Mandibular Angle Region Research Articles

Large Keratocyst Extending to Mandibular Ramus and Coronoid Process: A Case Report

Odontogenic keratocysts are odontogenic epithelial-originated developmental cysts characterized by minimal expansion, high recurrence rate, and aggressive nature. They are usually asymptomatic and detected in routine dental examinations so can be overlooked until the lesions reach large sizes. The treatment of odontogenic keratocyst is controversial, and there are various surgical approaches ranging from conservative approaches to more invasive procedures. In this case report, a 16-year-old female patient with an enlarged odontogenic keratocyst associated with an impacted third molar and extending through the mandibular angle, ramus, and coronoid process regions is presented with the clinical, radiological, and histopathological findings and the surgical treatment plan.

Relations between bone density from computed tomography and bone regeneration after reduction mandibuloplasty

BackgroundBone regeneration in the mandibular angle region after reduction mandibuloplasty may compromise the aesthetics of the lower face and thus lead to revision surgery. Bone quality is known to play an important role in osteogenesis. However, no study has evaluated the relationship between mandibular bone quality and bone regeneration volume. MethodsThe bone density of the mandibular angle immediately after surgery (BD) was determined as the grey level in computed tomography (CT) images. Based on the immediate postoperative and long-term follow-up CT images, the volumes of the regenerated angle (VSA) and the regenerated outer cortex (VOC) were measured after model reconstruction, automatic alignment and Boolean operation. Correlation analyses were then performed between VSA and BD, VOC and BD. Results23 patients (46 mandibular angles) were included in this study. The average BD was 907.09 ± 111.89 HU. The mean VSA was 201.66 (131.73–357.24) mm3. Spearman correlation analysis revealed a positive correlation between BD and VSA (r = 0.5449, p < 0.0001). The mean VOC was 236.23 ± 151.35 mm3. Pearson correlation analysis found a negative correlation between BD and VOC (r = -0.3501, p = 0.0171). ConclusionsCT images can provide a quantitative assessment of mandibular bone quality. BD may influence the volumes of bone regeneration in different areas of the mandibular angle portion after reduction mandibuloplasty, in the regenerated angle area positively and in the regenerated outer cortex region negatively. Therefore, slight over-grinding may be a choice to prevent secondary angulation.

A finite element analysis on the indication for extracting partially impacted mandibular third molars considering mandibular trauma

BackgroundPatients presenting with partially impacted lower third molars (M3) have a higher likelihood of experiencing angle fractures while simultaneously decreasing the risk of condylar fractures. However, the specific biomechanical mechanism responsible for this occurrence remains unclear. Moreover, there is an ongoing debate regarding whether the removal of M3s might actually increase the risk of condylar fractures. This study aimed to evaluate how the presence of M3s influences mandibular fractures resulting from blows to the symphysis and lateral mandibular body, and to determine the indication for extracting M3s in such cases.MethodsModels of the mandible with a partially M3-impacted model (M3I), M3-extracted model (M3E), and M3-absent model (M3A) were generated using a computer. A traumatic blown force of 2000 N was applied to the symphysis and the right body of the mandible. Von Mises and principal stresses were analyzed, and failure indexes were determined. Two cases of mandibular linear fractures were chosen for model verification and interpretation.ResultsWhen force was applied to the symphysis, the condylar region exhibited the highest stress levels, while stress in the mandibular angle region was much less regardless of the M3 state. On applying the force to the right mandibular body, stress in the condylar region decreased while stress in the mandibular body increased, especially in the blown regions. Impacted tooth or cavity formation post-M3 extraction led to uneven stress distribution on the blown side of the mandible, increasing the risk of mandibular angle fractures. In cases where M3 was absent or the extraction socket had healed, stress from lateral traumatic blown force was evenly distributed along both the inner and outer oblique lines of the mandible, thereby reducing the risk of mandibular fractures.ConclusionsThe reduced risk of condylar fractures in patients with partially impacted lower M3s and mandibular angle fractures is mainly due to lateral blows on the mandible, which generate less stress in the condylar region than blows on the mandibular symphysis, rather than being caused by the M3 itself. Extraction of the lower M3 can decrease the risk of mandibular fractures, with a minor influence on condylar fractures.

