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The influence of third molars in the line of mandibular angle fractures on wound and bone healing

Authors
  • Ulbrich, N.1
  • Ettl, T.1
  • Waiss, W.1
  • Gosau, M.2
  • Moralis, A.1
  • Reichert, T. E.1
  • Mueller, S.1
  • 1 Regensburg University Medical Centre, Department of Oral and Maxillofacial Surgery, Franz-Josef-Strauß-Allee 11, Regensburg, 93053, Germany , Regensburg (Germany)
  • 2 Nuremberg Hospital, Department of Oral and Maxillofacial Surgery, Breslauer Straße 201, Nürnberg, 90471, Germany , Nürnberg (Germany)
Type
Published Article
Journal
Clinical Oral Investigations
Publisher
Springer-Verlag
Publication Date
Sep 28, 2015
Volume
20
Issue
6
Pages
1297–1302
Identifiers
DOI: 10.1007/s00784-015-1612-3
Source
Springer Nature
Keywords
License
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Abstract

ObjectivesThe objective of this study was to evaluate postoperative complications after removal or retention of the third molar in the line of mandibular angle fractures.Materials and methodsThis retrospective study included the data of 98 patients with a molar in the line of a mandibular angle fracture treated with internal reduction and mini-plate fixation at our department over 9 years. Patients were classified into two groups: tooth removal during osteosynthesis (n = 45) and tooth retention (n = 55). The primary target criterion was the incidence of minor (outpatient treatment, local measures) and major (surgical revision, rehospitalisation) complications. Time between trauma and surgery was 1.4 days (range 0 to 12), and the average follow-up 291 days (range 66 to 863).ResultsRegarding the eruption status, 26 of 52 (50.0 %) impacted third molars, 11 of 19 (57.9 %) incompletely erupted and 8 of 27 (29.6 %) completely erupted molars had been removed during open reduction. Overall, 17 (17.3 %) patients had postoperative minor (n = 7) or major (n = 10) complications, in detail 10/45 (22.0 %) patients after tooth removal and 7/55 (13 %) patients after tooth retention (p = 0.286). Complication rates between impacted and incompletely erupted third molars (impacted molars 15.0 %, incompletely erupted molars 10.0 %) did not differ significantly, but completely erupted molars had a complication rate of 26.0 %.ConclusionsMandibular angle fractures with a completely erupted third molar show the highest complication rate after open reduction and osteosynthesis. Retention of a non-infectious third molar facilitates open reduction and does not increase the complication risk.Clinical relevanceThe study helps with the decision of removing or retention of a third molar during surgical treatment of a mandibular angle fracture.

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