Line Of Mandibular Fractures Research Articles

The Evaluation of Objective and Subjective Fate of Teeth in the Mandible Fracture Line and the Management-A Center's Experience.

The decision to retain or extract teeth in the line of mandibular fractures has been a subject of debate in much of the scientific literature, and there is a need for further evidence to clear this issue. Thus, the aim of this study was to investigate both the positive and negative effects of teeth in the line of mandibular fractures provide more evidence in this field, as well as take into consideration patients' quality of life after the surgery. Patients after trauma with teeth in the line of mandibular fractures were included in this study. Open reduction and rigid internal fixation, elastic intermaxillary reduction were expected to achieve a satisfactory occlusion and/or anatomical reduction in the fragments as assessed by orthopantomogram, computed tomography scans, and clinical examination. The remaining cases had maxillomandibular fixation (MMF) with an arch bar and bridle wire. All the patients included in this study will take the Visual Analog Scale score evaluation before and after surgery subjectively to further verify the impact on their life qualify, as well as the further treatment needed. A total of 78 patients with teeth in the line of mandibular fractures were included in this study. Open reduction and rigid internal fixation was used in 37 patients, whereas another 35 patients accepted elastic intermaxillary reduction. Six cases underwent MMF. The number of involved teeth was 83. Three of the 83 teeth involved in the fracture lines healed with complications. In the cases where the teeth had been removed before fracture treatment, or in cases of delayed extractions, no complications were noted. The majority of the patients felt good about the whole treatment, however, 4 in the MMF group complained about worry about their oral health due to MMF leading to mouth open limitation. The factors that should be considered for removal include the condition of the teeth and alveolar bone, the timing and the type of treatment, as well as the patients' desire, if possible. This is an individual-based decision that needs to consider more objective and subjective potential risks to avoid complications.

Children mandibular fractures: Epidemiological and anatomo-clinical aspects

IntroductionMaxillofacial trauma in children is uncommon, accounting for between 1 % and 14 % of all facial trauma in the general population. ObjectiveTo describe the epidemiological and anatomical-clinical aspects of mandibular fractures in children. Material and methodThis was a retrospective descriptive cross-sectional study with non-probabilistic accidental sampling. It took place in the maxillofacial surgery and stomatology department of Cocody University Hospital in the Republic of Côte d'Ivoire, over a 20-year period (2000–2019). The study population consisted of patients aged 0–16 years admitted to our department for a mandibular fracture. At the end of this study, we identified 58 patients. Data was entered using Excel 2016. Tables and graphs were processed using Excel version 2016. Resultswe have identified 58 patients. The mean age of patients was 9.35 ± 2.1 years, with extremes of 1 and 16 years, and a sex ratio of 2,22 in favouring men. The 6–12 age group was the most affected (n: 34 cases or 60.35 %). Soft tissue wounds were present in all our patients, followed by peri-mandibular swelling (n: 37 cases or 63.79 %) and disorders of the dental articulation (n: 28 cases or 48.2 %). Condylar fractures were the most frequent (46.87 %).Mandibular fracture lines were uni-focal in 75 % of cases. These fractures were associated with other facial lesions in 48.28 % of cases and with extra-facial lesions in 34.48 % of cases. ConclusionMandibular fractures are common in maxillofacial trauma in children. Condylar fractures are the most common, almost always associated with chin injuries. Hence the importance of a systematic examination of the mandibular condyles.

Retention of teeth in the fracture gaps of the mandible: a retrospective analysis.

Since the introduction of miniplate osteosynthesis and the use of prophylactic antibiotics, the complication rate related to the teeth in the fracture gap has significantly decreased. Currently, there are still no established guidelines for the management of such teeth in mandibular fracture lines. However, the long-term viability of these teeth within the fracture gap remains uncertain. Therefore, this study aimed to assess the survival rate of teeth located within the mandibular fracture line and evaluate related follow-up treatments over a minimum period of one year. This retrospective study examined 184 patients who underwent surgical treatment for mandibular fractures between January 2018 and December 2021. A total of 189 teeth located in the fracture line were analyzed. Clinical and radiological parameters were collected, including patient age and gender, fracture etiology and location, intraoperative tooth treatment, as well as complications related to both the fracture and the affected teeth in long term. Most of the examined teeth remained uneventful, with postoperative tooth-related complications seen in 14 (7.4%) teeth. The most common complications were symptomatic apical periodontitis (n = 9, 4.8%) and increased tooth mobility (n = 3, 1.5%). A correlation was found between complications and trauma-related tooth luxation (p = 0.002, OR = 15.2), as well as prior teeth connected to retainers or orthodontic appliances (p = 0.001, OR = 10.32). Tooth-related complications are rare when intact teeth are retained within the fracture gap. Therefore, unless there is a definitive intraoperative indication for extraction, it is recommended to preserve the teeth in the fracture line. Intact teeth in the fracture line of the mandible should not be primarily extracted.

