scholarly journals Late mandibular fracture after attempted third molar surgery: case report

2020 ◽  
Vol 9 (3) ◽  
Author(s):  
Rodrigo Capalbo-Silva ◽  
Henrique Hadad ◽  
Jonathas Eduardo Virgilio Piassi ◽  
Luara Teixeira Colombo ◽  
Bruno Coelho Mendes ◽  
...  
Keyword(s):  
Case Report ◽  
Third Molar ◽  
Mandibular Fracture ◽  
Third Molar Surgery ◽  
Mandibular Fractures ◽  
Third Molars ◽  
Mandibular Angle ◽  
Mandibular Angle Fracture ◽  
Maxillofacial Fractures ◽  
Surgical Extraction

Removal of lower third molar corresponds to one of the most common procedures in oral surgery. The extraction can result in several intraoperative or postoperative complications, especially when fully impacted molars are involved. This case report describes a mandibular angle fracture following removal of a fully impacted lower third molar of a 41 years old male patient. The fracture occurred 3 days after the attempt to extract the tooth 38 by a dentist surgeon. Several factors influencing the possibility of fracture including gender, age, dental position, and angulation were reviewed and associated with the injury. A fracture line in the angular region of the jaw was observed in radiological and tomographic analysis, both essential to perform the diagnosis. Open reduction internal fixation treatment approach was realized to ensure the best patient’s recovery. We conclude that the difficult to maintain a soft diet and the complete dentition factor could have been determinant to cause the fracture.Descriptors: Mandibular Fractures; Fracture Fixation; Molar, Third.ReferencesAl-Belasy FA, Tozoglu S, Ertas U. Mastication and late mandibular fracture after surgery of impacted third molars associated with no gross pathology. J Oral Maxillofac Surg. 2009; 67(4):856-61.daBodner L, Brennan PA, McLeod NM. Characteristics of iatrogenic mandibular fractures associated with tooth removal: review and analysis of 189 cases. Br J Oral Maxillofac Surg. 2011;49(7):567-72.Bouloux GF, Steed MB, Perciaccante VJ. Complications of third molar surgery. Oral Maxillofac Surg Clin North Am. 2007;  19(1):117-28.Joshi A, Goel M, Thorat A. Identifying the risk factors causing iatrogenic mandibular fractures associated with exodontia: a systemic meta-analysis of 200 cases from 1953 to 2015. Oral Maxillofac Surg. 2016;20(4):391-96.Libersa P, Roze D, Cachart T, Libersa JC. Immediate and late mandibular fractures after third molar removal. J Oral Maxillofac Surg. 2002;60(2):163-66.Perry PA, Goldberg MH. Late mandibular fracture after third molar surgery: a survey of Connecticut oral and maxillofacial surgeons. J Oral Maxillofac Surg. 2000;58(8):858-61.Pires WR, Bonardi JP, Faverani LP, Momesso GAC, Muñoz XMJP, Silva AFM et al. Late mandibular fracture occurring in the postoperative period after third molar removal: systematic review and analysis of 124 cases. Int J Oral Maxillofac Surg. 2017;46(1):46-53.Krimmel M, Reinert S. Mandibular fracture after third molar removal. J Oral Maxillofac Surg. 2000;58(10):1110-12.Wagner KW, Otten JE, Schoen R, Schmelzeisen R. Pathological mandibular fractures following third molar removal. Int J Oral Maxillofac Surg. 2005;34(7):722-26.Ethunandan M, Shanahan D, Patel M. Iatrogenic mandibular fractures following removal of impacted third molars: an analysis of 130 cases. Br Dent J. 2012;212(4):179-84.Ellis E 3rd. Management of fractures through the angle of the mandible. Oral Maxillofac Surg Clin North Am. 2009;21(2):163-74.Pell GJ, Gregory GT. Report on a ten year study of a tooth division technique for removal of impacted teeth. Am J Orthodont Surg. 1942; 28:660-71.Antoun JS, Lee KH. Sports-related maxillofacial fractures over an 11-year period. J Oral Maxillofac Surg. 2008;66(3):504-8.Chrcanovic BR, Custódio AL. Considerations of mandibular angle fractures during and after surgery for removal of third molars: a review of the literature. Oral Maxillofac Surg. 2010; 14(2):71-80. Iizuka T, Tanner S, Berthold H. Mandibular fractures following third molar extraction. A retrospective clinical and radiological study. Int J Oral Maxillofac Surg. 1997;26(5):338-43.Woldenberg Y, Gatot I, Bodner L. Iatrogenic mandibular fracture associated with third molar removal. Can it be prevented?. Med Oral Patol Oral Cir Bucal. 2007;12(1):E70-2.Miyaura K, Matsuka Y, Morita M, Yamashita A, Watanabe T. Comparison of biting forces in different age and sex groups: a study of biting efficiency with mobile and non-mobile teeth. J Oral Rehabil. 1999;26(3):223-27.Bezerra TP, Studart-Soares EC, Pita-Neto IC, Costa FW, Batista SH. Do third molars weaken the mandibular angle?. Med Oral Patol Oral Cir Bucal. 2011;16(5):e657-63.Grau-Manclús V, Gargallo-Albiol J, Almendros-Marqués N, Gay-Escoda C. Mandibular fractures related to the surgical extraction of impacted lower third molars: a report of 11 cases. J Oral Maxillofac Surg. 2011;69(5):1286-90.

