumar Singamaneni
- Department of Conservative Dentistry and Endodontics, S. L. Dental College, Rajahmundry, Andhra Pradesh, India
| | - Panchineni Rajesh
- Department of Prosthodontic, Anil Neerukonda Institute of Dental Sciences, Visakhapatnam, Andhra Pradesh, India
| |
Collapse
|
22
|
Tahim AS, Goodson AMC, Payne KFB, Brennan PA. A review of oral surgery-related papers published in the British Journal of Oral and Maxillofacial Surgery during 2011 and 2012. Br J Oral Maxillofac Surg 2013; 53:e3-8. [PMID: 23764498 DOI: 10.1016/j.bjoms.2013.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 05/13/2013] [Indexed: 11/24/2022]
Abstract
This paper is a synopsis of all articles relating to oral surgery that were published in the British Journal of Oral and Maxillofacial Surgery (BJOMS) between January 2011 and December 2012. Of the 57 published, 40 (70%) were full-length articles that predominantly focused on implantology, dentoalveolar surgery, and bisphosphonate osteonecrosis of the jaws (BONJs). In addition, a number of short communications, technical notes, and letters to the editor described rare cases, unusual complications, and novel surgical techniques.
Collapse
Affiliation(s)
- A S Tahim
- Department of Oral and Maxillofacial Surgery, King's College Hospital, London SE5 9RS, UK.
| | - A M C Goodson
- Department of Oral and Maxillofacial Surgery, King's College Hospital, London SE5 9RS, UK
| | - K F B Payne
- Department of Oral and Maxillofacial Surgery, King's College Hospital, London SE5 9RS, UK
| | - P A Brennan
- Maxillofacial Unit, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK
| |
Collapse
|