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

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.

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Late Mandibular Angle Fracture After Impacted Third Molar Extraction: Case Report and Review of Predisposing Factors

International journal of odontostomatology ◽

10.4067/s0718-381x2013000200019 ◽

2013 ◽

Vol 7 (2) ◽

pp. 287-292 ◽

Cited By ~ 2

Author(s):

Valdir Cabral Andrade ◽

Patrício José de Oliveira Neto ◽

Márcio de Moraes ◽

Luciana Asprino

Keyword(s):

Case Report ◽

Third Molar ◽

Predisposing Factors ◽

Mandibular Angle ◽

Impacted Third Molar ◽

Third Molar Extraction ◽

Mandibular Angle Fracture ◽

Angle Fracture ◽

Molar Extraction

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Transoperative mandibular angle fracture from third molar extraction, case report

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2019.03.809 ◽

2019 ◽

Vol 48 ◽

pp. 264-265

Author(s):

R. Cota ◽

A. Goto ◽

L. Dias

Keyword(s):

Case Report ◽

Third Molar ◽

Mandibular Angle ◽

Third Molar Extraction ◽

Mandibular Angle Fracture ◽

Angle Fracture ◽

Molar Extraction

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Displacement of the third molar bud to the sublingual space during open reduction and internal fixation of mandibular angle fracture: A case report

Clinical Case Reports ◽

10.1002/ccr3.3451 ◽

2020 ◽

Vol 8 (12) ◽

pp. 3479-3482

Author(s):

Reza Sharifi ◽

Lotfollah Kamaliehakim ◽

Narges Matloubi

Keyword(s):

Case Report ◽

Internal Fixation ◽

Open Reduction ◽

Third Molar ◽

Mandibular Angle ◽

The Third ◽

Mandibular Angle Fracture ◽

Angle Fracture

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Late mandibular fracture after attempted third molar surgery: case report

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v9i3.4673 ◽

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.

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Surgical Management of Unusual Biangular Mandibular Fractures

Case Reports in Surgery ◽

10.1155/2017/6149838 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Stefan Cocis ◽

Umberto Autorino ◽

Fabio Roccia ◽

Chiara Corio

Keyword(s):

Internal Fixation ◽

Maxillofacial Surgery ◽

Third Molar ◽

Mandibular Fractures ◽

Mandibular Angle ◽

Mandibular Angle Fracture ◽

Angle Fracture ◽

Angle Fractures ◽

Inferior Border ◽

Surgery Department

Bilateral mandibular angle fractures, while representing a rarity among mandibular fractures, are a huge challenge of complex management for the maxillofacial surgeon. There are still many open questions regarding the ideal management of such fractures, including the following: the removal of the third molar in the fracture line, the best surgical approach, and the fixation methods. In this report the authors present the case of 40-year-old man presenting with a bilateral mandibular angle fracture referred to the Maxillofacial Surgery Department of Turin. Open reduction and internal fixation has been made for both sides. The left side third molar was removed and the internal fixation was achieved through internal fixation with one miniplate according to Champy’s technique and transbuccal access for a 4-hole miniplate at the inferior border of the mandible. Right side third molar was not removed and fixation was achieved through intraoral access and positioning of a 4-hole miniplate along the external ridge according to Champy. An optimal reduction was achieved and a correct occlusion has been restored.

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Late mandibular angle fracture after third molar removal: A case report and critical review

Oral Surgery ◽

10.1111/ors.12599 ◽

2020 ◽

Author(s):

Carolina Chaves Gama Aires ◽

Eugênia Leal de Figueiredo ◽

Bruno José Carvalho Macêdo Neres ◽

Fernando Ferreira dos Santos Neto ◽

Ricardo José de Holanda Vasconcellos ◽

...

