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

Abstract

AbstractIntroductionLate mandibular angle fracture after surgical removal of a lower third molar is a major complication. The aetiology of this complication is believed to be multifactorial and might be associated with age, gender, angulation and the level of third molar impaction. The aims of this study were to report the case of a mandibular angle fracture that occurred 21 days after third molar removal and to perform a critical review of the subject.Case reportA 44‐year‐old male patient reported a distinct cracking noise in his right mandibular angle during masticatory movements, 21 days after surgery to remove his right lower third molar. Based on the clinical and imaging findings, surgical reduction was performed under general anaesthesia and the fracture was properly fixed with two 2.0‐mm plate and screw systems installed at fractured site using transbuccal instrumentation.DiscussionMultiple factors are related to mandibular angle fractures resulting from the removal of third molars, such as age, gender, state of dentition, parafunctional habits, angulation and level of impaction of the third molar, relative depth and volume of the tooth in bone and local or systemic disease, which may compromise bone strength and the surgical technique.ConclusionsThe decision to remove lower third molars must be made taking into account all risks associated with the procedure, especially mandibular angle fractures. An accurate diagnosis and optimal timing of this procedure are necessary to minimize the occurrence of these complications.