scholarly journals Lag Screw Technique for Treating a Mandibular Angle Fracture: Case Report

2018 ◽  
Vol 1 (3) ◽  
pp. 263-267
Author(s):  
Gabriela Mayrink ◽  
Marcelo Mendes ◽  
Roger Moreira ◽  
Ferdinando De Conto ◽  
Renato Sawazaki
Keyword(s):  
Case Report ◽  
Third Molar ◽  
Mandibular Fractures ◽  
Mandibular Angle ◽  
Intermaxillary Fixation ◽  
Cross Sectional ◽  
Postsurgical Complications ◽  
Lag Screw ◽  
Mandibular Angle Fracture ◽  
Angle Fracture

The treatment of mandibular angle fractures involves several postsurgical complications and is in greater demand when compared to therapeutic approaches for other types of mandibular fractures. Such postsurgical complications as bleeding, swelling, infection, dehiscence, pseudoarthrosis and paresthesia might affect individuals in both sexes and at all age groups. The presence of a mandibular third molar, a cross-sectional area thinner than the tooth-bearing region, and biomechanical forces might hamper the surgery, making it longer and more complex. Internal fixation is aimed at undisturbed healing under condition of functional and without any period of intermaxillary fixation. Adequate fixation depends on different fracture types, patients' general health and compliance, and the timing of the operation. This case report involves a mandibular angle fracture successfully treated with the lag screw technique, a simple approach to treat one of the most common fractures involving the mandible, quickly restoring the patient ́s oral functions.

scholarly journals Low-intensity laser efficacy in postoperative extraction of third molars

2017 ◽  
Vol 65 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Tiago Nascimento MILETO ◽  
Fabiano Goulart AZAMBUJA
Keyword(s):  
Laser Therapy ◽  
Randomized Clinical Trials ◽  
Third Molar ◽  
Recovery Phase ◽  
Low Level Laser Therapy ◽  
Clinical State ◽  
Third Molar Surgery ◽  
Third Molars ◽  
Level Laser ◽  
Surgical Extraction

ABSTRACT The search for means that enable a better quality of life for postoperative patients should be incessant. The surgical extraction of third molars can result in potential complications such as pain, swelling and trismus, along with discomfort in the recovery phase. Therefore, this narrative review was to analyze, from systematic reviews and randomized clinical trials, the use of low level laser therapy as influencer the clinical state after third molar surgery. Scientific articles were searched through PubMed and Science Direct database. In spite of the evaluated studies have cited the effectiveness of laser therapy such as tissue repair, anti-inflammatory and analgesic, variety of analysis models and diversity of dosimetry leaves a gap on their true efficacy. Based on the research conducted, we suggest the adjuvant use of diode laser GaAlAs with 810 nm (λ), 100 mW constant power and 4 J/cm2 of energy, intra and extra oral form at least three sections to minimize possible occurrences of third molar surgery.

scholarly journals Piezo-surgery technique and intramuscular dexamethasone injection to reduce postoperative pain after impacted mandibular third molar surgery: a randomized clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wissam Nehme ◽  
Youssef Fares ◽  
Linda Abou-Abbas
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Third Molar ◽  
Mouth Opening ◽  
Mean Difference ◽  
Third Molar Surgery ◽  
Third Molars ◽  
Dexamethasone Group ◽  
Mandibular Third Molar ◽  
Surgical Extraction