Incidence and Management of Tooth Root Fracture in Mandibular Fracture Line - A Retrospective Study.

In cases of trauma, the most common fractures of the facial region are the nasal bone fractures followed by mandibular fractures. About 60% of mandible fractures are associated with teeth in the fracture line; however conversely, the dentulous mandible has a higher susceptibility of fracture in any impact. Whenever a tooth is involved in the fracture line, it is not unlikely that the tooth root fracture will be associated with it. The prognosis and treatment of such a tooth persistent in a fracture line depends upon the level of tooth root fracture. This retrospective study was conducted in the Department of Oral and Maxillofacial Surgery in a Meerut hospital. The eligibility criteria were based on the cases involving fracture line passing through the teeth bearing area of mandible. Total of 56 cases of mandibular fracture treated from January 2021 till December 2022 by open reduction and fixation were included in the study. A total of 56 patients (66 fracture lines) with mandibular fractures were selected, out of which 18 (32%) patients had fracture of the root of the tooth in the fracture line. Third molar root fracture were present in 12 cases (66.6%), first premolars in 4 cases (22.2%), and first molars in 2 cases (11.1%). There were 14 multi rooted teeth (77.7%) and 4 single rooted teeth (22.2%) involvement. All the multi rooted teeth fracture were treated by extraction during open reduction and fracture fixation. The single rooted teeth were successfully treated by endodontic treatment postoperatively. The fracture line passing through the dentate segment may fracture the tooth crown and/or root or propagate through the socket without any injury to the root. Root fracture at cervical and middle third is constantly exposed to oral fluids. The affected tooth may be mobile and lose vitality. Teeth in the line of fracture must be removed when they preclude the correct reduction of the segments or if they represent a risk for infection. If the tooth or root does not cause any hindrance during reduction or it is not infected, the tooth can be salvaged by endodontic therapy. The incidence of root fracture was seen in 32% of cases. Fracture of the third molar roots was the single largest group (66.6%). No root fracture was observed in the anterior segment.

Characteristics and management of teeth in the line of mandibular fractures treated with internal fixation.

The ideal management of teeth in the line of mandibular fractures is unclear and controversial. The aim of this study was to analyze the characteristics and management of teeth in the line of mandibular fractures treated with open reduction and internal fixation. Medical records of patients with mandibular fractures in the symphysis, body and angle regions seen between July 2019 and January 2021 were evaluated. Personal data, etiology, location of fractures, characteristics of the teeth involved in the fracture lines and management were collected. The relationship between the fracture lines and the periodontium was classified according to Kamboozia & Punnia-Moorthy. Fractures were divided into two groups according to the management of the tooth in the fracture line: removal and retention. The likelihood ratio test was used (p< .050). During the study period, 52 patients with mandibular fractures were seen, of which 42 patients (83.3% men) with a mean age of 29.6 years and 54 fractures were included. The most frequent location was the angle of the mandible (41.3%) (p< .001). The removal group represented 35.2% of the fractures, and the retention group represented 64.8%. The most frequently removed tooth was the third molar (p< .001), and the most frequent classification of dental involvement in the fracture line was type II (p= .047). There was no correlation between age, gender, or etiology and the management of the teeth involved. The retention of teeth in the fracture line predominated, and the third molar in angle fractures was the most often removed tooth when the fracture line followed the root surface but did not cross the apical region, probably due to the greater frequency of this type of relationship between the fractures and the periodontium.

Should Degree of Third Molar Eruption Influence Operative Management of Mandibular Angle Fractures? A Systematic Review.