Mandibular Contouring in Subjects With Class II or Class III Dentofacial Deformities and Treatment Needs

Facial contouring relates to hard and soft structures that make up the face. Skeletal class II and III subjects present bone structure and position changes, significantly impacting the soft tissues. This study aims to analyze the morphology of the mandible at mandibular ramus and angle level in subjects with skeletal facial deformity class II and III who are candidates for orthognathic surgery and to define implications in facial contour. A cross-sectional study used cone beam computed tomography to compare the mandibular contour (mandibular angle and ramus region) in orthognathic surgery candidates. One hundred sixty orthognathic surgery candidates were analyzed, ranging in age from 18 to 58 years (31.29 ± 11.97). Regarding the skeletal class, 95 (59.37%) were skeletal class II, and 65 (40.62%) were skeletal class III. Class II subjects had a larger antegonial notch than class III subjects. Concerning the mandibular contour, class II subjects presented less vertical distance than class III subjects, but both presented similar gonial angles. Concerning the ideas to assess the need for mandibular contouring surgery, the 2 proposals to determine the need for mandibular contouring surgery in class II and III subjects present a similar distribution. The mandibular notch is an objective element and is commonly present in subjects with a class II facial pattern; this element can be used in contour analysis to define expected facial characteristics, including the patient’s facial sex, in the decision of surgical techniques for lower facial contour augmentation or reduction.

Three-Dimensional Anthropometric Facial Analysis and Fitting Discrepancies Between Stereophotogrammetry and CT.

The reliability and repeatability of stereophotogrammetry and CT in 3-dimensional anthropometric facial analysis were investigated in this study, which also explored the clinical application of supine CT. In this study, 3D CT and 3dMD stereophotogrammetry were used on 20 healthy volunteers. The fitting distance between stereophotogrammetry and CT scans at landmark points was measured, along with facial feature measurements (Al-Al) face width (Go-Go, Zy-Zy, Ex-Ex), and hemi-face height (Sn-Gn). The intraclass correlation coefficient (ICC) was employed to assess interrater agreement and to verify the reliability of the measurement methods. Paired t -analysis was utilized for analyzing intramethod displacement. The alare, nasion, and pronasale points were found to be minimally influenced by different positions and are more recommended as landmark points for registration. CT demonstrated good interrater reliability on all indicators. In stereophotogrammetry, measurements for Go-Go and Zy-Zy displayed an interclass correlation coefficient (ICC) of less than 0.75. Significant differences between the 2 methods were observed for En-En, Ex-Ex, and Go-Go ( P < 0.05). Specifically, CT analysis for Go-Go showed a measurement 2.34 mm larger than that obtained with the 3dMD method. Both CT and stereophotogrammetry were found to be reliable methods for evaluating facial soft tissue. It is speculated that Go-Go measurement is primarily influenced by factors such as different positions, facial expressions, and gravity. These variables should be carefully considered during the evaluation of the mandibular angle region.

In the face and neck, keloid scar distribution is related to skin thickness and stiffness changes associated with movement.

Keloid scars tend to occur in high-tension sites due to mechanical stimuli that are involved in their development. To date, a detailed analysis of keloid distribution focused specifically on facial and neck areas has not been reported, and limited literature exists as to the related mechanical factors. To rectify this deficiency of knowledge, we first quantified the facial and neck keloid distribution observed clinically in 113 patients. Subsequently, we performed a rigorous investigation into the mechanical factors and their associated changes at these anatomic sites in healthy volunteers without a history of pathologic scarring. The association between keloid-predilection sites and sebaceous gland-dense and acne-prone sites was also examined. To assess skin stretch, thickness and stiffness, VECTRA, ultrasound and indentometer were utilised. Baseline skin stiffness and thickness were measured, as well as the magnitude of change in these values associated with facial expression and postural changes. Within the face and neck, keloids were most common near the mandibular angle (41.3%) and lateral submental (20.0%) regions. These areas of increased keloid incidence were not associated with areas more dense in sebaceous glands, nor linked consistently with acne-susceptible regions. Binomial logistic regression revealed that changes in skin stiffness and thickness related to postural changes significantly predicted keloid distribution. Skin stiffness and thickness changes related to prolonged mechanical forces (postural changes) are most pronounced at sites of high keloid predilection. This finding further elucidates the means by which skin stretch and tension are related to keloid development. As a more detailed analysis of mechanical forces on facial and neck skin, this study evaluates the nuances of multiple skin-mechanical properties, and their changes in a three-dimensional framework. Such factors may be critical to better understanding keloid progression and development in the face and neck.