Keyword(s):

Case Report ◽

Critical Review ◽

Third Molar ◽

Mandibular Angle ◽

Mandibular Angle Fracture ◽

Angle Fracture

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The influence of wisdom tooth impaction and occlusal support on mandibular angle and condyle fractures

Scientific Reports ◽

10.1038/s41598-021-87820-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hesham Mohammed Al-Sharani ◽

Zhang Bin ◽

Mubarak Ahmed Mashrah ◽

Endi Lanza Galvão ◽

Essam Ahmed Al-Moraissi ◽

...

Keyword(s):

Logistic Regression ◽

Third Molar ◽

Epidemiological Data ◽

Mandibular Fractures ◽

Mandibular Angle ◽

Mandibular Angle Fracture ◽

Medical Institutions ◽

Tooth Impaction ◽

Angle Fracture ◽

Relationship Of

AbstractThis study aimed to analyze the relationship of the occlusal support together with the lower third molars to the mandibular fractures of the angle and condyle among patients in our medical institutions. This was a retrospective study that reviewed the medical records and radiographs of all patients treated for mandibular fractures from 2015 to 2019. The data collected by using picture archiving and communicating system. Only records with mandibular angle or condyle fractures were included. The dependent variable was the presence of the fractures of the mandibular angle or condyle. The independent variables were epidemiological data, third molar characteristics, existence or absence of occlusal support. The data was analyzed through Univariate logistic regression and multivariate logistic regression. From a total of 187 mandibular fractures, 44 presented mandibular angle fracture and 29 shown condyle fractures. The average age was 40.34 ± 13.47 years. The absence of occlusal support increased the chance of condyle fractures by 5.1 times (95% CI 1.61–17.29). The lack of occlusal support is more associated with condyle fractures than the presence of occlusal support, regardless of third molar presence and characteristics and other variables evaluated.

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Lower third molar displaced to lateral pharyngeal space after mandibular angle fracture: a case report

Oral and Maxillofacial Surgery ◽

10.1007/s10006-018-0673-2 ◽

2018 ◽

Vol 22 (2) ◽

pp. 231-233

Author(s):

Rodrigo dos Santos Pereira ◽

Jonathan Ribeiro da Silva ◽

João Paulo Bonardi ◽

Eduardo Hochuli-Vieira

Keyword(s):

Case Report ◽

Third Molar ◽

Mandibular Angle ◽

Mandibular Angle Fracture ◽

Angle Fracture

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Qualitative and quantitative assessment of relationship between mandibular third molar and angle fracture on North Indian population: A clinico-radiographic study

European Journal of Dentistry ◽

10.4103/1305-7456.110188 ◽

2013 ◽

Vol 07 (02) ◽

pp. 212-217 ◽

Cited By ~ 9

Author(s):

Suresh Yadav ◽

Shallu Tyagi ◽

Naveen Puri ◽

Prince Kumar ◽

Puneet Kumar

Keyword(s):

Third Molar ◽

Indian Territory ◽

Mandibular Angle ◽

The North ◽

Mandibular Angle Fracture ◽

Mandibular Third Molar ◽

Angle Fracture ◽

Angle Fractures ◽

Inferior Border ◽

The Relationship

ABSTRACT Objective: To assess the relationship between impacted mandibular third molar presence and the risk for mandibular angle fracture with the effect of various positions of mandibular third molar and the risk of mandibular angle fracture. Materials and Methods: In the North Indian territory, a total of 289 patients with mandibular angle fractures were studied and evaluated for the possible relationship with impacted third molar on the basis of clinical and panoramic radiographical findings. Results: Results that confirmed the highest risk for mandibular angle fracture was associated with mesioangular angulations (45.42%) followed by vertical (26.34%), distoangular in sequence and least risk was found with bucco-version angulations (2.67%) according to Winter′s classification. Additionally, the highest risk of mandibular angle fracture was reported with partially erupted third molar (47.75%), followed by erupted (23.53%) and unerupted third molar (19.38%). Conclusion: The risk for mandibular angle fracture is not only affected by status of eruption, angulations, position, number of roots present in third molar but also by the distance of mandibular third molar from inferior border of mandible and the percentage of remaining amount of bone at the mandibular angle region.

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