Systematic review. There is a growing trend toward evidence-based management of third molars in the fracture line of mandibular angle fractures (MAFs). This study aimed to differentiate MAF fixation complications by degree of third molar eruption and by extraction strategy in patients undergoing Champy fixation. PubMed, EMBASE, OVID, SCOPUS, the Cochrane Library, and clinicaltrials.gov were queried through May 2020 for English-language publications for MAFs with third molar involvement for this systematic review. Bias was assessed using author-defined criteria. Relative risk (RR) of post-operative complications associated with extracted unerupted and retained partially erupted third molars (Group I) was calculated against controls of retained unerupted and extracted partially erupted third molars (Group II). Ten studies reported complications by eruption or extraction; however, only one study stratified complications by both eruption and extraction to meet inclusion criteria. The risk of bias was medium as only cases meeting defined follow-up were included. 73 cases (N) were included: 34 qualified for Group I and 39 for Group II. Quantitative synthesis of individual case data demonstrated significantly higher complication rate in Group I compared to Group II (23.5% vs 5.1%) (RR 4.6, 95% CI 1.04-20.1). No significant differences were observed between groups for infectious complications, mechanical complications, nonunion, or dehiscence. Reoperation was required significantly more often for Group I (P = .043). For MAFs involving the third molar, concomitant extraction of unerupted as well as retention of partially erupted third molars increases risk of complications with Champy fixation technique. For these patients, alternative strategies for fixation should be considered.

Is a Tooth Extraction Required If Dentition Lies Within a Mandible Fracture?

Is a Tooth Extraction Required If Dentition Lies Within a Mandible Fracture?

No apparent association between dental implants and mandibular fractures resulting from external forces.

Dental implants are cylindrical metallic screws inserted into the jawbone to replace missing teeth. Their location may affect the pattern of fractures that occur as a result of the traumatic forces to the mandible. The aim of this study was to investigate possible influences of dental implants on the patterns of mandibular fractures triggered by external forces. In this observational cross-sectional study, a total of 390 patients with mandibular fractures diagnosed between February 2016 and December 2020 were examined and the presence or absence of dental implants in the fracture gap was noted. Clinical and radiological data were analyzed in relation to the fracture line, the dental status, and the location of any implants. A total of 16 patients (4.1%) had previously placed dental implants in the mandible. Various fracture patterns were observed. Some yielded typical fracture lines located in the anatomically weak areas along the roots of the incisors, the mental foramina, and long-rooted molars. Occasionally, fracture lines were detected in combination with condylar fractures. Dental implants were not directly involved in any fracture line, except one. In that case, the fracture line extended from the alveolar process straight along the implant body, mimicking initial disintegration of the implant, with erosion of the surrounding bone. Once dental implants have osseointegrated, mandibular fractures are rarely projected along the implant surface. This observational retrospective cross-sectional study failed to associate mandibular fracture lines with the presence of dental implants.

Prognosis of teeth in mandibular fracture lines.

Teeth in a jaw fracture line, because of the presence of the periodontal ligament, may communicate with the oral cavity. There are no guidelines for the management of teeth in mandibular fracture lines. The aim of this study was to investigate the factors related to dental problems with teeth involved in mandibular fracture lines and to determine the best treatment option. This retrospective study was based on the medical and radiographic records of patients with mandibular fractures. The relationships among the patient's age, gender, smoking history, amount of bony displacement, surgery, trauma-surgery period, apical involvement, tooth mobility, and periodontal status were investigated. Group comparisons were performed using the chi-squared test, Fisher's exact test, and Mann-Whitney U-test. A total of 238 patients (247 fracture lines) with mandibular fractures including a tooth in the line of the fracture were examined. Post-operative dental complications occurred in 42 cases (17.0%). Extraction of related teeth occurred in 34 cases (80.9%) compared to eight cases (19.0%) related to root canal therapy. This study defined "dental problem" as "a case with a tooth extracted or endodontically treated after trauma." The variables associated with an increased risk of dental problems were the amount of bony displacement (p<.01), tooth mobility (p<.01), and pre-existing marginal alveolar bone loss (p=.027). The prognosis of teeth in mandibular fracture lines was related to tooth mobility, periodontal state, and the amount of bony displacement.