Prevalence and correlation with sex, age, and dental status of bone apposition at the mandibular angle and radiographic alterations of the temporomandibular joints: a retrospective observational study in an adult Swiss population

BackgroundThe purpose of this study was to determine the prevalence of radiographic changes in the mandibular angle (bone apposition) and osseous alterations in the temporomandibular joints (TMJs) in the adult population of Switzerland. In addition, the study intended to investigate possible correlations between the two sites of contour bone changes (mandibular angle and TMJ) and to analyze various patient-related factors, including sex, age, dental status, and medical history.MethodsPanoramic radiographs of 600 patients distributed into six age groups (283 females, 317 males, aged 20 to 79 years) were included to evaluate radiographic changes. The bone in the mandibular angle region and the shape of the condylar heads were examined for contour changes (bone apposition at the jaw angles and osseous changes of the TMJs). General estimating equations, binormal tests, and chi-squared tests were used for statistical analysis.ResultsApproximately half of the mandibular angles (47.8%) showed bone apposition, mostly bilateral. TMJ alterations were less common (27%), often unilateral, with flattening being the most frequent finding. No significant correlation was found between the two sites. Bone apposition at the mandibular angle showed a significant male predominance, whereas TMJ changes did not differ by sex. Alterations in both sites increased with age, and were not related to dental status or analgesic use.ConclusionsBone apposition at the mandibular angle should be interpreted as part of the natural functional adaptation of the bone associated with aging. Assuming that parafunctional habits may influence the development and progression of alterations in the mandibular angle or TMJs, the presence of radiographic changes in these areas should prompt dental clinicians to investigate further in this direction.Trial registrationThe study was approved by the Swiss Association of Research Ethics Committees (swissethics), BASEC reference number: 2020–00963 (25.05.2020).

Resolution of blood eosinophilia and limited mouth opening after short-term follow-up in a pediatric Langerhans cell histiocytosis case.

Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasia that often affects children, presenting a broad clinical spectrum. Here, we report a 13-year-old male Salvadorian patient who was referred presenting a nodular swelling at the mandibular angle region, mildly symptomatic, few weeks ago, which relevantly was associated with limited mouth opening. Intraoral examination was unremarkable. Imaginological exams revealed an osteolytic lesion affecting the vestibular cortex at the right mandibular angle. The blood test results were normal, except for eosinophilia (21%; absolute eosinophil count 4 × 109/L). After an incisional biopsy, microscopical and immunohistochemical analyses were consistent with LCH diagnosis, which corresponded to a single system-single site category. After a few weeks, the mandibular movements were re-established, and complete resolution of blood eosinophilia was observed. LCH with blood eosinophilia is rarely reported. To our knowledge, 3 cases have been previously published.

Comparative evaluation of trabecular bone structures of bruxist and non-bruxist individuals with bone apposition in the mandible angle region by fractal analysis.

This study aimed to compare the trabecular internal structure of different regions of the mandible according to the grades of appositional classification in the mandible angle region in probable bruxist individuals and non-bruxist G0(Convex course of the basal cortex, no directional change, no bone apposition) individuals by measuring fractal dimension (FD) on panoramic radiographs. 200 sample jaws, bilaterally, of 80 probable bruxists and 20 non-bruxist G0 individuals were included in the study. According to the classification in the literature, each mandible angle apposition severity was classified as G0-G1-G2-G3. FD was calculated by selecting the region of interest (ROI) area of 7 regions from each sample. Gender differences in changes between ROIs in radiographs and independent samples t-test were evaluated. Relation between categorical variables was determined by chi-square test (p < .05). In the comparison of the probable bruxist and non-bruxist G0 groups, FD was found to be statistically significantly higher in the mandible angle (p=0.013) and cortical bone (p=0.000) regions in the probable bruxist group than in the non-bruxist G0 group. There is a statistically significant difference between probable bruxist G0 and non-bruxist G0 grades in terms of FD averages in cortical bone (p < 0.001). A statistically significant difference was found in the relationship of ROIs with gender in canine apex (p=0.021) and canine distal (p=0.041) regions. FD was found to be higher in the mandibular angle region and cortical bone in probable bruxist individuals than in non-bruxist G0 individuals. Morphological changes seen in the mandible angulus region may be a finding that may raise suspicion for bruxism for clinicians.

