The Effect of Mandibular Impacted Third Molar on Fracture of Mandibular Angle and Condyle: An Observational Study

Abstract

Objective: The factors that may increase the risk of mandibular angle fractures are the abrupt change in angulation and its association with impacted teeth. Condyle, a common mandibular fracture site, is spared if the impact is absorbed in the angle. The study aimed to determine the relationship between the status of impacted mandibular third molars and mandibular angle and condylar fractures in patients with a history of road traffic accidents, within the age group of 18 to 50 years. Methods: In this observational study, 136 patients were examined clinically to diagnose mandibular angle and/or condylar fractures which were confirmed using an orthopantomogram. The status of the mandibular third molars was assessed radiographically. Results: Among the 173 fracture sites detected, 43 were diagnosed at the angle and 130 at the condyle. The demographic assessment demonstrated an age predisposition between 31 and 50 years (44%) in males and 21 and 30 years (47%) in females, with an overall peak incidence in the age group of 21 to 30 years (45%). There was a significant relationship between the status of impacted third molars and the occurrence of angle (P<0.01) and condylar fractures (P=0.05). The incidence of angle and condylar fractures in patients with/without associated impacted mandibular third molars were found to be 91% and 64% and 9% and 36%, respectively. Conclusions: The presence of impacted third molars had a significant relationship with the high incidence of angle fractures and the low incidence of condylar fractures. Knowledge about the common fracture patterns associated with impacted mandibular third molars would alert the clinician to contemplate fractures based on the anatomic distribution.