New design titanium miniplate in mandibular angle fracture treatment: a biomechanical study

Angle mandible is one of the most common fractures in the mandible. Fractures of the angle mandible are one of the most problematic areas in the facial area due to the high frequency of complications and difficult access to the surgical site. Although there are many available miniplates and screws with several geometrical models for use in mandibular angle fractures, geometrical features of these materials and the optimal number and site of placement of plates have yet to be determined. An ideal plate should be durable and potent enough to endure the functional burden. This study employed 12 mandible replicas made of rigid polyurethane resin used with appropriately standardized measurements. A full-thickness fracture line was present on the angle of all mandible replicas. Four groups were formed. In the our study, mandibular angle fracture line was fixed with parallel two straight plates, a butterfly plate, a square plate, and a newly designed three-dimensional (3D) hourglass-shaped plate. Fixation was performed with a different miniplate in each group. Three samples were formed from each group. Each model was subjected to a compression test at a displacement-controlled loading. Loading was continued after maximum load was reached. The latter revealed a significant difference between the newly designed plate and the other three plates (p < 0.05). In conclusion, we suggest that with the newly designed plate, which was used for the first time in the our study and showed a greater resistance in mandibula fractures, designed plate application will be more effectively used in clinical practice.

Evaluation of the Prognosis of the Teeth in the Mandibular Fracture Line.

The aim of this study was to evaluate the prognosis of the teeth in the mandibular fracture line and to analyze the relationship between the degree of displacement of fracture fragments, the relationship of the fracture line to the periodontium, and the relationship between the condition of the teeth at the first postoperative (post-op) year. A total of 60 teeth from 38 patients (11 female and 27 male) who had erupted teeth in the line of mandibular fracture and were treated with open reduction were examined. The data were collected from the patients' clinical records and radiographs. Age at the time of injury, gender, cause of trauma, site of fracture, the relationship of the fracture line to the periodontium, the degree of displacement of fracture fragments, and the condition of the teeth in the line of the fracture at the first post-op year were evaluated. The degree of displacement of fracture fragments had an effect on the condition of the teeth at the first post-op year (P = .036) and the regions of the mandible had an effect on the degree of displacement of the fracture fragments (P = .000). The survival rate of the pulp of the teeth was 69.8%. A preventive approach should be preferred for teeth in the mandibular fracture line. Retained teeth in the fracture line should be monitored clinically and radiologically for at least 1 year, and unnecessary endodontic treatments should be avoided.

Surgical Management of Mandibular Angle Fractures: Does the Extraction of the Third Molar Lead to a Change in the Fixation Pattern? A European Multicenter Survey

The authors conducted a retrospective, multicenter study to investigate the differences in the fixation patterns, in terms of number and thickness of plates, between patients in whom a third molar (3M) was maintained or removed in the line of mandibular angle fractures. The study was conducted in 6 European level I and II maxillofacial trauma centers. Data were collected on patients ≥ 16years of age who underwent open reduction internal fixation (ORIF) for mandibular angle fractures (MAF) from 2008 to 2018, in whom a 3M in the fracture line was present and who had a follow-up duration of 6months. The study population was divided into 2 groups: patients treated with ORIF in whom the 3M was maintained (group 1) and those treated with ORIF in whom the 3M was extracted (group 2) during treatment. The 2 groups were compared for differences in the internal fixation pattern, specifically in terms of the number and thickness of the plates. A total of 749 patients with 774 MAF were collected. A total of 1,050 plates were placed: 849 were ≤ 1.4mm thick (80.9%) and 201 plates≥1.5mm thick (19.1%). 548 patients were treated with ORIF and 3M maintained (group 1), and 201 treated with ORIF and 3M extracted (group 2). Statistically significant differences were seen in the number of ≤1.4mm plates between the 2 groups for single undisplaced/displaced MAF(P value≤0.5) and for undisplaced/displaced angle+parasymphysis/body fractures (P-value≤0.5). Analyses of data collected from 6 European maxillofacial centers indicated that the majority of surgeons of our sample perceived the MAF as being more unstable when removing the 3M during ORIF leading them to perform a rigid fixation in the angular region.