Surgery first in cosmetically driven orthognathic surgery

Surgery first is an option in orthognathic surgery that meets the demands of patients with dentofacial deformity looking for an expedited solution to their esthetic concerns. These cosmetically driven patients are also looking to maximize facial esthetics with the surgical procedures. Ancillary surgical procedures such as implants in the malar region, mandibular angle region, and chin are some of the options to enhance the surgical result. Fat grafting and submental lipectomy are also minimally invasive procedures that can add volume in certain areas of the face and reduce in others such as the submental region to achieve better facial contours. Rhinoplasty also is a major cosmetic adjunct to orthognathic surgery that often is done in an asynchronous manner to enhance facial esthetics. In some instances, rhinoplasty is required to correct the undesired soft tissue effects in the nasomaxillary complex with orthognathic surgery.

Computer-guided buccal cortical plate separation for removal of calcified benign odontogenic tumors affecting the mandibular angle region

PurposeSurgical removal of intra-bony calcific benign lesions is technically challenging regarding its accessibility, proximity to vital structures, and deteriorating effect on the remaining bony structures.MethodsComputer-guided buccal cortical plate separation was performed for ten patients using patient-specific osteotomy locating guides and pre-bent plates. The guide was designed to outline the osteotomy, the buccal cortical plate was separated, the lesion was removed, and finally, the pre-bent plates were used to fix the separated cortex.ResultsSurgical procedures were uneventful for all patients, operation time was 39.5 ± 13.01 min, postoperative pain decreased within the follow-up time intervals, and there was a statistical significant difference between the time intervals (P value < 0.001). Edema and trismus were acceptable. One case showed nerve affection which resolved after 4 weeks.ConclusionComputer-guided buccal cortical plate separation for removal of intra-bony calcified benign lesions provides a promising approach, especially for inexperienced surgeons.Trial registrationClinicalTrials.gov NCT05329974. Registered on 6 April 2022—retrospectively registered.

Biomechanical validation of structural optimized patient-specific mandibular reconstruction plate orienting additive manufacturing

Background and objectiveOwing to the unexpected in vivo fracture failure of the original design, structural optimized patient-specific mandibular reconstruction plates (PSMRPs) were created to boost the biomechanical performance of bridging segmental bony defect in the mandibular reconstruction after tumor resection. This work aimed to validate the biomechanical benefit of the structural optimized PSMRPs relative to the original design and compare the biomechanical performance between PSMRP1 with generic contour customization and PSMRP2 with a tangent arc upper margin in mandibular angle region. MethodsFinite Element Analysis (FEA) was used to evaluate the biomechanical behavior of mandibular reconstruction assemblies (MRAs) concerning these two structural optimized PSMRPs by simulating momentary left group clenching and incisal clenching tasks. Bonded contact was set between mandibular bone and fixation screws and between PSMRP and fixation screws in the MRA, while the frictionless connection was allocated between mandibular bone and PSMRP. The loads were applied on four principal muscles, including masseter, temporalis, lateral and medial pterygoid, whose magnitudes along the three orthogonal directions. The mandibular condyles were retrained in all three directions, and either the left molars or incisors area were restrained from moving vertically. ResultsThe peak von Mises stresses of structural optimized PSMRPs (264 MPa, 296 MPa) were way lower than that of the initial PSMRP design (393 MPa), with 33 and 25% reduction during left group clenching. The peak magnitude of von Mises stress, minimum principal stress, and maximum principal strain of PSMRP1 (264 MPa, 254 MPa; -297 MPa, -285 MPa; 0.0020, 0.0020) was lower than that of PSMRP2 (296 MPa, 286 MPa; -319 MPa, -306 MPa; 0.0022, 0.0020), while the peak maximum principal stress of PSMRP1 (275 MPa, 257 MPa) was higher than that of PSMRP2 (254 MPa, 235 MPa) during both left group clenching and incisal clenching tasks. ConclusionsThe structural optimized PSMRPs reveal their biomechanical advantage compared with the original design. The PSMRP1 presents better biomechanical performance to the patient-specific mandibular reconstruction than PSMRP2 as a result of its superior safety, preferable flexibility, and comparable stability. The PSMRP2 provides biomechanical benefit in reducing the maximum tension than PSMRP1, indicated by lower peak maximum principal stress, through tangent arc upper margin in mandibular angle region.