Abstract Background Surgical extraction of the impacted mandibular third molar is commonly associated with postoperative pain, swelling, and trismus. Usually, rotatory instruments like burs have been used for osteotomy, while Piezosurgery is an innovative technique introduced to overcome the weaknesses related to the conventional technique. In addition, Dexamethasone administration before the extraction of impacted third molars is an efficient way to reduce postoperative pain due to robust anti-inflammatory activity. The purpose of the study is to evaluate the effect of piezo-surgery and dexamethasone injection on postoperative sequelae after the surgical extraction of impacted mandibular third molars, and ultimately to compare their effect on reducing postoperative pain. Methods A randomized controlled clinical trial was conducted with a sample of 80 patients. Participants were divided into four groups: Group 1 (Conventional rotatory), Group 2 (Conventional rotatory with 8 mg dose of dexamethasone 30 min before surgery), Group 3 (Piezo-surgery), and Group 4 (Piezo-surgery with 8 mg dose of dexamethasone 30 min before surgery). The outcome variables were surgical working time calculated in minutes, maximal mouth opening measured in millimeters using Vernier Caliper at baseline and day 3 and postoperative pain assessed using a Visual Analog Scale (VAS) on days 1, 3, and 7. Results The surgical working time was longer in piezo-surgery groups compared with the conventional rotatory instruments groups (15.82 ± 3.47 vs 23.33 ± 2.54; p value < 0.0001). The lowest reduction in mouth opening between baseline and 3rd-day post-op was found in the Piezo-surgery with Dexamethasone group (mean difference = 5.0, SD = 3.9, p value < 0.0001) followed by the Piezosurgery without Dexamethasone group (mean difference = 5.8, SD = 4.5, p value < 0.0001) and the highest average was reported by the Conventional rotatory without Dexamethasone (mean difference = 9.7, SD = 4.5, p value < 0.0001. In the four groups, the mean pain score was highest on the 1st day and gradually decreased over the following days. Comparison of the 1st and 3rd postoperative pain between groups revealed a lowest mean pain score in the Piezo-surgery with Dexamethasone group, followed by Conventional rotatory with Dexamethasone group and a highest mean score in the Conventional rotatory without Dexamethasone group (p value < 0.0001). Conclusion The association of Piezosurgery osteotomy and Dexamethasone intramuscular injection could be an effective combination to reduce postoperative pain and trismus after impacted third molar surgery. Trial registration: NCT04889781 (https://clinicaltrials.gov/), Date of Registration: 17/05/2021 (retrospectively registered), https://clinicaltrials.gov/ct2/show/NCT04889781?term=NCT04889781&draw=2&rank=1

scholarly journals Comparison of Two Different Doses of Dexamethasone to Control Swelling and Trismus following Mandibular Third Molar Surgery

2021 ◽  
Vol 1 (2) ◽  
pp. 1-6
Author(s):  
Pranay Ratna Sakya ◽  
Dipti Shrestha ◽  
Reena Shrestha ◽  
Dhiraj Khadka Khadka ◽  
Ratina Tamrakar ◽  
...  
Keyword(s):  
Third Molar ◽  
Third Molar Surgery ◽  
P Value ◽  
Third Molars ◽  
Surgical Extraction ◽  
Facial Swelling ◽  
Degree Of Swelling ◽  
Interincisal Distance ◽  
Mandibular Third Molar Surgery ◽  
Different Doses

Introduction: Third molar surgery is one of the most common procedures performed by dental surgeons in clinical practice, where postoperative sequelae like pain, trismus, and swelling are often encountered. Thus, in this study, we compared medications employed to reduce such complications. Objective: To compare the effect of two different doses (4 and 8 mg) of dexamethasone in the control of swelling and trismus after the surgical extraction of mandibular impacted third molars. Methods: An experimental study consisted of twenty-seven (27) healthy adult patients of both genders with bilateral impacted lower third molars, where surgical extraction was indicated, 4 mg and 8 mg of dexamethasone were given orally to the patients 1 hour before the surgical procedure at both the surgeries. The swelling was recorded by measuring the length of 3 facial planes using a measuring tape. Trismus was evaluated by measuring the maximum interincisal distance. Recording of facial swelling and maximum interincisal distance was done preoperatively and on the 1st and 2nd days postoperatively. Results: Based on statistical analysis (Independent T-test), the results showed a difference in the measurements of the degree of swelling and trismus of the treated sample. 8 mg of dexamethasone promoted a greater reduction of symptoms than 4mg of dexamethasone though there was no statistically significant (p-value >0.05) difference between the two doses. Conclusions: 8 milligrams of the dexamethasone had better effectiveness than 4 milligrams of the dexamethasone in reducing the degree of swelling and trismus. Keywords: Dexamethasone; impacted third molars; swelling; trismus.