Complication rates in angle fractures with or without retaining third molars: A comparative study

Aim: The aim of this study is to assess whether the third molar in the line of mandibular angle fracture predisposes to post-operative infection, which further may lead to implant retrieval. Materials and Methods: Surgically rehabilitated cases of mandibular angle fracture at our center Sanjay Gandhi institute of trauma and orthopedics from 2016 to 2019 were considered in the study. During this period 49 cases were followed up for over a period of 6 months at 3 moths and 6months interval. All the cases were operated by the same surgeon using universal aseptic precautions using semi- rigid fixation. Results: Out of 49 cases, 20 cases the third molar was removed and in 29 cases the third molar was retained. The mean age group of the population of the study was 33.67 (18 to 60 years), out of which majority of the cases 93.9%(46) were male patients and 6.3%(3) were female patients. The main etiology of the cases were attributed to RTA. 96.3%. At the end of the 6 months follow up it was noted that 4 plates in case of retained group and 2 plates in removed group. In the 3 month follow up in 4 cases of the retained third molar was extracted due to signs of infection. When the tooth in question was removed, infection did not occur. At the 3rd to 6 month follow another 4 retained third molars were extracted along with implant retrieval. Statistically the relationship between the two groups were analyzed using Chi-square test bivariate statistics. A P ? 0.05 was taken as significant. Conclusion: In our study we could not provide any concrete evidence to form a protocol for the management for the third molar in the line of mandibular angle. Retaining the third molar in the line of fracture has an increased chance of post-operative infection. We would like to conclude that partially impacted tooth are best to be removed during the procedure for better outcomes provided the fractured segments stability is maintained. Until an algorithm is set for the management of the third mola

Management of Teeth in the Line of Mandibular Angle Fractures Treated with Open Reduction and Internal Fixation: A Systematic Review and Meta-Analysis.

Mandibular angle fractures are common and frequently involve a tooth in the fracture line. Despite trends toward more conservative indications for tooth extraction during open repair, the literature remains heterogeneous. This review aims to ascertain the effect of tooth extraction/retention on patient outcomes following mandible open reduction and internal fixation and to evaluate the evidence surrounding indications for extraction. PubMed, EMBASE, the Cochrane Library, Elsevier text mining tool database, and clinicaltrials.gov were queried through March of 2018 for English language publication on adults with traumatic mandibular fractures. The review protocol was not registered online. Quality of evidence was assigned using the Grading of Recommendations Assessment, Development and Evaluation methodology. Meta-analyses were performed when definitions of outcomes were deemed similar. Overall, 26 of 1212 identified studies met inclusion criteria. Indications for tooth extraction and rates of extraction varied considerably across studies. The quality of evidence was low or very low for all outcomes. Tooth retention was associated with lower overall complications (OR, 0.54; 95 percent CI, 0.37 to 0.79), major complications requiring readmission or reoperation (OR, 0.47; 95 percent CI, 0.24 to 0.92), and malocclusion (OR, 0.56; 95 percent CI, 0.32 to 0.97); there was no difference in wound issues or nonunion. Removal of asymptomatic teeth was associated with inferior alveolar nerve injury (39.4 percent versus 16.1 percent). The literature is limited by retrospective study deign and poor follow-up; however, when indicated, tooth extraction is not associated with an increased risk of infection or nonunion. Removal of asymptomatic teeth was associated with a risk of inferior alveolar nerve injury. Additional high-quality studies are needed to evaluate potentially expanded indications for tooth extraction.

Effect of third molars in the line of mandibular angle fractures on postoperative complications: systematic review and meta-analysis

The aim of this systematic review was to verify whether the presence of a lower third molar in the mandibular angle fracture line is associated with postoperative complications. An electronic survey was conducted in five databases. Eligibility criteria included observational and experimental studies that evaluated the association between the presence of the lower third molar in the fracture line of mandibular angle fractures and possible postoperative complications, including infection, paresthesia, necessity of plate removal, temporomandibular joint disorders, malocclusion, dehiscence, and non-union. Thirty-four papers were included in the qualitative analysis and 26 of those in the meta-analysis. The risk of bias of observational studies was assessed by Newcastle–Ottawa scale and of the clinical trials by Cochrane Collaboration risk-of-bias tool. Absence of the third molar was associated with a lower chance of postoperative infection in angle fractures compared to presence of the tooth (odds ratio 0.55, 95% confidence interval 0.34–0.88). No statistically significant difference between the groups was found for the other outcomes evaluated. The findings of this systematic review suggest that the absence of the third molar in the mandibular angle fracture line is associated with a lower postoperative infection rate when compared to angle fractures with a third molar present.