Squamous cell carcinoma metastatic from uterus to mandible – Case report

The present study is a case report of a possible case of metastasis of a squamous cell carcinoma from the uterus to the mandible. In this case, the patient had symptoms of volume increasing on the left side of the mandible some months after being diagnosed and treated for a squamous cell carcinoma in the uterus. The maxillofacial lesion reached the left mandibular angle region, which required surgical resection of the affected area and the installation of a 2.4-mm titanium plate system. Histopathological examination of the mandibular lesion pointed to squamous cell carcinoma. The patient died a few months after the procedure in the mandible due to complications of the primary tumor in the uterus. After an extensive literature review, no cases of metastatic squamous cell carcinoma from the uterus to the maxillofacial region were found, meaning this work may be the first case report in the literature.

Stafne Bone Cyst in the Right Mandibular Angle Region: A Case Report with Literature Review

Stafne bone cysts (SBC) are rare, small, well-demarcated, and radiolucent lesions that usually occur below the mandibular canal near the mandibular angle. Despite several theories, the etiopathogenesis of SBC remains unknown. As SBCs usually show no clinical signs, radiographic evaluation is the first stage of the diagnostic process. When the lesions are atypical, as in our instance, correct differential diagnosis is critical. This case study presents an unusual Type I SBC in a 66 year old man and reviews relevant literature.

Management of unilateral temporomandibular joint ankylosis with facial asymmetry

Long-standing temporomandibular joint (TMJ) ankylosis may compromise facial form and function. Treatment planning needs to address both the ankylosis and the facial deformity. A 21-year-old male patient with unilateral TMJ ankylosis of the right side with gross facial asymmetry was planned for a two-stage surgical procedure. First-stage surgery was done to release fibrous ankylosis, create a new functional joint and achieve adequate mouth opening. A vertical ramus osteotomy with superior repositioning of the proximal ramal segment and interpositional temporalis myofascial flap was done to achieve a functional joint and correct the facial height discrepancy. As the mouth opening was &lt;35 mm, ipsilateral coronoidectomy was done and the resected coronoid process was used a graft in the mandibular angle region. 35 mm of mouth opening was achieved intraoperatively.

Solitary skin-colored nodule on a child’s face

Sir, A healthy, six-year-old boy presented with a slowly grown dome-shaped nodule on the mandibular angle region present for two years. The patient’s past medical and family history were unremarkable. A physical examination revealed a solitary, 1.3 × 1 cm, firm, painless, flesh-colored tumor (Fig. 1). Dermoscopy showed branching, serpentine vessels on a pink background (Fig. 2a). These features disappeared when slight pressure was exerted on the dermoscope and the tumor exhibited a central, white, structureless area (Fig. 2b). An excisional biopsy was performed. A microscopic examination showed a well-circumscribed, paucicellular dermal tumor composed of eosinophilic collagen bundles separated by clefts and forming a storiform pattern. Scattered fibroblasts were found among the collagen bundles. The overlying epidermis was slightly flattened (Fig. 3). The diagnosis of solitary sclerotic fibroma was established. Sclerotic fibroma (SF), also known as storiform collagenoma, is a rare benign skin tumor. It usually manifests itself as an asymptomatic, slowly growing, white-to-skin-colored papule or nodule [1]. It was first described in patients with Cowden’s disease, yet may also occur sporadically [2]. There were no mucocutaneous features of Cowden’s disease (tricholemmomas, oral fibromas, acral keratoses, palmar pits, and gingival and palatal papules) in the patient and her family members. Dermatofibroma, the main differential diagnosis of SF, usually exhibits hyperplastic changes of the epidermis instead of atrophy, and the boundaries of the lesion are unclear [2]. Only two papers have been published describing the dermoscopic findings of SF, consisting of a white background with peripheral arborizing vessels [3]. A white background may be related to an increased dermal collagen density. It is also described in dermatofibroma, typically with a peripheral pigmentation network. Although dermoscopy may improve the clinical diagnosis of SF, histopathological analysis is required.

Bone apposition at the mandibular angles as a radiological sign of bruxism: a retrospective study

BackgroundThe main objective of this investigation was to determine on panoramic radiographs the prevalence of macroscopically visible alterations (bone apposition in combination with directional change) in the mandibular angle region in bruxism patients. Another aim was to describe and detect different morphological characteristics of the jaw angles.MethodsTwo hundred panoramic radiographs were studied: 100 images of adults with clinically diagnosed bruxism (73 women, 27 men, age range 21–83 years), 100 images of a comparison group consisting of adolescents (66 girls, 34 boys, age range 12–18 years).ResultsThe morphological changes of the 400 jaw angles could be classified into four degrees. In the adult group, almost half of mandibular angles showed bone apposition. Conversely, the prevalence in the control group was zero. The localization of the appositions corresponds to the insertions of the masseter and medial pterygoid muscles at the mandibular angle.ConclusionsThe bone apposition at the mandibular angles should be interpreted as a functional adaptation to the long-term increased loads that occur during the contraction of the jaw closing muscles due to bruxism. Hence, radiologically diagnosed bone apposition may serve as an indication or confirmation of bruxism.

