N Ulbrich1, T Ettl2, W Waiss1, M Gosau3, A Moralis1, T E Reichert1, S Mueller1. 1. Department of Oral and Maxillofacial Surgery, Regensburg University Medical Centre, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany. 2. Department of Oral and Maxillofacial Surgery, Regensburg University Medical Centre, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany. tobias.ettl@klinik.uni-regensburg.de. 3. Department of Oral and Maxillofacial Surgery, Nuremberg Hospital, Breslauer Straße 201, 90471, Nürnberg, Germany.
Abstract
OBJECTIVES: The 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 METHODS: This 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). RESULTS: Regarding 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 %. CONCLUSIONS: Mandibular 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 RELEVANCE: The study helps with the decision of removing or retention of a third molar during surgical treatment of a mandibular angle fracture.
OBJECTIVES: The 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 METHODS: This 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). RESULTS: Regarding 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 %. CONCLUSIONS: Mandibular 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 RELEVANCE: The study helps with the decision of removing or retention of a third molar during surgical treatment of a mandibular angle fracture.