Teeth in the Line of Mandibular Fracture

Teeth in the Line of Mandibular Fracture

Morbidity of Teeth in Mandibular Fracture Lines - A Retrospective Study.

Teeth in mandibular fracture lines is common in maxillofacial trauma, but their retention or extraction is a matter of controversy. The aim of this study was to determine the factors related to retaining or extracting teeth situated in mandibular fracture lines and to decide the best treatment option. The study included 115 patients with a single mandibular fracture that had a tooth in the line of fracture. All patients were evaluated for complications and pulp status. Patient distribution was analyzed according to the complications that occurred. Statistical analysis was performed using SPSS 13.0 software. There were significant effects of tooth type and tooth location on the occurrence of complications. There were no significant differences in the occurrence of complications between the retained teeth group and the extracted teeth group irrespective of age and gender in adult patients. There were significant differences in treatment procedures between the retained teeth group and the extracted teeth group. Mandibular anterior teeth involved in the fracture line should be retained, while in the mandibular angle area, they should be extracted because retaining teeth in this region increases the prediction of complications. There is no role of pulp testing in the assessment of pulp status, but root canal treatment of retained teeth helps to reduce the occurrence of complications. This article is protected by copyright. All rights reserved.

The effect of teeth in mandibular fracture lines.

The decision to retain or extract teeth in the line of mandibular fractures has been a subject of debate in the scientific literature, and there is a need for further evidence to clear this issue. Thus, the aim of this study was to investigate the effects on healing of teeth in the line of mandibular fractures in order to contribute to the field. The case notes of 100 patients with teeth in the line of 106 mandibular fractures were reviewed. Open reduction and rigid internal fixation (ORIF) was used if elastic intermaxillary reduction failed to achieve a satisfactory occlusion and/or anatomical reduction in the fragments as assessed by orthopantomogram (OPG) and clinical examination. The remaining cases had maxillomandibular fixation (MMF) with an arch bar and bridle wire. Three of the 106 teeth involved in the fracture lines healed with complications. In the cases where the teeth had been removed prior to fracture treatment, or in cases of delayed extractions, no complications were noted. The factors which should be considered for removal include the condition of the teeth and alveolar bone, the timing and the type of treatment. This decision should be made on an individual basis considering potential risks to avoid complications.

Evaluation of Teeth in Line of Mandibular Fractures Treated with Stable Internal Fixation.

To determine whether retention or removal of teeth in line of mandibular fractures affects the incidence of postoperative complications. To evaluate the fate of teeth retained in mandibular fractures based on location of fracture line in relation to apical foramen and lateral periodontium of retained tooth. 51 mandibular fracture sites in 39 patients were treated by open reduction and internal fixation using miniplates. Teeth in line of fracture were removed if showed extensive caries, excessive mobility of tooth, or root fracture. Accordingly patients were divided into two groups, group I tooth removed (15 sites) and group II tooth retained (36 sites). Teeth retained in fracture line were classified based on position of the fracture in relation to apical foramen and the lateral periodontium of involved tooth estimated from preoperative panoramic radiograph into four types. Postoperative periodic follow up done for 1year and seen for incidence of postoperative complications and fate of tooth in line of fracture. Out of 36 fracture sites in which teeth were retained 5 (13.89%) showed postoperative complications, and out of 15 fracture sites in which teeth were removed 3 (20%) showed postoperative complications. Out of 36 fracture sites in which tooth was retained we found in 3 cases fracture line passed through 2 adjacent teeth. Thus we had in total 39 teeth in fracture line out of them 26 required no treatment 9 required endodontic treatment and 4 teeth required extraction. Need for extraction and endodontic treatment was found more in type I and type III relation. There is an increased risk for postoperative complications when a tooth is removed, although it is not statistically significant. Evaluation of fate of retained teeth showed better prognosis of teeth in type II cases than type III and type I cases. Results of this study leads to conclusions that teeth associated with mandibular fractures need not be removed on prophylactic basis.

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

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.