The fate of teeth in mandibular fracture lines. A clinical and radiographic follow-up study.

The aim of this study was to compare the morbidity of permanent teeth associated with mandibular fractures treated with plates with those treated with interdental wiring. Fractures involving third molars were excluded. Sixty-three teeth in the line of fractures in 40 patients were investigated clinically (tooth vitality; periodontal status) and with periapical radiographs. Of these, 34 teeth were in the plated group and 29 teeth were in the wired group. Thirty-nine teeth adjacent to the fracture lines were also examined. The time from injury to examination ranged from 1 to 4 years. An electric pulp tester was used to measure pulpal response, corresponding teeth on the contralateral side serving as controls. Results showed that 68% of teeth in the line of fracture in the plated group were nonvital, as compared with 41% in the wired group, while 71% of teeth adjacent to the fracture line were nonvital in the plated group, as compared with 14% in the wired group. Of the total of 35 nonvital teeth in the whole group, 63% were seen in type I fracture, and 49% were related to minimal and 51% to gross displacement of fractures. These findings show a significant increase in nonvitality of teeth in the line (P = 0.018), and adjacent (P = 0.0004) to the fractures of the mandible which were treated by plates, as compared with interdental wiring. We recommend retention of teeth associated with fracture lines unless there is an absolute indication for removal.