Right mandibular angle and left comminuted mandibular body fractures stabilised with a combination of an acetabular plate and secured pin intermandibular ventral epoxy resin (SPIVER) frame in a four-month-old puppy

2020 ◽  
Vol 8 (3) ◽  
pp. e001131
Author(s):  
Fabrizio di Virgilio ◽  
Alexandros Bourbos ◽  
Filippo Cinti ◽  
Guido Pisani
Keyword(s):  
Epoxy Resin ◽  
Mandibular Fracture ◽  
Mandibular Fractures ◽  
Mandibular Angle ◽  
Mandibular Angle Fracture ◽  
Angle Fracture ◽  
Mandibular Body ◽  
Fracture Configuration ◽  
Osteosynthesis Techniques ◽  
One Year

This case report aimed to describe a surgical technique combining a secured pin intermandibular ventral epoxy resin (SPIVER) frame and an acetabular plate to manage a complex mandibular fracture configuration in a puppy. A four-month-old, entire male, German wirehaired pointer was referred for assessment of a combination of recent (three days before hospitalisation) and older traumatic (45 days before hospitalisation) facial injuries inflicted by the dam. CT revealed multiple mandibular and maxillary fractures with complex acute mandibular fractures requiring surgical stabilisation. wo techniques were combined on stabilisation of the mandible: a single acetabular plate 2.7 to repair the mandibular angle fracture and a SPIVER frame to repair the comminuted mandibular fracture. Both fractures healed uneventfully, and the dog had normal jaw function one year postoperatively. Occlusion was not modified compared with the preoperative condition, considering that the patient already had a malocclusion defect due to old lesions. The combination of two different osteosynthesis techniques had satisfactory short-term and long-term outcomes in this puppy.

scholarly journals Posttraumatic Parotid Sialocele Complicating a Mandibular Fracture: A Case Report

2017 ◽  
Vol 10 (4) ◽  
pp. 314-317
Author(s):  
Jesse Falk ◽  
Ryan Borgwardt ◽  
Stephen MacLeod
Keyword(s):  
Case Report ◽  
Parotid Gland ◽  
Blunt Trauma ◽  
Mandibular Fracture ◽  
Transoral Approach ◽  
Mandibular Angle ◽  
Unique Case ◽  
Mandibular Angle Fracture ◽  
Angle Fracture

Blunt trauma to the parotid resulting in the formation of a sialocele is rare, with only three cases identified in the literature. We present a unique case involving a 32-year-old man with blunt trauma resulting in a left mandibular angle fracture. The patient underwent open reduction and internal fixation of the left mandibular angle fracture via transoral approach. At follow-up, after resolution of the edema from the injury, a sialocele was noted in the region of the left anterior parotid gland. The patient was treated conservatively with antisialagogues, pressure dressings, and multiple percutaneous aspirations that ultimately resulted in resolution of the sialocele.

scholarly journals Impacted Maxillary Third Molar: Report of Two Cases

2017 ◽  
Vol 6 (1) ◽  
pp. 1430
Author(s):  
Tsvetan Borisov Tsvetanov ◽  
Nicola Stamenov
Keyword(s):  
Case Report ◽  
High Risk ◽  
Maxillary Sinus ◽  
Postoperative Period ◽  
Third Molar ◽  
Third Molars ◽  
The Third ◽  
Bone Removal ◽  
Maxillary Third Molar ◽  
Surgical Extraction

The aim of this case report was to review two cases of patients with impacted maxillary third molars. Both were symptomatic and presence of pathology clinically and radiographically. Surgical extraction of these third molars with accessible positions requires a bone removal. Moreover, it contains a high risk of displacement of the third molars into the maxillary sinus. The postoperative period for both cases was without complications.

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