The influence of third molars in the line of mandibular angle fractures on wound and bone healing.

Abstract

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. 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 9years. 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 1.4days (range 0 to 12), and the average follow-up 291days (range 66 to 863). 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%. 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. The study helps with the decision of removing or retention of a third molar during surgical treatment of a mandibular angle fracture.