Multiple Odontogenic Keratocysts in a Non-syndromic Young Patient: An Unusual Case Report

Odontogenic keratocyst (OKC) is a benign intraosseous lesion with invasive and aggressive behavior. It comprises approximately 2-21.8% of all jaw cysts. Odontogenic keratocysts (OKCs) are believed to arise from remnants of the dental lamina most common site in the molar ramus area. OKCs have a specific histopathologic appearance and are found to be locally aggressive and have a high recurrence rate, thus requires close long-term follow-up. OKCs are one component of the Gorlin-Goltz syndrome and all patients with multiple OKCs should be evaluated for this syndrome. In this paper, we present a case of a 13-year old non-syndromic female patient with multiple OKCs located at symphysis and bilateral mandibular angle region who was treated surgically with no obvious post-operative complications during follow-up period.

Additional treatment with Carnoy solution in surgical therapy of ameloblastomas: Case report

Introduction: Ameloblastoma is a benign neoplasm characterized by the proliferation of odontogenic epithelium that mainly affects the gnathic bones and, due to its invasive and expansive growth, presents high rates of recurrence to surgical treatment. Among the most conservative treatments are enucleation and marsupialization; among radicals, resections are more widespread. Objective: The objective is to present, through a case report, conservative surgical treatment with enucleation followed by the use of the Carnoy solution. Case report: A 24-year-old male patient arrives at the outpatient clinic of Hospital da Restauração with painful complaints of mild and constant intensity in the region of the left mandibular angle, with an evolution of three weeks. After a panoramic X-ray, the presence of the included 38 tooth was associated with an extensive unilocular radiolucent lesion, surrounding the angle and mandibular ramus. Preoperative examinations were performed for incisional biopsy. Histopathological diagnosis was unicystic ameloblastoma. In view of the histopathology obtained, we opted for enucleation of the lesion with concomitant use of direct Carnoy solution in the region of the lesion. Discussion: The choice of therapeutic behavior depends on the size, type of lesion, location and histopathology. After the surgical decision, a radiographic clinical follow-up is necessary to assess possible recurrences. Carnoy's solution is a cauterizing agent with moderate tissue penetration, rapid local fixation and hemostatic action, whose surgical use in cystic lesions has occurred since the beginning of the 20th century. Conclusion: Conservative treatment with the enucleation technique followed by complementary therapy using Carnoy's solution proved to be quite effective.

IMPACTED THIRD MOLARS AND ASSOCIATED RISK OF MANDIBULAR ANGLE FRACTURE - A CROSS SECTIONAL STUDY

Objective:&#x0D; To determine frequency of impacted third molar in mandibular angle fracture.&#x0D; Materials and Methods:&#x0D; This descriptive, cross sectional study was carried out in the Oral &amp; Maxillofacial Surgery Department, Khyber College of Dentistry Peshawar from April 2016 to March 2017. 216 patients with mandible angle fractures were included in the study. Data regarding gender, age, angle fracture and impacted mandibular third molar were collected through history, clinical examination and was confirmed by orthopentomogram (OPG). Impacted third molar in mandibular angle fracture was stratified using chi square test among gender and age. P&lt;0.05 was considered significant.&#x0D; Results:&#x0D; Among 216 patients presenting with angle fractures , impacted lower third molar was present in 179 patients (82.9%) and absent in 37 patients (17.1%).Amongst them 181 (83.8%) were males and 35 (16.2%) females. Mandibular angle fracture was predominant in male gender with male to female ratio of 5.17:1. The mean age was 24.69 SD± 6.61. Most of the patients were in third decade (44.9%) followed by second decade (39.3%).&#x0D; Conclusion:&#x0D; The results of current study support that the frequency of impacted third molar was high in patients presenting with fractures of mandibular angle region and males were more commonly involved in than females. Third decade of life was the commonest age group for mandibular angle fractures.